Meta-analysis on protective efficacy of 23-valent pneumococcal polysaccharide vaccine in aged people

Abstract

Objective To evaluate protective efficacy of 23-valent pneumococcal polysaccharide vaccine (PPV23) against invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP) in the population aged above 60 years. Methods By searching databases such as National Center for Biotechnology Information, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang Database, we included randomized controlled trial (RCT) , cohort study, case-control study on efficacy of PPV23 against IPD or PP in the population aged ≥60 years in the research. The relative risk (RR) or odds ratio (OR) for IPD and PP between vaccination group and control group from each study were pooled. Vaccine efficacy (VE) was calculatedif the pooled estimates of RR or OR were statistical significant. RevMan 5.3 software was adopted for all analyses. Results We identified 4 RCT studies, 5 cohort studies and 8 case-control studies. Pooled VEs against IPD and PP in RCT were 73% (95%CI: 10%-92%) and 64% (95%CI: 35%-80%) , respectively. Pooled VEs against IPD and PP in cohort studies were 45% (95%CI: 15%-65%) and 48% (95%CI: 25%-63%) , respectively. Pooled VEs against IPD and PP in case-control studies were 59% (95%CI: 35%-74%) and 45% (95%CI: 27%-59%) , respectively. Conclusions Our meta-analysis reveals significant VE of PPV23 against both IPD and PP in the population aged over 60 years. Due to its broad serotype coverage and the effectiveness of reducing the incidences of IPD and PP, PPV23 is recommended in the elderly aged above 60 years. Key words: Pneumonia, pneumococcal; 23-valent pneumococcal polysaccharide vaccine; Efficacy; Meta-analysis