TITLE

Efficacy of pneumococcal vaccination in adults: a meta-analysis

AUTHOR(S)
Huss, Anke; Scott, Pippa; Stuck, Andreas E.; Trotter, Caroline; Egger, Matthias
PUB. DATE
January 2009
SOURCE
CMAJ: Canadian Medical Association Journal;1/6/2009, Vol. 180 Issue 1, p48
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Clinical trials and meta-analyses have produced conflicting results of the efficacy of unconjugated pneumococcal polysaccharide vaccine in adults. We sought to evaluate the vaccine's efficacy on clinical outcomes as well as the methodologic quality of the trials. Methods: We searched several databases and all bibliographies of reviews and meta-analyses for clinical trials that compared pneumococcal polysaccharide vaccine with a control. We examined rates of pneumonia and death, taking the methodologic quality of the trials into consideration. Results: We included 22 trials involving 101 507 participants: 11 trials reported on presumptive pneumococcal pneumonia, 19 on all-cause pneumonia and 12 on allcause mortality. The current 23-valent vaccine was used in 8 trials. The relative risk (RR) was 0.64 (95% confidence interval [CI] 0.43-0.96) for presumptive pneumococcal pneumonia and 0.73 (95% CI 0.56-0.94) for all-cause pneumonia. There was significant heterogeneity between the trials reporting on presumptive pneumonia (I2 = 74%, p < 0.001) and between those reporting on all-cause pneumonia (I2 = 90%, p < 0.001). The RR for all-cause mortality was 0.97 (95% CI 0.87-1.09), with moderate heterogeneity between trials (... = 44%, p = 0.053). Trial quality, especially regarding double blinding, explained a substantial proportion of the heterogeneity in the trials reporting on presumptive pneumonia and all-cause pneumonia. There was little evidence of vaccine protection in trials of higher methodologic quality (RR 1.20, 95% CI 0.75-1.92, for presumptive pneumonia; and 1.19, 95% CI 0.95-1.49, for all-cause pneumonia in double-blind trials; p for heterogeneity > 0.05). The results for all-cause mortality in double-blind trials were similar to those in all trials combined. There was little evidence of vaccine protection among elderly patients or adults with chronic illness in analyses of all trials (RR 1.04, 95% CI 0.78-1.38, for presumptive pneumococcal pneumonia; 0.89, 95% CI 0.69- 1.14, for all-cause pneumonia; and 1.00, 95% CI 0.87-1.14, for all-cause mortality). Interpretation: Pneumococcal vaccination does not appear to be effective in preventing pneumonia, even in populations for whom the vaccine is currently recommended.
ACCESSION #
35826033

 

Related Articles

  • Immune Response to Pneumococcal Conjugate and Polysaccharide Vaccines in Otitis-Prone and Otitis-Free Children. Barnett, Elizabeth D.; Pelton, Stephen I.; Cabral, Howard J.; Eavey, Roland D.; Allen, Carole; Cunningham, Michael J.; McNamara, Eileen R.; Klein, Jerome O. // Clinical Infectious Diseases;7/1/99, Vol. 29 Issue 1, p191 

    Provides information on a study which compared responses to the pneumococcal conjugate vaccine (PCV) and pneumococcal polysaccharide vaccine to understand the roles of vaccines in the prevention of pneumococcal disease including otitis media. How the study was conducted; Results; Discussion of...

  • pneumococcal vaccine.  // Royal Society of Medicine: Medicines;2002, p443 

    The article presents information on pneumococcal vaccine which is used for immunization against pneumonia. There are two types of vaccine. First is the polyvalent unconjugated pneumococcal polysaccharide vaccine and second is the polyvalent pneumococcal polysaccharide conjugated vaccine....

  • Pneumovax II.  // Royal Society of Medicine: Medicines;2002, p443 

    The article presents information on Pneumovax II which is a proprietary, prescription-only vaccine preparation of pneumococcal vaccine in the form polyvalent unconjugated pneumococcal polysaccharide vaccine. It can be used for the prevention of pneumococcal pneumonia in people over two years for...

  • Pnu-Imune.  // Royal Society of Medicine: Medicines;2002, p443 

    The article presents information on Pnu-Imune which is a proprietary, prescription-only vaccine preparation of pneumococcal vaccine in the form polyvalent unconjugated pneumococcal polysaccharide vaccine. It can be used for the prevention of pneumococcal pneumonia in people over two years for...

  • Should the new pneumococcal vaccine be used in high-risk children? Finn, A.; Booy, R.; Moxon, R.; Sharland, M.; Heath, P. // Archives of Disease in Childhood;Jul2002, Vol. 87 Issue 1, p18 

    Evaluates evidence concerning the use of the pneumococcal vaccine. Children at high risk for pneumococcal disease; Prevention of pneumococcal disease in high risk groups; Suggested dose regimens for pneumococcal immunization of vaccine naive high risk children.

  • Adult immunization rates significantly lacking. Shafer, Emily // Infectious Disease News;Oct2012, Vol. 25 Issue 10, p1 

    The article reports that coverage rate for pneumococcal vaccine among adults aged 19 to 64 years in the U.S. remains low as of October 2012.

  • Erratum to: Pneumococcal vaccination: what have we learnt so far and what can we expect in the future? Torres, A.; Bonanni, P.; Hryniewicz, W.; Moutschen, M.; Reinert, R.; Welte, T. // European Journal of Clinical Microbiology & Infectious Diseases;Feb2015, Vol. 34 Issue 2, p415 

    A correction to the article "Pneumococcal Vaccination: What Have We Learnt So Far and What Can We Expect in the Future?" that was published in the October 2014 issue is presented.

  • Acquisition of Streptococcus pneumoniae Carriage in Pilgrims During the 2012 Hajj. Benkouiten, Samir; Gautret, Philippe; Belhouchat, Khadidja; Drali, Tassadit; Salez, Nicolas; Memish, Ziad A.; al Masri, Malak; Fournier, Pierre-Edouard; Brouqui, Philippe // Clinical Infectious Diseases;Feb2014, Vol. 58 Issue 4, pe106 

    To investigate the nasal carriage of some respiratory bacterial pathogens that are responsible for infections associated with person-toperson transmission, the authors conducted a cohort survey of pilgrims departing to Mecca for the 2012 Hajj season. In this report, they demonstrate the...

  • Pneumococcal Polysaccharide Conjugate Vaccine (13-Valent, Adsorbed) [Prevenar 13].  // Drugs;2010, Vol. 70 Issue 15, p1973 

    No abstract available.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics