Childhood Vaccines Could Alleviate Significant Rise in CAP Hospitalizations

Between 2000 and 2019, adult hospitalizations related to community-acquired pneumonia (CAP) increased by nearly 50%, according to a study published in Pulmonology.¹ With continuously rising trends and an aging population, researchers agree pediatric pneumococcal vaccination is a crucial addition needed within national immunization programs (NIPs).

“Countries that have introduced [pneumococcal conjugate vaccine] PCV vaccination programs for children have recorded a significant decrease in the incidence of invasive pneumococcal disease caused by vaccine serotypes and pneumonia in all age groups thanks to the direct and indirect (herd) protection provided by the vaccinations,” wrote authors of a previous study published in Vaccine.² “The indirect effect of vaccination (herd immunity) increases the impact of PCV on improving health condition and lowering the cost burden in the health care system, and this effect is reflected in the high vaccine coverage.”

PCVs are the current standard of care for protecting patients against CAP and other pneumococcal diseases.³ However, both CAP and the vaccines that protect against it are significantly novel. According to the study authors, the first recognized guidelines for CAP weren’t published until 1993.¹ The following decade, PCVs became available with the 7-valent PCV formulation (PCV7).⁴

READ MORE: Pharmacists Guide Pneumonia Treatment, Safety, and Vaccination

Since then, researchers and pharmaceutical manufacturers have worked to develop further PCVs that cover a variety of disease serotypes.³ But despite around-the-clock deliberation in finding more effective immunization, researchers have also uncovered a concerning increase in CAP cases and hospitalizations over the years.¹

Like many other developed countries, in Portugal—where the current study was conducted—CAP hospitalizations increased by 28.2% during the 2000 to 2004 and 2005 to 2009 periods. With increasing CAP cases and hospitalizations, as well as the disease in general rising as a leading cause of adult mortality and morbidity, researchers wanted to get to the bottom of CAP and PCV trends spanning from 2000 and onwards.

“The objective of this study was to characterize the evolution of hospital admissions of adults with CAP from 2010 to 2019, compare it with the period from 2000 to 2009, and evaluate the impact of universal and free pediatric pneumococcal vaccination included in the NIP from 2015 onwards,” wrote authors of the current study.¹ “This analysis of a 20-year period aims to contribute to the understanding of the national epidemiological reality and to support better interventions by the official Portuguese health authorities.”

Using data from Portugal’s Central Administration of the Health System, researchers conducted their review with the inclusion of adults hospitalized with CAP between January 1, 2010, and December 31, 2019. They also gathered data from 2000 to 2009 to compare CAP hospitalizations with previous trends.

Finally, researchers also included PCV13 data among Portuguese children following January 1, 2025, when the vaccine was first included in the country’s NIP. The final analysis included 462,910 CAP-related hospitalizations among Portuguese adults (average age, 76.7 years; 54% men) from 2010 to 2019.

“There were 462,910 hospitalizations of adults for CAP in mainland Portugal, which represented 6.2% of the total adult hospitalizations for all causes,” they continued.¹ “These data confirm the extremely significant impact of CAP hospitalizations and the rapidly increasing trend, compared to the previous decade of 2000 to 2009.”

In what researchers called a “relative increase” of 49%, CAP hospitalizations from 2000 to 2009 went from 3.61 per 1000 persons to 5.38 in the 2010 to 2019 period. Furthermore, 82.9% of hospitalizations were among patients 65 and older, yet CAP hospitalizations decreased significantly for this population following 2015.

Overall, the consistent trends in CAP cases and hospitalizations provide yet another recommendation for introducing PCVs across NIPs. Although it could be a gradual process for long-term patient benefits, establishing PCVs into children’s routine vaccination could be crucial for future public health efforts.

“Importantly, this retrospective study suggests the benefits of the pediatric pneumococcal vaccination program implemented in the NIP in 2015, which may be associated with a significant trend of reduction in adult CAP-related hospital admissions observed since 2016 in individuals aged 65 years or older,” they concluded.¹ “These findings, which need to be confirmed by further studies, underscore the positive impact of the pediatric pneumococcal vaccination program in reducing the burden of CAP among the adult population.”

READ MORE: Pneumococcal Resource Center

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REFERENCES

1. Froes F, Diniz A, Mergulhão P, et al. Evolution of hospitalizations of adults for community-acquired pneumonia in Portugal and the impact of pediatric pneumococcal vaccination. Pulmonology. 2025;31(1). https://doi.org/10.1080/25310429.2025.2592347

2. Gajewska M, Lewtak K, Goryński P, et al. Effect of the PCV 10 vaccination on community-acquired pneumonia hospitalisations after four years of its introduction into the Polish National Immunisation Programme: follow-up study. Vaccine. 2024;42(13):3257-3262. https://doi.org/10.1016/j.vaccine.2024.04.019

3. Pneumococcal vaccine recommendations. CDC. July 3, 2024. Accessed December 2, 2025. https://www.cdc.gov/pneumococcal/hcp/vaccine-recommendations/index.html

4. Progress in introduction of pneumococcal conjugate vaccine --- worldwide, 2000--2008. CDC. October 24, 2008. Accessed December 2, 2025. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5742a2.htm