Faced with an increase in cases of pneumococcus and the increased risks of this sometimes fatal infection among seniors, the High Authority for Health (HAS) recommended on Tuesday that vaccination be extended to all French people aged 65 and over, beyond the most vulnerable.
This vaccination has been recommended since July 2023 for adults at risk of severe disease due to an increase in the incidence of invasive pneumococcal infections.
The HAS now considers it necessary to extend it to "all people aged 65 and over, and not just seniors with comorbidities", the authority said in a press release, which took the matter into its own hands, whereas it is usually consulted by the Ministry of Health.
It is up to the Minister of Health to follow the recommendation or not.
The bacterium Streptococcus pneumoniae, responsible for pneumococcal infections, is in France the leading cause of invasive infections (meningitis, bacteremia) in adults. It is also one of the main factors in bacterial superinfection of influenza in adults.
With the expansion of the vaccination target, a "double objective" is displayed by the High Authority of Health: to increase vaccination coverage but also to simplify the vaccination schedule by key age.
Vaccination coverage is generally considered "very insufficient": "between 5 and 16.9%", while "the incidence of invasive infections has remained high among adults at risk and increases significantly with age", notes the authority.
However, "age is a risk factor in itself to recommend expansion": 60% of cases of invasive pneumococcal infections concern people aged 65 and over, and the severity of these infections is multiplied by three at 65 years of age.
Mortality from pneumococcal pneumonia affects one in ten hospitalized patients, and even more in elderly patients.
Half of adults aged 65 and over hospitalized for acute pneumonia and more than a quarter of patients hospitalized for invasive pneumococcal disease occur in people without comorbidities, escaping current vaccination recommendations.
The HAS indicates that it has taken into account the data on the efficacy and tolerance of the Prevenar-20 vaccine (American laboratory Pfizer), but also on pharmacovigilance.
For those aged 65 and over, four vaccines (Covid, flu, shingles, pneumococcus) and a booster (DTP) are now recommended.
The single-dose pneumococcal vaccine can be given separately or together with a flu vaccine and a Covid booster.
The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) is expected to give its opinion this week on the pneumococcal vaccine (PCV21) developed by MSD (the foreign name of the American laboratory Merck) to protect seniors.
This vaccine covers the pneumococcal serotypes responsible for 88% meningitis and bacteremia, according to MSD.
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