The CAPiTA trial, a randomized trial that included nearly 85,000 Dutch adults ≥65 years age, compared protection against pneumococcal disease in recipients of PCV13 or placebo. This trial demonstrated 46 percent efficacy of PCV13 against vaccine-type pneumococcal pneumonia, 45 percent efficacy against vaccine-type nonbacteremic pneumococcal pneumonia, and 75 percent efficacy against vaccine-type invasive pneumococcal disease [ 38 ]. Three important points need to be made about this trial: there was no comparison with PPSV23, which, historically, has demonstrated an even higher rate of protection; universal vaccination of children was not accomplished before the start of the study; and immunocompromised adults were excluded. Importantly, in this study, persons who developed an immunocompromising condition during the years of observation after they received PCV13 had no demonstrable protection from PCV13. (See 'Efficacy' below.)
Inflammation of the meninges may lead to abnormalities of the cranial nerves , a group of nerves arising from the brain stem that supply the head and neck area and which control, among other functions, eye movement, facial muscles, and hearing.   Visual symptoms and hearing loss may persist after an episode of meningitis.  Inflammation of the brain ( encephalitis ) or its blood vessels ( cerebral vasculitis ), as well as the formation of blood clots in the veins ( cerebral venous thrombosis ), may all lead to weakness, loss of sensation, or abnormal movement or function of the part of the body supplied by the affected area of the brain.