Impact of pneumococcal conjugate vaccination: a retrospective study of hospitalization discharge for pneumonia in North-East Italy



Pneumonia remains a common reason for hospitalizing infants and the elderly worldwide, and streptococcal infection is the most common cause. The aim of this study was to assess the burden of pneumonia in a large general population.


All pneumonia-related hospitalizations from 2004 to 2013 in north-east Italy were identified from hospital discharge records with a diagnosis of pneumonia or pneumonia-associated meningitis, septicemia or empyema. We identified major comorbidities, calculated age-specific case-fatality rates (CFR), and estimated the related cost to the health care system.


Of the 149,313 hospitalizations analyzed, 97.5% were cases of pneumonia, 1.9% of septicemia, 0.4% of meningitis, and 0.2% of empyema; 71.2% of hospitalizations involved ≥65-year-olds. The overall CFR was 13.3%, and it increased with age, peaking in people over 80 (22.3%).

The mean annual pneumonia-associated hospitalization rate was 243.0 per 100,000 population, and peaked in 0- to 4-year-old children (484.3 per 100,000 in males, 436.3 in females), and adults over 65 (955.1 per 100,000 in males, 675.2 in females).

Hospitalization rates dropped over the years for the 0-4 year-olds, and rose for people over 80. The estimated overall annual cost of these pneumonia-related hospitalizations was approximately â¬51 million.


This study shows that the burden on resources for pneumonia-related hospitalization is an important public health issue. Prevention remains the most valuable tool to contain pneumonia, and vaccination strategies can help in the primary prevention of infection, possibly reducing the number of cases in all age groups.