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Effectiveness of pneumococcal vaccines in preventing pneumonia in adults, a systematic review and meta-analyses of observational studies

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  • Myint Tin Tin Htar
  • Anke L Stuurman
  • Germano Ferreira
  • Cristiano Alicino
  • Kaatje Bollaerts
  • Chiara Paganino
  • Ralf René Reinert
  • Heinz-Josef Schmitt
  • Cecilia Trucchi
  • Thomas Vestraeten
  • Filippo Ansaldi

Abstract

Introduction: S. pneumoniae can cause a wide spectrum of diseases, including invasive pneumococcal disease and pneumonia. Two types of pneumococcal vaccines are indicated for use in adults: 23-valent pneumococcal polysaccharide vaccines (PPV23) and a 13-valent pneumococcal conjugate vaccine (PCV13). Objective: To systematically review the literature assessing pneumococcal vaccine effectiveness (VE) against community-acquired pneumonia (CAP) in adults among the general population, the immunocompromised and subjects with underlying risk factors in real-world settings. Methods: We searched for peer-reviewed observational studies published between 1980 and 2015 in Pubmed, SciELO or LILACS, with pneumococcal VE estimates against CAP, pneumococcal CAP or nonbacteremic pneumococcal CAP. Meta-analyses and meta-regression for VE against CAP requiring hospitalization in the general population was performed. Results: 1159 unique articles were retrieved of which 33 were included. No studies evaluating PCV13 effectiveness were found. Wide ranges in PPV23 effectiveness estimates for any-CAP were observed among adults ≥65 years (-143% to 60%). The meta-analyzed VE estimate for any-CAP requiring hospitalization in the general population was 10.2% (95%CI: -12.6; 33.0). The meta-regression indicates that VE against any-CAP requiring hospitalization is significantly lower in studies with a maximum time since vaccination ≥60 months vs.

Suggested Citation

  • Myint Tin Tin Htar & Anke L Stuurman & Germano Ferreira & Cristiano Alicino & Kaatje Bollaerts & Chiara Paganino & Ralf René Reinert & Heinz-Josef Schmitt & Cecilia Trucchi & Thomas Vestraeten & Filip, 2017. "Effectiveness of pneumococcal vaccines in preventing pneumonia in adults, a systematic review and meta-analyses of observational studies," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-16, May.
    • Handle: RePEc:plo:pone00:0177985
    DOI: 10.1371/journal.pone.0177985
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    References listed on IDEAS

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    1. Julia Schiffner-Rohe & Annika Witt & Jana Hemmerling & Christof von Eiff & Friedrich-Wilhelm Leverkus, 2016. "Efficacy of PPV23 in Preventing Pneumococcal Pneumonia in Adults at Increased Risk – A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-21, January.
    2. Viechtbauer, Wolfgang, 2010. "Conducting Meta-Analyses in R with the metafor Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 36(i03).
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    Cited by:

    1. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.

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