A Study to Learn How Effective is PCV20 to Help Stop Adults Who Have a Higher Chance of Getting Pneumonia

Inclusion Criteria: 19-64 years of age cohort 1. Aged ≥19 at some point between July 1, 2022 and May 31, 2025 with 1-year continuous membership prior to July 1, 2022 2. At least 1 year of continuous enrollment as a KPSC member prior to the index date, allowing for 45-day administrative gaps 3. Age 19-64 years of age on the index date with ≥1 medical condition or risk factor identified during the 1-year continuous enrollment period prior to the index date 4. At least one outpatient visit prior to the index date * 65 years cohort 1. Aged ≥19 at some point between July 1, 2022 and May 31, 2025 with 1-year continuous membership prior to July 1, 2022 2. ≥1 year of continuous enrollment as a KPSC member prior to the index date, allowing for 45-day administrative gaps 3. Age ≥65 years on the index date 4. At least one outpatient visit prior to the index date Exclusion Criteria: 19-64 years of age cohort <!-- --> 1. Received PCV20 prior to June 1, 2022, turning age 19 years, or meeting the medical condition or behavioral risk factor inclusion criteria 2. Vaccinated index date is \>30 days after the first PCV20 vaccination date or \>1 dose of PCV20 is received \<30 days prior to the index date 3. Received PCV15 or PCV21 prior to the index date 4. Received PPSV23 ≤2 years prior to the index date 5. Received PCV13 ≤5 years prior to the index date 6. Outcome-related diagnosis code in the EHR \<30 days prior to the index date * 65 years cohort 1. Received PCV20 prior to June 1, 2022 or prior to turning ≥65 years of age 2. Vaccinated index date is \>30 days after the first PCV20 vaccination date or \>1 dose of PCV20 is received \<30 days prior to the index date 3. Received PCV15 or PCV21 prior to the index date 4. Received PPSV23 ≤2 years prior to the index date 5. Received PCV13 ≤5 years prior to the index date 6. Outcome-related diagnosis code in the EHR \<30 days prior to the index date