RESUMEN
Objective To evaluate the clinical efficacy and cost-benefit of 23-valent pneumococcal polysaccharide vaccine (PPV23) in prevention of lower respiratory tract infections (LRTIs) in the elderly over 60 years old in Jiading District, Shanghai. Methods A prospective cohort study was conduct, in which the sample size was 1 000 for both inoculated and uninoculated groups. This study followed the two groups for three years. Incidence and economic burden of LRTIs were compared between the two groups. Re-sults Compared with the uninoculated group,the incidence of LRTIs in the inoculated group reduced sig-nificantly and the efficacy of PPV23 was stable. Inoculation of about every 10 elderly people could prevent one incidence of LRTIs. The overall protective efficacy of PPV23 against LRTIs, usage of antibiotics and hospitalization were 59.5%,63.5% and 89%,respectively. As the incidence of LRTIs increased,the pro-tective rate of PPV23 also tended to increase. Subgroup analysis showed that PPV23 reduced the incidence of LRTIs,usage of antibiotics and hospitalization in the elderly with hypertension,and decreased the incidence of LRTIs and usage of antibiotics in the elderly who were healthy or had diabetes.The cost-benefit ratio was 1 : 1.64 and the net benefit was ￥58 544. Adverse events following immunization were mostly local reac-tions and none were treated. Conclusion PPV23 can effectively reduce the incidence of LRTIs in the elder-ly over 60 years old with stable efficacy,safety and benefits outweighing costs.