Should pneumococcal vaccine be used for alcohol dependents?

Research into use of pneumococcal vaccine to treat alcohol dependents

Published on 14 June 2018

A dramatic rise in deaths from respiratory infections among alcoholics in the North East has led to calls for the introduction of a vaccine that has the potential to save lives.

Public health researchers at the University of Sunderland are recommending the Department of Health trials the use of the pneumococcal vaccine to treat people who are alcohol dependent as part of their prevention measures.

Alcoholism suppresses the immune system and is the most important risk factor for invasive pneumococcal disease, a serious and often life threatening infection.

Researchers argue that alcoholism should be considered an ‘indicator condition’ for receiving the pneumococcal vaccine in the North East, alongside other at-risk groups – including children under age two and adults over 65. The North East has the record highest rate of alcohol related deaths in England and the latest figures suggest nearly half a million adults in the North East are drinking enough alcohol to increase the health risks – with the majority under-estimating their intake and most not aware of alcohol guidelines.The figures also show that it is not young people who are most likely to be drinking above the “low risk” guideline of 14 units per week – but adults aged 45-54.

Lead researcher John Mooney, Senior Lecturer in Public Health at the University of Sunderland, says: “Given that alcohol dependence is long acknowledged as one of the strongest risk factors for deaths from the invasive pneumococcal disease, we feel there is an increasingly compelling case to look again at UK vaccine guidance which conflicts with that of the World Health Organisation and the Centre for Disease Control in the USA, who recommend alcoholism as an indicator condition that would potentially benefit from receiving the vaccine.

“A re-think would represent a responsible evaluation of vaccination guidance and have the potential to save lives in a very marginalised and vulnerable section of the population.”

John adds that given the high burden of alcohol related diseases alongside the increased cases of invasive pneumococcal disease, a properly evaluated regional revision in vaccine eligibility, even for a trial period, would be highly informative around the benefits of the vaccine.

Other factors for using the vaccine include data that links those who misuse alcohol being notoriously difficult to engage within mainstream health services. To overcome barriers to receiving vaccinations would be to target those who are referred to specialist alcohol services and those identified as being at risk of moderate to severe Alcohol Use Disorder (AUD).

In terms of cost effectiveness, economic comparison studies in the USA found that the vaccination was cost effective and in some cases a cost saving strategy.

John says: “Most vaccine are not 100 per cent effective, but the pneumococcal vaccine we are highlighting does give enough protection for the World Health Organisation, as well as a number of other European countries to recommend its use for people who misuse alcohol.”

To read the full report, published in Vaccines — Open Access Journal, click here