Immunisation With a Polyvalent Pneumococcal Vaccine

Riley, Ian; Andrews, Matthew; Howard, Rudolph G.; Tarr, Phillip I.; Pfeiffer, Mat­thias; Challands, P.; Jennison, G.; Douglas, Robert M.

doi:10.1016/s0140-6736(77)92552-1

Cited by 163 publications

(20 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found 12 reports of 13 randomised comparisons of polyvalent polysaccharide pneumococcal vaccines for inclusion with a total of 45,226 subjects ([12,13,14,15,16,17,18,19,20,21,22,23] Table 1). The report by Austrian et al, 1980 [15] comprised two separate trials.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Are the pneumococcal polysaccharide vaccines effective? Meta-analysis of the prospective trials

2000

View full text Add to dashboard Cite

The objective was to review the evidence of effectiveness of the polyvalent polysaccharide pneumococcal vaccine from prospective properly randomised controlled trials comparing pneumococcal vaccines with placebo in subjects who are immunocompetent and those likely to have an impaired immune system.Databases searched included the Cochrane Library, (issue 2, 2000), MEDLINE (1966-August 2000), PubMed (to August 2000) and EMBASE ( to August 2000). Reference lists of reports and reviews were also searched. To be included in the analysis, a study had to have been a prospective randomised comparison of a polysaccharide pneumococcal vaccine (any valency) and to have a placebo or no treatment comparison group. Papers had to report important clinical outcomes, such as rates of pneumonia, pneumococcal pneumonia, lower respiratory tract infections, pneumonia deaths or bacteraemia. Serological outcomes were not sought. Thirteen randomised comparisons with over 45,000 subjects were identified in an extensive literature review. Eight studies had a quality score of 3 or more on a scale of 1 to 5. In three comparisons with 21,152 immunocompetent subjects (South African gold miners, New Guinea highlanders) pneumococcal vaccination was effective in reducing the incidence of all-cause pneumonia (relative risk 0.56, 95% confidence interval 0.47 to 0.66), pneumococcal pneumonia (0.16; 0.11 to 0.23), pneumonia deaths (0.70; 0.50 to 0.96) and bacteraemia (0.18; 0.09 to 0.34). In ten comparisons in over 24,000 people who were elderly or likely to have impaired immune systems, pneumococcal vaccination was without effect for any outcome.Present guidelines recommend pneumococcal vaccination for "high-risk" groups. There is no evidence from randomised trials that this is of any benefit.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Three comparisons [12,13,14] reported outcomes in 21,152 healthy, mostly young, adults likely to have a normal immune system. Ten [15,16,17,18,19,20,21,22,23] reported outcomes on 24,074 people likely to have an impaired immune system because of age or ill health.…”

Section: Resultsmentioning

confidence: 99%

Are the pneumococcal polysaccharide vaccines effective? Meta-analysis of the prospective trials

2000

View full text Add to dashboard Cite

show abstract

“…RCTs used in that meta-analysis and published between 1980 and 2006 did not found any evidence about PPSV23 as protective vaccine to avoid pneumonia [40,41,53-58]. It means that the conclusion of Moberley et al is based on only two RCTs: Kaufman (1948) [13] and Riley (1977) [59]. It is important to note that these RCTs [13,59] did not identified infection by S. pneumoniae but Diplococcus pneumoniae , which is a different microorganism.…”

Section: Discussionmentioning

confidence: 99%

“…It means that the conclusion of Moberley et al is based on only two RCTs: Kaufman (1948) [13] and Riley (1977) [59]. It is important to note that these RCTs [13,59] did not identified infection by S. pneumoniae but Diplococcus pneumoniae , which is a different microorganism.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of pneumococcal conjugate vaccine 13-valent in older adults in Colombia

Ordóñez

Orozco

2014

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundNowadays, there are two vaccination strategies in Colombia to prevent pneumococcal diseases in people over 50 years. Our aim is to estimate cost-effectiveness of pneumococcal conjugate vaccine 13-valent (PCV13) versus pneumococcal polysaccharide vaccine 23-valent (PPSV23) to prevent pneumococcal diseases and their related mortality in people over 50 years old in Colombia.MethodsA Markov model was developed with national data, including pneumococcal serotypes distribution in Colombia between 2005 and 2010. Vaccination of a cohort was simulated and a five year time horizon was assumed. Analysis was done from a perspective of a third party payer. Direct costs were provided by a national insurance company; sensitive univariate and probabilistic analysis were done for epidemiological and clinical effectiveness parameters and costs.ResultsPCV13 avoids 3 560 deaths by pneumococcal infections versus PPSV23 and 4 255 deaths versus no vaccine. PCV13 prevents 79 633 cases by all-cause pneumonia versus PPSV23 and 81 468 cases versus no vaccine. Total costs (healthcare and vaccines costs) with PCV13 would be U.S. $ 97,587,113 cheaper than PPSV23 and it would save U.S. $ 145,196,578 versus no vaccine.ConclusionPCV13 would be a cost-saving strategy in the context of a mass vaccination program in Colombia to people over 50 years old because it would reduce burden of disease and specific mortality by pneumococcal diseases, besides, it saves money versus PPSV23.

show abstract

“…Despite numerous studies, contradictory results have been reported and several meta-analyses have been inconclusive to date. Excluding earlier trials in younger adults,[21,22] prospective RCTs have failed to demonstrate a significant protective effect of the vaccination. However, several case-control and cohort studies have reported a considerable protective effect (ranging between 40-80%) in preventing IPD in different populations [23-28].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of the 23-valent polysaccharide pneumococcal vaccine against invasive pneumococcal disease in people 60 years or older

et al. 2010

View full text Add to dashboard Cite

BackgroundThe 23-valent polysaccharide pneumococcal vaccine (PPV) is currently recommended in elderly and high-risk adults. However, its efficacy in preventing pneumococcal infections remains controversial. This study assessed the clinical effectiveness of vaccination against invasive pneumococcal disease (IPD) among people over 60 years.MethodsPopulation-based case-control study that included 88 case patients over 60 years-old with a laboratory-confirmed IPD (bacteraemic pneumonia, meningitis or sepsis) and 176 outpatient control subjects who were matched by primary care centre, age, sex and risk stratum. Adjusted odds ratios (ORs) for vaccination were calculated using conditional logistic regression, controlling for underlying conditions. Vaccine effectiveness was estimated as (1 - OR) ×100.ResultsPneumococcal vaccination rate was significantly lower in cases than in control subjects (38.6% vs 59.1%; p = 0.002). The adjusted vaccine effectiveness was 72% (OR: 0.28; 95% CI: 0.15-0.54) against all IPD and 77% (OR: 0.23; 95% CI: 0.08-0.60) against vaccine-type IPD. Vaccination was significantly effective against all IPD in both age groups: 60-79 years-old (OR 0.32; 95% CI: 0.14-0.74) and people 80 years or older (OR: 0.29; 95% CI: 0.09-0.91). Vaccination appears significantly effective as for high-risk immunocompetent subjects (OR: 0.29; 95% CI: 0.11-0.79) as well as for immunocompromised subjects (OR: 0.12; 95% CI: 0.03-0.53).ConclusionThese findings confirm the effectiveness of the 23-valent PPV against IPD, and they also support the benefit of vaccination in preventing invasive infections among high-risk and older people.

show abstract

Immunisation With a Polyvalent Pneumococcal Vaccine

Cited by 163 publications

References 6 publications

Are the pneumococcal polysaccharide vaccines effective? Meta-analysis of the prospective trials

Are the pneumococcal polysaccharide vaccines effective? Meta-analysis of the prospective trials

Cost-effectiveness analysis of pneumococcal conjugate vaccine 13-valent in older adults in Colombia

Effectiveness of the 23-valent polysaccharide pneumococcal vaccine against invasive pneumococcal disease in people 60 years or older

Contact Info

Product

Resources

About