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Important Safety InformationProduct Monograph
Risk factorsRisk factors for pneumococcal pneumonia and IPD

The risk of developing pneumococcal pneumonia and IPD has been observed to be higher in patients 50 and over, and in patients 18 and older with the following:1-7*†‡§

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  Chronic lung disease (including asthma and COPD) Chronic heart disease Diabetes Cancer Smoking
Pneumococcal pneumonia2,3* 4–10X vs. healthy adults2,3 4–5X vs. healthy adults3 3X vs. healthy adults3 Increased
risk vs. healthy adults2 		3–4X vs. healthy adults3
IPD5-7 5–17X vs. healthy
adults6† 		3–7X vs. healthy adults6† 2–5X vs. healthy adults6† 22–38X vs. healthy adults5‡ Found to be the strongest independent factor in immunocompetent adults 18-64 years7§
Adapted from Torres et al., Shea et al.,Kyaw et al., Van Hoek et al., Nuorti et al.2,3,5–7*†‡§COPD: chronic obstructive pulmonary diseaseIn a retrospective cohort study using data from 3 US-based healthcare claims repositories from 2006 to 2010, rates of pneumococcal disease were compared in immunocompetent adults with chronic medical conditions, immunocompromised adults, and in adults without these conditions. These rates were stratified among age groups 18–49 years, 50–64 years and ≥ 65 years. Risk profiles and episodes of pneumococcal disease – all-cause pneumonia, pneumococcal pneumonia, and IPD – were established according to diagnosis, procedure, and drug codes.3The 1999 and 2000 data from the Active Bacterial Core surveillance (ABCs) and the National Health Interview Survey (NHIS) were used to determine rates of IPD in healthy adults (18 years old) and in adults with various high-risk conditions. The risks of IPD in persons with specific chronic illnesses were compared with those in healthy adults, controlling for age, race, and the other chronic illnesses.5Over 22,000 IPD patients in England (from March 2002 to March 2009, aged ≥2) were linked to their hospitalization records. The prevalence of risk factors in these patients was compared to the prevalence of risk factors in the general population.6Immunocompetent patients aged 18 to 64 and who had IPD (as defined by the isolation of Streptococcus pneumonia from a normally sterile site) by active surveillance of laboratories in Atlanta, Baltimore and Toronto, were selected for the study. Telephone interviews were conducted with 228 patients and 301 control subjects who were reached by random-digit dialing.8References:McNeil SA, Qizilbash N, Ye J, et al. A retrospective study of the clinical burden of hospitalized all-cause and pneumococcal pneumonia in Canada. Can Respir J. 2016;2016:3605834.Torres A, Menéndez R & Wunderink RG. Bacterial pneumonia and lung abscess. In: Murray and Nadel's Textbook of Respiratory Medicine (Sixth Edition). Philadelphia: Elsevier Saunders; 2016.Shea KM, Edelsberg J, Weycker D, et al. Rates of Pneumococcal Disease in Adults With Chronic Medical Conditions.
Open Forum Infect Dis. 2014;1(1):1–9.Public Health Agency of Canada. Notifiable Diseases On-Line. Invasive Pneumococcal Disease. http://diseases.canada.ca/notifiable/charts?c=abs. Accessed on September 21, 2018.Kyaw MH, Rose CE Jr, Fry AM, et al., for the Active Bacterial Core Surveillance Program of the Emerging Infections Program Network. The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults. J Infect Dis. 2005;192(3):377–386.Van Hoek AJ, Andrews N, Waight PA, et al. The effect of underlying clinical conditions on the risk of developing invasive pneumococcal disease in England. J Infect. 2012;65(1):17–24.Nuorti JP, Butler JC, Farley MM, et al. Cigarette smoking and invasive pneumococcal disease. N Engl J Med. 2000;342(10):681–689.
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