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Journal of Tuberculosis and Lung Disease ›› 2023, Vol. 4 ›› Issue (4): 283-294.doi: 10.19983/j.issn.2096-8493.20230064

• Original Articles • Previous Articles     Next Articles

Analysis of the status and effects of the public-funded free 23-valent pneumococcal polysaccharide vaccination among elderly aged 60 years or older in Shanghai, 2013—2023

Peng Xiangdong1,2, Xu Yaoyao3, Hu Xiaojiang2,4(), Guo Lijun1(), Bo Jia1   

  1. 1Shanghai University of Medicine & Health Sciences, School of Nursing and Health Management, Shanghai 201318, China
    2Beijing Yi’an Research Center for Health and Immunization, Beijing 100005, China
    3Weifang Medical University, School of Public Health, Weifang 261053, China
    4Beijing Normal University, School of Sociology, Beijing 100875, China
  • Received:2023-05-11 Online:2023-08-20 Published:2023-08-15
  • Contact: Hu Xiaojiang, Email:; Guo Lijun, Email:
  • Supported by:
    Commissioned Technical Consulting Project of Beijing Normal University(2022310031002563)


Objective: To analyze the overall implementation of the public funded 23-valent pneumococcal polysaccharide vaccine project (PPV23 project) for elderly aged 60 and above in Shanghai in 2013—2023, and to provide insights for the promotion of vaccination among the elderly and the further improvement of vaccination rate in China. Methods: Keywords including ‘Shanghai’‘elderly’‘pneumococcal polysaccharide vaccine’ or ‘pneumococcal vaccine’ were searched from academic database, government and public institution websites, media reports and social media articles. The vaccination rate was estimated, and the antibody positive conversion rate, protection rate, safety, and vaccination willingness and satisfaction with vaccination services were analyzed by extracting and summarizing the relevant data. Results: From 2013 to 2023, 1.818 million elderly people aged 60 or above in Shanghai received free PPV23 vaccination, of which 1.5686 million are still alive. The estimated gross vaccination coverage of PPV23 in 2023 was 27.74% (1568600/5655100). The PPV23 coverage increased rapidly in 2013—2015 (APC (95%CI)=39.65% (29.95%-49.80%); χ t r e n d 2=176388.24, P<0.001),and increased slightly in 2016—2020 (APC (95%CI)=3.53% (2.01%-5.17%); χ t r e n d 2=35475.49, P<0.001),and showed a slow declining trend in 2020—2023 (APC (95%CI)=-1.07%(-1.68%--0.46%); χ t r e n d 2=1255.63, P<0.001). The antibody positive conversion rate was 60.50% (121/200) after 3 months of vaccination. The protection rate against pneumonia ranged 57.70%-88.00% in different regions one year after vaccination, and 52.30%-59.50% 3 years after vaccination. After 5 years, the protection rate against community acquired pneumonia (CAP) was 41.60%. The monitoring data of adverse events following immunization (AEFI) during 2013—2017 reported 433 AEFI cases out of 1310660 doses of PPV23. The incidence rate was 33.04/100000 doses, of which 90.53% (392 cases) were mild reactions, and 3.93% (17 cases) were abnormal reactions, which were cured or improved after treatment. There were 5.31% (23 cases) coincidences and 0.23% (1 case) psychogenic reactions. Conclusion: From 2013—2023, the PPV23 free vaccination project for elderly people aged 60 and above in Shanghai achieved good health benefits,but the vaccination rates remained stagnant after reaching around 30%. It is recommended to scientifically develop strategies based on the changing trend of the aging population structure, allocate adequate resources to vaccination institutions, strengthen research on the elderly people’s vaccination willingness, collect evidence, and promote and improve information disclosure,in order to breakthrough the bottleneck of vaccination rate of PPV23.

Key words: Health services for the aged, Pneumococcal vaccines, Vaccination, State medicine, Health care surveys

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