TOPLINE:

Pneumococcal community-acquired pneumonia (CAP) was a significant cause of hospitalizations in US adults, especially among those aged 65 years or older. This was largely due to Streptococcus pneumoniae serotypes covered by the new 21-valent pneumococcal conjugate vaccine (V116).

METHODOLOGY:

• Pneumonia remains a major global health concern, with S pneumoniae as a leading cause of CAP. Despite the success of conjugate vaccines, shifting serotype patterns and the recent approval of V116 underscores the need for ongoing surveillance.
• Researchers conducted a cross-sectional, active surveillance study in Tennessee and Georgia, to estimate the incidence of hospitalization rates for all-cause CAP, pneumococcal CAP, and pneumococcal CAP caused by serotypes included in V116.
• Pneumococcal infection was identified using specialized urine tests and routine clinical tests involving blood cultures and respiratory specimens collected within 48 hours of hospital admission.
• The detected serotypes were compared with the serotypes included in pneumococcal conjugate vaccines (PCV15, PCV20, and V116).

TAKEAWAY:

• A total of 2016 adults were hospitalized with all-cause CAP (median age, 60 years). Of them, 279 had pneumococcal CAP with 198 of cases specifically attributed to serotypes included in V116.
• The overall annual incidence of hospitalizations for all-cause CAP per 100,000 adults was 340 (95% CI, 323-358) with the highest rates reported in those aged 65 years or older at 1073 (95% CI, 991-1154).
• The overall annual incidence of hospitalizations for pneumococcal CAP was 43 (95% CI, 41-46), whereas that for pneumococcal CAP attributed to V116 serotypes was 30 (95% CI, 29-32). Incidence was highest in year 2, was lowest in year 4, and increased with age.

IN PRACTICE:

“With vaccination as the primary preventive measure for pneumococcal pneumonia, improved pneumococcal vaccines with appropriate vaccination coverage could lessen the burden of severe pneumonia on the US population, especially among older adults,” the authors wrote.

SOURCE:

This study was led by Carlos G. Grijalva, MD, MPH, Vanderbilt University Medical Center, Nashville, Tennessee. It was published online on August 06, 2025, in JAMA Network Open.

LIMITATIONS:

Incidence estimates varied across sites and years, partly influenced by COVID-19, with other factors such as recruitment changes and healthcare-seeking behaviors needing further study. Estimates relied on surveillance hospital data, assuming patient similarity across hospitals, and pneumonia etiology in adults was often undetermined.

DISCLOSURES:

This study received funding from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co, Inc. Vanderbilt University Medical Center and Emory University received research funding from Merck Sharp & Dohme LLC to conduct this study. Some authors reported financial relationships, grants, employment, stock ownership, patents, or consulting arrangements with GSK or Merck, all outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.