TY - JOUR AV - public SN - 2041-1723 A1 - Thindwa, Deus A1 - Clifford, Samuel A1 - Kleynhans, Jackie A1 - von Gottberg, Anne A1 - Walaza, Sibongile A1 - Meiring, Susan A1 - Swarthout, Todd D A1 - Miller, Elizabeth A1 - McIntyre, Peter A1 - Andrews, Nick A1 - Amin-Chowdhury, Zahin A1 - Fry, Norman A1 - Jambo, Kondwani C A1 - French, Neil A1 - Almeida, Samanta Cristine Grassi A1 - Ladhani, Shamez N A1 - Heyderman, Robert S A1 - Cohen, Cheryl A1 - de Cunto Brandileone, Maria Cristina A1 - Flasche, Stefan N2 - Invasive pneumococcal disease (IPD) risk increases with age for older adults whereas the population size benefiting from pneumococcal vaccines and robustness of immunogenic response to vaccination decline. We estimate how demographics, vaccine efficacy/effectiveness (VE), and waning VE impact on optimal age for a single-dose pneumococcal vaccination. Age- and vaccine-serotype-specific IPD cases from routine surveillance of adults ??55 years old (y), ??4-years after infant-pneumococcal vaccine introduction and before 2020, and VE data from prior studies were used to estimate IPD incidence and waning VE which were then combined in a cohort model of vaccine impact. In Brazil, Malawi, South Africa and England 51, 51, 54 and 39% of adults older than 55?y were younger than 65?years old, with a smaller share of annual IPD cases reported among <?65?years old in England (4,657; 20%) than Brazil (186; 45%), Malawi (4; 63%), or South Africa (134, 48%). Vaccination at 55?years in Brazil, Malawi, and South Africa, and at 70?years in England had the greatest potential for IPD prevention. Here, we show that in low/middle-income countries, pneumococcal vaccines may prevent a substantial proportion of residual IPD burden if administered earlier in adulthood than is typical in high-income countries. PB - Springer Science and Business Media LLC JF - Nature Communications VL - 14 TI - Optimal age targeting for pneumococcal vaccination in older adults; a modelling study N1 - This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article?s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article?s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. ID - discovery10165288 UR - https://doi.org/10.1038/s41467-023-36624-8 Y1 - 2023/02/16/ ER -