U-turn over pneumococcal vaccination for over-65s

DoH advisors have overturned a call to scrap the pneumococcal vaccination programme for over-65s after new evidence emerged for its effectiveness.

The joint committee on vaccination and immunisation (JCVI) advised that people over 65 should continue to be vaccinated against invasive pneumococcal disease (IPD). It said alternative programmes would be more costly to implement.

The government has accepted the decision and said vaccination campaign will continue.

RCGP immunisation spokesman and Berkshire GP Dr George Kassianos told GP: 'I welcome the decision of the JCVI to recommend continuation of the pneumococcal immunisation campaign in the over 65s that was more or less suspended with a previous JCVI recommendation.'

In March, DoH director of immunisation Professor David Salisbury revealed that the JCVI had called for the programme to be scrapped, saying it has had ‘no discernible impact on the incidence of invasive pneumococcal disease in older people’.

But in minutes from its most recent meeting, released on Wednesday, the committee reversed its recommendation after it considered a new, unpublished analysis by the Health Protection Agency (HPA).

This study, which covered a far larger number of people, showed the vaccine, PPV23, was ‘moderately effective’ against IPD.

Although the vaccine only granted two years of protection across the whole population, this rose to five years among healthy people aged 65-74.

The committee also noted that universal vaccination often achieves more widespread uptake among at-risk groups than targeted action, which can prove less cost effective.

It concluded that the vaccination campaign was cost effective, not because the vaccine was highly effective, but because it was relatively inexpensive, as it can be administered alongside the seasonal flu jab.

The committee said that due to evidence on protective effect, cost effectiveness and the difficulty implementing alternative programmes, 'the majority of the committee agreed that the existing programme should continue'.

It added that epidemiological data on pneumococcal disease should be kept under review.

The committee agreed with a call from the UK Vaccine Industry Group to allow manufacturers to submit evidence for effectiveness and cost earlier in the process.

At the JCVI meeting, the committee decided to investigate whether the meningococcal C vaccine should be administered in adolescence rather than infancy.

It had heard evidence suggesting only 10% of children aged under six when vaccinated against meningococcal C retain protective levels of antibodies by adolescence. In contrast, this rose to 50% when administered in children over six years old.

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