Pneumococcal conjugate vaccine against serotype 3 pneumococcal pneumonia in adults: A systematic review and pooled analysis

Serotype 3 pneumococcal disease has not substantially declined at the population level after the routine introduction of 13-valent pneumococcal conjugate vaccine (PCV13) into pediatric immunization programs across the globe. This epidemiological finding has generated debate regarding the effectivene...

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Bibliographic Details
Published in:Vaccine Vol. 37; no. 43; pp. 6310 - 6316
Main Authors: McLaughlin, John M., Jiang, Qin, Gessner, Bradford D., Swerdlow, David L., Sings, Heather L., Isturiz, Raul E., Jodar, Luis
Format: Journal Article
Language:English
Published: Netherlands Elsevier Ltd 08.10.2019
Elsevier Limited
Subjects:
13-valent pneumococcal conjugate vaccine (PCV13)
Adults
Allergy and Immunology
Argentina
case-control studies
Community-acquired pneumonia (CAP)
Conjugates
Effectiveness
Efficacy
Elderly
Epidemiology
Heterogeneity
Immunization
Kentucky
Literature reviews
Netherlands
Pneumonia
Pooled analysis
Population decline
randomized clinical trials
Serotype 3
serotypes
Streptococcus infections
Streptococcus pneumoniae
Studies
Systematic review
Vaccine efficacy
Vaccines
United States > US
Argentina
Netherlands
Kentucky
PCV
PCV13
RCT
Effectiveness
CDC
Serotype 3
Pooled analysis
PCV10
CI
Efficacy
MeSH
CAPiTA
TND
mITT
VE
CAP
13-valent pneumococcal conjugate vaccine (PCV13)
Adults
Community-acquired pneumonia (CAP)
IPD
Elderly
ECDC
invasive pneumococcal disease
Centers for Disease Control and Prevention
test-negative design
Medical Subject Headings
vaccine efficacy or effectiveness
pneumococcal conjugate vaccine
European Centers for Disease Control
community-acquired pneumonia
Community-acquired Pneumonia Immunization Trial in Adults
randomized controlled trial
10-valent pneumococcal conjugate vaccine
13-valent pneumococcal conjugate vaccine
confidence interval
modified intent-to-treat
ISSN:0264-410X, 1873-2518, 1873-2518
Online Access:Get full text
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Summary:Serotype 3 pneumococcal disease has not substantially declined at the population level after the routine introduction of 13-valent pneumococcal conjugate vaccine (PCV13) into pediatric immunization programs across the globe. This epidemiological finding has generated debate regarding the effectiveness of PCV13 against serotype 3 disease. Evaluating PCV13 effectiveness against serotype 3 is especially critical in adults, where serotype 3 makes up an important amount of remaining pneumococcal disease. We performed a systematic review of the published literature to assess the direct effectiveness of PCV13 against serotype 3 community-acquired pneumonia (CAP) among adults. We then estimated overall vaccine effectiveness (VE) using a pooled analysis of the individual-level, raw data. Two published studies met inclusion criteria. One was a randomized controlled trial conducted in the Netherlands and published in 2014. The other was a recently-published case-control study conducted in Louisville, Kentucky that used a test-negative design (TND). We also identified a third TND study conducted in Argentina that was recently presented as a conference abstract but is not yet published. All three studies were conducted in adults aged ≥65 years. PCV13 VE against serotype 3 hospitalized CAP was 52.5% (95%CI: 6.2–75.9%) from the pooled analysis of individual-level data from all three studies. Results were similar if the unpublished estimate was excluded (serotype 3 VE = 53.6% [95%CI: 6.7–76.9%]). No heterogeneity was observed. Currently-available evidence, although limited to three studies, suggests that PCV13 provides direct protection against serotype 3 hospitalized CAP in adults aged ≥65 years.
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ISSN:0264-410X
1873-2518
1873-2518
DOI:10.1016/j.vaccine.2019.08.059