The full benefits of adult pneumococcal vaccination: A systematic review

Abstract

BackgroundPneumococcal disease causes substantial morbidity and mortality, including among adults. Adult pneumococcal vaccines help to prevent these burdens, but they are underused. Accounting for the full benefits of adult pneumococcal vaccination may promote more rational resource allocation decisions with respect to adult pneumococcal vaccines.ObjectivesUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to assess the extent to which the literature has empirically captured (e.g., through measurement or modeling) the full benefits of adult pneumococcal vaccination.MethodsWe systematically searched PubMed and Embase to identify studies published between January 1, 2010 and April 10, 2016 that examine adult pneumococcal vaccination. We included articles if they captured any health or economic benefit of an adult pneumococcal vaccine administered to adults age ≥ 50 or ≥ 18 in risk groups. Finally, we summarized the literature by categorizing the types of benefits captured, the perspective taken, and the strength of the evidence presented. Our protocol is number 42016038335 in the PROSPERO International prospective register of systematic reviews.ResultsWe identified 5,857 papers and included 150 studies for analysis. While most capture health gains and healthcare cost savings, far fewer studies consider additional benefit categories, such as productivity gains. However, the studies with a broader approach still exhibit significant limitations; for example, many present only abstracts, while others offer no new measurements. Studies that examine the 13-valent pneumococcal conjugate vaccine focus more on broad economic benefits, but still have limitations.ConclusionsThis review highlights the need for more robust empirical accounting of the full benefits of adult pneumococcal vaccination. Literature outside this realm indicates that these broad benefits may be substantial. Failing to investigate the full benefits may lead society to undervalue vaccines' contributions and therefore underinvest in their development and adoption.

Pneumococcal disease burden from an Indian perspective: Need for its prevention in pulmonology practice

“…The vaccine exerts this effect by slowing the spread of resistant pneumococcal serotypes (19A) and by preventing the disease in the first place, thereby eliminating the need for antibiotics. [ 40 ] A reduction in the rate of antibiotic-resistant infection among older adults was also observed in a laboratory-based study. The incidence rate of pneumococcal diseases caused by penicillin-resistant strains reduced to 8.4 from 16.4 cases/100,000.…”

Clinical and financial burden of hospitalised community-acquired pneumonia in patients with selected underlying comorbidities in England

“…Furthermore, it is important to consider the personal impact on quality of life for these patients and their families along with some of the often unreported consequences of CAP, including wider societal implications such as time off work. 25 The increasing numbers of patients with comorbidities and elderly patients hospitalised with CAP will consume a Open access large percentage of health resources in the future. 26 Our data suggest that those with underlying conditions continue to be at an increased risk of hospitalised CAP and its associated consequences.…”

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“…There is also evidence of a complex indirect relationship between VPDs and frailty [24,25], cognitive decline [26] and depression [17,27]. Disease burden estimates of the value of vaccines generally do not include the benefits of preventing these downstream conditions [28] or resulting events such as falls caused by weakness following a VPD episode, suggesting that the true impact is underestimated [29]. The role of vaccines in preventing NCD events is also underappreciated in clinical settings and should have more prominence in the management and prevention of those diseases [24,30].…”