Effectiveness of the PCV13 in Older Thai Adults

The investigators select a 1:2 matched control with criteria as follows; 10-year-interval of age, ward (the same patient care such as out or in-patient, or admitted in the same level ward).

Patient data will be collected through review of medical records and interview of the patients or their relatives for visits to the doctors using standard Case Record Form (CRF) by trained research assistance.

Definition of CAP is defined according to clinical evidence and radiological evidence17. The clinical evidence consists of ≥2 of the following: fever, hypothermia, chills or rigors, pleuritic chest pain, cough, sputum production, dyspnea, tachypnea, malaise, or abnormal auscultatory findings suggestive of pneumonia; while the radiological evidence includes a chest radiograph and/or a computed tomographic image with an infiltrate consistent with pneumonia as determined by the treating healthcare provider or radiologist at the time of presentation. The investigators consider PCV13 status when the vaccine has been given ≥14 days before onset of CAP for cases or ≥14 days before the date of admission for control. The PCV13 status is ascertained by staff blinded to whether the patients are case or control. Status will be confirmed by hospital record or vaccination card. If history of vaccination is verbal confirmation by patient or their relatives, then the investigators plan to figure vaccine status out in all hospitals that individuals has visited before admission.

Inclusion criteria

Prospective collection For case

• Thai older adults aged ≥60 years with or without health conditions diagnosed with culture confirmed pneumococcal community acquired pneumonia during 2012 - 2024.
• Be given treatment either in-hospital admission or out-patient visiting hospital.
• They ensure their PCV13 status (either received or not received is acceptable)
• Willing to participate in the study by their own decision or as a legal guardian.

For matched control

• Thai older adults aged ≥60 years with or without health conditions diagnosed with non-pneumococcal community acquired pneumonia by doctor in-charge during 2012 - 2024.
• Be given treatment either in-hospital admission or out-patient visiting in the same hospital with matched-case.
• They ensure their PCV13 status (either received or not received is acceptable)
• Willing to participate in the study by their own decision or as a legal guardian.

Retrospective collection For case

• Thai older adults aged ≥60 years with or without health conditions diagnosed with culture confirmed pneumococcal community acquired pneumonia during 2012 - 2024.
• Be given treatment either in-hospital admission or out-patient visiting hospital.
• Certain documented PCV13 status (either received or not received is acceptable)
• Recorded ICD: J13

For matched control

• Thai older adults aged ≥60 years with or without health conditions diagnosed with non-pneumococcal community acquired pneumonia by doctor in-charge during 2012 - 2024.
• Be given treatment either in-hospital admission or out-patient visiting in the same hospital with matched-case.
• Certain documented PCV13 status (either received or not received is acceptable)
• Recorded ICD: J09-18 (except J13)

Exclusion criteria

For case

• Unknown PCV13 status/history
• Timing between PCV13 and the onset of community acquired pneumonia <14 days.
• Unable to collect confirmed pneumococcal samples from microbiology laboratory.

For control

• Unknown PCV13 status/history
• Timing between PCV13 and the onset of community acquired pneumonia <14 days.