Indoor Tanning Among Young Non-Hispanic White Females

Abstract

In the primary analyses, PPV23 vaccination did not substantially alter the risk of CAP (hazard ratio [HR], 0.94 [95% CI, 0.80-1.12];P = .51),AMI (HR, 1.01 [95% CI, 0.82-1.25];P = .92),or ischemic stroke (HR, 1.03 [95% CI, 0.83-1.28];P = .81).After propensity and multivariate adjustments, PPV23 vaccination remained unassociated with the outcomes studied (Table 2).Discussion | Our data do not support a cardiovascular protective role of PPV23 and refute prior data reporting a protective effect in our interim analysis. 4Our findings show an increased short-term risk of acute thrombotic events among patients with CAP (2.8% and 0.7% of them developed AMI or ischemic stroke within 30 days after a CAP diagnosis, respectively), but vaccination did not reduce these risks.The major strengths of this study were its populationbased design and the validation of outcome events by checking clinical records.The main limitation is that vaccination status was not randomized.We used rigorous methods to adjust for the propensity for vaccination and further adjusted for underlying conditions in multivariate analyses; however, as with all observational studies, a residual confounding cannot be completely excluded.Those individuals who had received PPV23 more than 5 years ago were considered to be unvaccinated.It is possible that some of these individuals could have a certain degree of antibody immunity that was not considered; however, a possible bias is unlikely considering that vaccination did not seem to be effective in more recent vaccinated subjects.In conclusion, we found that the PPV23 does not provide any clinically relevant benefit against overall CAP, AMI, or stroke among the general population old than 60 years.More effective antipneumococcal vaccination strategies (eg, using conjugated and/or protein-based pneumococcal vaccines) 5,6 for adults are needed.