Abstract
Adult vaccination is high on the agenda in many countries. Two different vaccines are available for the prevention of pneumococcal disease in adults: a 23-valent polysaccharide vaccine (PPV23), and a 13-valent conjugated vaccine (PCV13). The objective of this review is to update the evidence base for vaccine efficacy and effectiveness of PPV23 and PCV13 against invasive pneumococcal disease and pneumonia among an unselected elderly population. We systematically searched for clinical trials and observational studies published between January 1 2016 and April 17 2019 in Pubmed, Embase, Cinahl, Web of Science, Epistemonikos and Cochrane databases. Risk of bias was assessed using Cochrane Risk of Bias tool for and the Newcastle–Ottawa Scale. Results were stratified by vaccine type and outcome. We identified nine studies on PCV13 and six on PPV23. No new randomized clinical trials were identified. Due to different outcomes, it was not possible to do a meta-analysis. New high-quality observational studies indicate protective vaccine effectiveness for both vaccines against vaccine type pneumonia. Our estimates for the protective vaccine efficacy and effectiveness (VE) of PPV23 on pneumonia and pneumococcal pneumonia overlap with results from previously published reviews. Some of the results indicate that the effectiveness of the PPV23 is best in younger age groups, and that it decreases over time.
Highlights
IntroductionStreptococcus pneumoniae is a leading cause of mortality and morbidity in the elderly population
Streptococcus pneumoniae is a leading cause of mortality and morbidity in the elderly population.The most severe form of pneumococcal disease is invasive pneumococcal disease (IPD)
We categorized the Spanish cohort study evaluating PCV13 vaccine efficacy and effectiveness (VE) as high quality according to the Newcastle–Ottawa Scale (NOS), we found some important problems
Summary
Streptococcus pneumoniae is a leading cause of mortality and morbidity in the elderly population. The most severe form of pneumococcal disease is invasive pneumococcal disease (IPD). S. pneumoniae can cause non-invasive disease such as pneumonia, sinusitis and otitis media. Estimates show that the number of hospitalizations due to pneumococcal pneumonia will double in the US from 2004 to 2040 without any interventions, and that this will lead to a $ 2.5 billion increase in health. Pathogens 2020, 9, 259 care expenditure [1]. In an effort to reduce this burden, two different vaccines have been developed. - a 23-valent polysaccharide vaccine (PPV23, Pneumovax 23, Sanofi Pasteur, MSD) and a 13-valent conjugate vaccine (PCV13, Prevenar, Pfizer). With the exception of serotype 6A, all serotypes in PCV13 are included in PPV23
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