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Human Vaccines & Immunotherapeutics Dec 2022In 2010, a 10-valent pneumococcal non-typeable protein D conjugate vaccine (PHiD-CV) was introduced in the Brazilian national immunization program; the 3 + 1 dose...
In 2010, a 10-valent pneumococcal non-typeable protein D conjugate vaccine (PHiD-CV) was introduced in the Brazilian national immunization program; the 3 + 1 dose schedule was replaced by a 2 + 1 dose schedule in 2016. This systematic review presents the latest published evidence (2015-2020) on the impact after 10-year use of PHiD-CV in Brazil from a total of 29 publications. Overall, the PHiD-CV program had a positive impact on the morbidity and mortality associated with invasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM) in children <5 years-old. A reduction in the vaccine-type invasive disease was observed in all-ages; suggesting indirect protection unvaccinated older children and adults. The occurrence of non-vaccine type disease was evidenced in some studies. Higher vaccination coverage is required at national and state level for sustained population impact. Given the change in the vaccination schedule and the dynamics of pneumococcal disease epidemiology, continuous surveillance is warranted.GSK Study identifier: HO-18-19438.
Topics: Adolescent; Brazil; Child; Child, Preschool; Humans; Infant; Otitis Media; Pneumococcal Infections; Pneumococcal Vaccines; Vaccination; Vaccines, Conjugate
PubMed: 33735585
DOI: 10.1080/21645515.2021.1879578 -
International Journal of Infectious... Oct 2020Epidemiological studies suggest that there is a link between pneumococcal infection and adverse cardiovascular outcomes such as myocardial infarction. Multiple studies... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Epidemiological studies suggest that there is a link between pneumococcal infection and adverse cardiovascular outcomes such as myocardial infarction. Multiple studies have evaluated the protective effect of the 23-valent polysaccharide pneumococcal vaccination (PPV23), but results have varied. Therefore, a meta-analysis was conducted to summarize available evidence on the impact of PPV23 on cardiovascular disease.
METHODS
A literature search from January 1946 to September 2019 was conducted across Embase, Medline and Cochrane. All studies were included that evaluated PPV23 compared with a control (placebo, no vaccine or another vaccine) for any cardiovascular events, including: myocardial infarction (MI), heart failure and cerebrovascular events. Risk ratios (RRs) were pooled using random effects models.
RESULTS
Eighteen studies were included, with a total of 716,108 participants. Vaccination with PPV23 was associated with decreased risk of any cardiovascular event (RR: 0.91; 95% CI: 0.84-0.99), and MI (RR: 0.88; 95% CI: 0.79-0.98) in all age groups, with a significant effect in those aged ≥65 years, but not in the younger age group. Similarly, PPV23 vaccine was associated with significant risk reduction in all-cause mortality in all ages (RR: 0.78; 95% CI: 0.68-0.88), specifically in those aged ≥65 years (RR: 0.71; 95% CI: 0.60-0.84). A significant risk reduction in cerebrovascular disease was not observed following pneumococcal vaccination.
CONCLUSIONS
Polysaccharide pneumococcal vaccination decreased the risk for some adverse cardiovascular events, specifically acute MI in the vaccinated population, particularly for those individuals aged ≥65 years. It would be highly beneficial to vaccinate the population who is at greater risk of cardiovascular diseases.
Topics: Adult; Aged; Aged, 80 and over; Cardiovascular Diseases; Humans; Middle Aged; Myocardial Infarction; Odds Ratio; Pneumococcal Infections; Pneumococcal Vaccines
PubMed: 32735953
DOI: 10.1016/j.ijid.2020.07.038 -
Vaccines Sep 2022A significant decline in pediatric vaccination uptake due to the COVID-19 pandemic has been documented. Little is known about the parental willingness and associated... (Review)
Review
A significant decline in pediatric vaccination uptake due to the COVID-19 pandemic has been documented. Little is known about the parental willingness and associated factors of pediatric vaccination during the COVID-19 pandemic. An extensive literature search in the databases of PubMed, Scopus, Web of Science, and EBSCOhost were conducted. A total of 20 eligible studies published from 2020-2022 were included for systematic summary by a thematic analysis, among which 12 studies were included in a meta-analysis conducted with R-4.2.1. The prevalence of parental willingness to childhood/routine vaccination and seasonal influenza vaccination was 58.6% (95%CI 2.8-98.6%) and 47.3% (95%CI 25.3-70.5%). Moreover, there is no sufficient evidence of significant change in parental willingness to childhood/routine vaccination, human papillomavirus vaccination, or pneumococcal conjugate vaccination during the pandemic. However, a significant increase in parental willingness to vaccinate their children against seasonal influenza was found. In addition to the factors of parental vaccination willingness/hesitancy that are well-studied in literature, children/parents' history of COVID-19 and children's perceived vulnerability to COVID-19 were associated with parental willingness. Developing synergetic strategies to promote COVID-19 vaccination together with other pediatric vaccination is warranted during the pandemic. This may help to improve and/or catch up the vaccine uptake of children during and/or after the COVID-19 pandemic.
PubMed: 36146530
DOI: 10.3390/vaccines10091453 -
PloS One 2024Streptococcus pneumoniae is a leading cause of morbidity and mortality globally, causing bacteremic pneumonia, meningitis, sepsis, and other invasive pneumococcal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Streptococcus pneumoniae is a leading cause of morbidity and mortality globally, causing bacteremic pneumonia, meningitis, sepsis, and other invasive pneumococcal diseases. Evidence supports nasopharyngeal pneumococcal carriage as a reservoir for transmission and precursor of pneumococcal disease.
OBJECTIVES
To estimate the pneumococcal nasopharyngeal burden in all age groups in Latin America and the Caribbean (LAC) before, during, and after the introduction of pneumococcal vaccine conjugate (PVC).
METHODS
Systematic literature review of international, regional, and country-published and unpublished data, together with reports including data from serotype distribution in nasopharyngeal carriage in children and adults from LAC countries following Cochrane methods. The protocol was registered in PROSPERO database (ID: CRD42023392097).
RESULTS
We included 54 studies with data on nasopharyngeal pneumococcal carriage and serotypes from 31,803 patients. In children under five years old, carriage was found in 41% and in adults over 65, it was 26%. During the study period, children under five showed a colonization proportion of 34% with PCV10 serotypes and 45% with PCV13 serotypes. When we analyze the carriage prevalence of PCV serotypes in all age groups between 1995 and 2019, serotypes included in PCV10 and those included in PCV13, both showed a decreasing trend along analysis by lustrum.
CONCLUSION
The data presented in this study highlights the need to establish national surveillance programs to monitor pneumococcal nasopharyngeal carriage to monitor serotype prevalence and replacement before and after including new pneumococcal vaccines in the region. In addition, to analyze differences in the prevalence of serotypes between countries, emphasize the importance of approaches to local realities to reduce IPD effectively.
Topics: Humans; Streptococcus pneumoniae; Latin America; Caribbean Region; Nasopharynx; Pneumococcal Infections; Carrier State; Pneumococcal Vaccines; Serogroup; Child, Preschool; Adult; Child; Prevalence
PubMed: 38768099
DOI: 10.1371/journal.pone.0297767 -
BMC Infectious Diseases Aug 2019HIV-infected children are at a higher risk of Invasive Pneumococcal Disease (IPD) and its mortality, even in the era of antiretroviral therapy. Therefore, an effective... (Meta-Analysis)
Meta-Analysis
Effectiveness of pneumococcal conjugate vaccination against invasive pneumococcal disease among children with and those without HIV infection: a systematic review and meta-analysis.
BACKGROUND
HIV-infected children are at a higher risk of Invasive Pneumococcal Disease (IPD) and its mortality, even in the era of antiretroviral therapy. Therefore, an effective vaccination strategy would be beneficial. To investigate the effectiveness of Pneumococcal Conjugate Vaccination (PCV) against IPD among HIV-Infected and HIV-Uninfected Children through a systematic review and meta-analysis.
METHODS
Observational studies and randomized trials on 7 years old or older children were searched in the Cochrane Library, Web of Science core collection, Embase, Medline/PubMed, and Google Scholar. Critical appraisal was done using the Cochrane risk of bias tool and the Newcastle-Ottawa quality assessment form. Effectiveness and efficacy of at least one dose of PCV was investigated among children with and without HIV considering subgroups of pneumococcal serotypes. We meta-analyzed the effect sizes using random-effects modeling.
RESULTS
Efficacy of PCV was estimated as 45.0% (31.2, 56.1) and 52.6% (25.7, 69.8) among HIV-infected and HIV-uninfected children, respectively. Effectiveness of PCV among HIV-infected children as - 6.2% (- 67.6, 32.7) was significantly lower than HIV-uninfected children 65.1% (47.3, 76.9). Effectiveness of PCV among HIV-infected children for IPDs caused by vaccine serotypes was estimated as 7.7(- 66.7, 48.9), and for IPDs caused by non-vaccine serotypes was estimated as - 402.8(- 1856, - 29.2).
CONCLUSION
Unlike the evidence on the efficacy of PCV against IPD among both of HIV-infected and HIV-uninfected children, its effectiveness against IPD among HIV-infected children is much less limited.
REVIEW REGISTRATION
The study protocol was registered at PROSPERO (registration ID: CRD42018108187).
Topics: AIDS-Related Opportunistic Infections; Child; Child, Preschool; Humans; Infant; Observational Studies as Topic; Pneumococcal Infections; Pneumococcal Vaccines; Randomized Controlled Trials as Topic; Vaccination; Vaccines, Conjugate
PubMed: 31382917
DOI: 10.1186/s12879-019-4325-4 -
Clinical Microbiology and Infection :... Oct 2019Vaccines may reduce antibiotic use and the development of resistance. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Vaccines may reduce antibiotic use and the development of resistance.
OBJECTIVES
To provide a comprehensive, up-to-date assessment of the evidence base relating to the effect of vaccines on antibiotic use.
DATA SOURCES
Ovid MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and WHO Trials Registry.
STUDY ELIGIBILITY CRITERIA
Randomized controlled trials (RCTs) and observational studies published from January 1998 to March 2018.
PARTICIPANTS
Any population.
INTERVENTIONS
Vaccines versus placebo, no vaccine or another vaccine.
METHODS
Titles, abstracts and full-texts were screened independently by two reviewers. Certainty of RCT evidence was assessed using GRADE.
RESULTS
In all, 4980 records identified; 895 full-text reports assessed; 96 studies included (24 RCTs, 72 observational). There was high-certainty evidence that influenza vaccine reduces days of antibiotic use among healthy adults (one RCT; n = 4253; rate reduction 28·1%; 95% CI 16·0-38·4); moderate-certainty evidence that influenza vaccines probably reduce antibiotic use in children aged 6 months to 14 years (three RCTs; n = 610; ratio of means 0·62; 95% CI 0·54-0·70) and probably reduce community antibiotic use in children aged 3-15 years (one RCT; n = 10 985 person-seasons; risk ratio 0·69, 95% CI 0·58-0·83); and moderate-certainty evidence that pneumococcal vaccination probably reduces antibiotic use in children aged 6 weeks to 6 years (two RCTs; n = 47 945; rate ratio 0·93, 95% CI 0·87-0·99) and reduces illness episodes requiring antibiotics in children aged 12-35 months (one RCT; n = 264; rate ratio 0·85, 95% CI 0·75-0·97). Other RCT evidence was of low or very low certainty, and observational evidence was affected by confounding.
CONCLUSIONS
The evidence base is poor. Although some vaccines may reduce antibiotic use, collection of high-quality data in future vaccine trials is needed to improve the evidence base.
PROSPERO REGISTRATION
CRD42018103881.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Drug Utilization; Female; Global Health; Humans; Infant; Infant, Newborn; Male; Middle Aged; Observational Studies as Topic; Randomized Controlled Trials as Topic; Vaccination; Young Adult
PubMed: 31284031
DOI: 10.1016/j.cmi.2019.06.030 -
Pneumonia (Nathan Qld.) Apr 2021Prophylactic administration of antipyretics at the time of immunization seems to decrease some side effects, however reduced immune responses have been reported in some... (Review)
Review
BACKGROUND
Prophylactic administration of antipyretics at the time of immunization seems to decrease some side effects, however reduced immune responses have been reported in some studies. This systematic review aimed to investigate the effect of prophylactic use of antipyretics on the immune response following administration of pneumococcal conjugate vaccines (PCVs).
METHODS
A systematic review of randomized controlled trials and observational studies concerning the immune response to PCVs after antipyretic administration was performed up to November 2020 in the electronic databases of Pubmed and Scopus.
RESULTS
Of the 3956 citations retrieved, a total of 5 randomized control trials including 2775 children were included in the review. Included studies were referred to PCV10 (3 studies), PCV7 and PCV13 (one study each). The prophylactic administration of paracetamol decreased the immune response to certain pneumococcal serotypes in all included studies. The effect was more evident following primary vaccination and with immediate administration of paracetamol. Despite the reductions in antibody geometric mean concentrations, a robust memory response was observed following the booster dose. Besides, antibody titers remained above protective levels in 88-100% of participants. The use of ibuprofen, that was evaluated in two studies, did not seem to affect the immunogenicity of PCVs .
CONCLUSION
Although the reviewed studies had significant heterogeneity in design, paracetamol administration seems to affect the immune response for certain serotypes. The clinical significance of reduced immunogenicity especially before booster dose needs further investigation.
PubMed: 33894782
DOI: 10.1186/s41479-021-00085-8 -
The Journal of Infection Oct 2020Colonisation with Streptococcus pneumoniae can lead to invasive pneumococcal disease and pneumonia. Pneumococcal acquisition and prevalence of colonisation are high in... (Meta-Analysis)
Meta-Analysis
Upper airways colonisation of Streptococcus pneumoniae in adults aged 60 years and older: A systematic review of prevalence and individual participant data meta-analysis of risk factors.
BACKGROUND
Colonisation with Streptococcus pneumoniae can lead to invasive pneumococcal disease and pneumonia. Pneumococcal acquisition and prevalence of colonisation are high in children. In older adults, a population susceptible to pneumococcal disease, colonisation prevalence is reported to be lower, but studies are heterogeneous.
METHODS
This is a systematic review and meta-analysis of prevalence of, and risk factors for, pneumococcal colonisation in adults ≥ 60 years of age (PROSPERO #42016036891). We identified peer-reviewed studies reporting the prevalence of S. pneumoniae colonisation using MEDLINE and EMBASE (until April 2016), excluding studies of acute disease. Participant-level data on risk factors were sought from each study.
FINDINGS
Of 2202 studies screened, 29 were analysable: 18 provided participant-level data (representing 6290 participants). Prevalence of detected pneumococcal colonisation was 0-39% by conventional culture methods and 3-23% by molecular methods. In a multivariate analysis, colonisation was higher in persons from nursing facilities compared with the community (odds ratio (OR) 2•30, 95% CI 1•26-4•21 and OR 7•72, 95% CI 1•15-51•85, respectively), in those who were currently smoking (OR 1•69, 95% CI 1•12-2•53) or those who had regular contact with children (OR 1•93, 95%CI 1•27-2•93). Persons living in urban areas had significantly lower carriage prevalence (OR 0•43, 95%CI 0•27-0•70).
INTERPRETATION
Overall prevalence of pneumococcal colonisation in older adults was higher than expected but varied by risk factors. Future studies should further explore risk factors for colonisation, to highlight targets for focussed intervention such as pneumococcal vaccination of high-risk groups.
FUNDING
No funding was required.
Topics: Aged; Carrier State; Child; Humans; Middle Aged; Nasopharynx; Pneumococcal Infections; Pneumococcal Vaccines; Prevalence; Risk Factors; Streptococcus pneumoniae
PubMed: 32562794
DOI: 10.1016/j.jinf.2020.06.028 -
Digestive Diseases and Sciences Jul 2023Patients with immune-mediated conditions such as IBD and RA are at risk for vaccine-preventable infections. Despite guideline recommendations, prior studies have shown... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Patients with immune-mediated conditions such as IBD and RA are at risk for vaccine-preventable infections. Despite guideline recommendations, prior studies have shown suboptimal vaccination rates.
AIM
We conducted a systematic review and meta-analysis to compare the different interventions intended to increase vaccination rates.
METHODS
A systematic search was conducted of MEDLINE/PubMed, Embase, CINAHL, and Cochrane Library up to 2020 for studies with interventions intended to increase vaccination rates. We performed a random-effects meta-analysis to generate pooled odds ratios (ORs) to assess all interventions against no interventions. Our primary outcome was pneumococcal vaccination (PCV) rate.
RESULTS
Our review found 8580 articles, for which 15 IBD and 8 RA articles met the inclusion criteria; 21 articles were included in the analysis. PCV was the predominant vaccination (91%). In our analysis of patients with IBD, almost all interventions (patient-oriented, physician-oriented, or barrier-oriented) increased PCV uptake [OR, 4.74; 95% CI, 2.44-6.56, I2 = 90%] compared to no intervention. The greatest effect was seen in barrier-oriented studies [OR, 12.68; 95% CI, 2.21-72.62, I2 = 92%]. For RA data, all interventions had increased PCV uptake compared to no interventions (OR 2.74; 95% CI, 1.80-4.17, I2 = 95%).
CONCLUSION
Our data suggest that many different interventions can increase PCV rates. It appears that barrier-oriented interventions may have the greatest positive effect on increasing PCV uptake. However, clinicians should be encouraged to implement measures best suited to their practice. Future high-quality randomized controlled trials are needed to determine the best approach to optimize vaccination rates.
Topics: Humans; Vaccination; Arthritis, Rheumatoid; Inflammatory Bowel Diseases; Postoperative Complications
PubMed: 37024741
DOI: 10.1007/s10620-023-07903-7 -
Brazilian Journal of Microbiology :... Jun 2020This study aimed to review and report the serotype distribution and antimicrobial resistance patterns of invasive pneumococcal disease (IPD) isolates, as this...
OBJECTIVES
This study aimed to review and report the serotype distribution and antimicrobial resistance patterns of invasive pneumococcal disease (IPD) isolates, as this information is important for policy making since China has not adopted any pneumococcal vaccines in the national immunization schedule.
METHODS
A systematic review of the published literature from January 2000 to December 2018 was performed to identify articles that describe the serotype and/or antimicrobial resistance patterns of IPD cases in children in mainland China. Analysis of the extracted data was performed with the Microsoft Excel spreadsheet program. The percentage of the serotypes was calculated by dividing the number of isolates for each serotype with the total number of isolates included in all the studies. The theoretical impact of the vaccine was estimated by calculating the percentage of isolates that exhibited the serotypes included in the vaccines. The prevalence of antimicrobial resistance was defined as the number of isolates that were resistant divided by the total number of isolates tested for resistance to the specific antimicrobial agent.
RESULTS
Forty-two articles were screened in the preliminary search, of which sixteen fulfilled inclusion criteria and were included in the final analysis. The predominant serotypes were 19A, 19F, 14, 23F, and 6B, and the estimated impact of PCV13 was 90.4%. The isolates exhibited a high frequency of resistance to cefuroxime, cefaclor, and erythromycin.
CONCLUSIONS
It is necessary for Chinese children to receive PCV13. Clinical workers should pay attention to the high frequency of resistance to antimicrobial agents.
Topics: Anti-Bacterial Agents; Child; Child Health; China; Drug Resistance, Bacterial; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Prevalence; Serogroup; Streptococcus pneumoniae
PubMed: 31797324
DOI: 10.1007/s42770-019-00198-9