The Effectiveness of 23-valent Pneumococcal Polysaccharide Vaccine on Elderly Colorectal Cancer Long-Term Survivors: A population-based exact-matched cohort study

ABSTRACT

Colorectal cancer (CRC) long-term survivor is a rapid enlarging group. However, the effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPSV23) on this group is unknown. This nationwide population-based study in Taiwan was designed to examine the effect of PPSV23 on incidence rate ratio (IRR) of pneumonia hospitalization, cumulative incidence, and overall survival rate for these long-term CRC survivors. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2000–2017. After individual exact matching to covariates with 1:1 ratio, there were a total of 1,355 vaccinated and 1,355 unvaccinated survivors. After adjusted by multivariate Poisson regression model, vaccinated group had a non-significantly lower pneumonia hospitalization risk than unvaccinated, with an adjusted IRR of 0.879 (p = .391). Besides, vaccinated group had both lower cumulative incidence rate and higher overall survival time than unvaccinated.

KEYWORDS:

• Pneumococcal polysaccharide vaccine
• colorectal cancer
• survivor
• pneumonia
• hospitalization

Acknowledgments

This study is based on data from the National Health Insurance Research Database provided by the Health and Welfare Data Science Center, the National Health Insurance Administration, Ministry of Health and Welfare, Taiwan. However, the interpretation and conclusions contained herein are not those of the National Health Insurance Administration, Ministry of Health and Welfare, Taiwan.

Author contributions

Conceptualization: W.-Y. C., C.-Y. L.; Project administration: W.-Y. C., M.-S. L., H.-Y. L., S.-K. H.; Funding acquisition: W.-Y. C., M.-S. L; Resources: M.-S. L., S.-K. H.; Data curation: B.-H. Y., W.-Y. C.; Methodology: W.-Y. C., C.-Y. L.; Software: C.-Y. L.; Formal Analysis: B.-H. Y., W.-Y. C.; Writing – original draft: W.-Y. C.; Writing – review & editing: W.-Y. C., S.-Y. C., F.-C. H., C.-C. W., L.-C. C., C.-H. C.; Supervision: W.-Y. C. All authors have read and agreed to the published version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Institutional review board statement

The Institutional Review Board of Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (approval number, B10704014-2) approved this study and waived the requirement for informed consent from the people involved because the National Health Insurance Research Database (NHIRD) is a de-identified database and the data were analyzed anonymously.

Informed consent statement

Written informed consent for participation was not provided by the participants/legal guardians/next of kin because the NHIRD encrypts patients’ personal information to protect privacy and provides researchers with anonymous identification numbers associated with the relevant claims’ information, including sex, date of birth, medical services received, and prescriptions. Therefore, informed consent is not required to access the NHIRD.

Data availability statement

The datasets generated and/or analyzed during the current study are not publicly available in accordance with the policy of the Health and Welfare Data Science Center, Ministry of Health and Welfare, Taiwan, but are available from the corresponding author upon reasonable request.

Additional information

Funding

We appreciate the research grants from the Dalin Tzu Chi Hospital [DTCRD 106(2)-I-19] and the Buddhist Tzu Chi Medical Foundation [TCMF-A 108-06]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.