Ms Amanda C. Miles (Pfizer Inc., NY, USA) reported a retrospective cohort study using insurance claims data (Medicare Parts A and B) carried out between July 2022 and June 2024 [1]. Adults aged ≥65 years were included if they had ≥1 year of continuous enrolment before the index date and ≥1 claim, and were excluded from time-segment calculations if they received PPSV23 ≤2 years, PCV13 ≤5 years prior, or PCV15. In total, the study enrolled 16.5 million adults, of whom 12.2% received PCV20 during the follow-up period.
Vaccine effectiveness against invasive pneumococcal disease was 25.6% (95% CI, 19.5-31.3) overall, with similar results across risk subgroups: immunocompromised individuals (25.0%), those with chronic medical conditions (22.6%), and those with low-risk factors (33.8%). Furthermore, vaccine effectiveness against all-cause pneumonia was 15.2% (95% CI 14.6-15.8), with similar effectiveness across risk subgroups (immunocompromised, 16.5%; chronic medical conditions, 15.6%; low-risk, 17.3%; see Figure). Overall, PCV20 led to an adjusted reduction in invasive pneumococcal disease cases of 12.0 cases/100,000 patient-years (95% CI 8.0-16.0), with absolute reductions of 32.0, 13.2, and 12.0/100,000 patient-years in the immunocompromised, chronic medical condition, and low-risk subgroups, respectively. Similarly, PCV20 led to absolute reductions of 758.0 cases/100,000 patient-years (95% CI 664.2-851.7) in all-cause pneumonia, with reductions of 1,864.1, 1,163.3, and 890.4 cases/100,000 patient-years among risk subgroups.
Figure. Adjusted VE among the entire population and subgroups [1]
ACP, all-cause pneumonia; CMC, chronic medical conditions; IC, immunocompromised; IPD, invasive pneumococcal disease; VE, vaccine effectiveness.
“PCV20 demonstrated effectiveness against invasive pneumococcal disease and substantial effectiveness against all-cause pneumonia among adults aged ≥65 years,” concluded Ms Miles. “This study provides the first data demonstrating PCV20 effectiveness among individuals in all risk groups, including those who are immunocompromised. PCV20 vaccination led to substantial absolute rate reductions, driven by prevention of all-cause pneumonia cases, particularly in individuals at increased risk of pneumococcal disease.”
- Miles AC, et al. Real-world effectiveness of 20-valent pneumococcal conjugate vaccine among older adults in the United States by risk group. 6th ESCMID Vaccines, 10–13 September 2025, Lisbon, Portugal.
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Table of Contents: ESCMID Vaccines 2025
Featured articles
Real-world data confirm PCV20 effectiveness against pneumococcal disease in adults aged ≥65 years
Pneumococcal Vaccination
A quarter of US children have incomplete pneumococcal vaccination by age 2
V116 shows promise for adults at risk of pneumococcal disease
Real-world data confirm PCV20 effectiveness against pneumococcal disease in adults aged ≥65 years
The V116 pneumococcal vaccine is a new option in children at risk for pneumococcal disease
Influenza and COVID-19 Vaccination
Omicron XBB.1.5 vaccination provides effective, but rapidly waning protection in immunocompromised individuals
Intranasal COVID-19 vaccine shows promising results in preclinical mouse models
Influenza vaccine in children shows moderate, broad protection during the 2024-2025 season
Lower age is linked to reduced uptake of influenza and COVID-19 vaccination
RSV vaccination and Immunisation
Combination respiratory vaccines show promise but face key challenges
Adjuvanted RSVPreF3 demonstrates high real-world effectiveness in the USA
RSV immunisation: Maternal versus direct infant immunisation
European pregnant women show openness to maternal RSV vaccination
Infants immunised with nirsevimab have a lower risk of respiratory-related recurrent hospitalisation
Adjuvanted RSVPreF3 can be co-administered with a COVID-19 mRNA vaccine in adults aged ≥50 years
Other Childhood and Routine Vaccinations
Pertussis vaccination: Could an intranasal vaccine help curb the rising cases of whooping cough?
Does the 2+1 vaccination schedule for Haemophilus influenzae type b increase case numbers?
Wastewater poliovirus detections in Europe may reflect seasonal infection patterns rather than consistent importation
Emerging and Future Vaccines
Where do we stand with vaccination for haemolytic streptococci?
The future looks promising for tuberculosis vaccination
Where do alternative vaccine administration routes fit in the clinical landscape?
Malaria immunisation beyond subunit vaccines: Current progress
SARI Definitions and Vaccine Effectiveness
Case definition discrepancies influence VE outcomes
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