Comparing pneumococcal conjugate vaccine schedules based on 3 and 2 primary doses: Systematic review and meta-analysis.


Scott, P; Rutjes, AW; Bermetz, L; Robert, N; Scott, S; Lourenço, T; Egger, M; Low, N; (2011) Comparing pneumococcal conjugate vaccine schedules based on 3 and 2 primary doses: Systematic review and meta-analysis. Vaccine, 29 (52). pp. 9711-21. ISSN 0264-410X DOI: 10.1016/j.vaccine.2011.07.042

Full text not available from this repository.

Abstract

BACKGROUND: Pneumococcal conjugate vaccines (PCV) were first licensed for use with 3 primary doses in infancy and a booster dose. The evidence for the effects of different schedules was examined in this systematic review and meta-analysis. METHODS: We searched 12 databases and trial registers up to March 2010. We selected randomised controlled trials (RCTs), cohort and case-control studies making direct comparisons between PCV schedules with (2p) or (3p) primary doses, with (+1) or without (+0) a booster dose. We extracted data on clinical, nasopharyngeal carriage and immunological outcomes and used meta-analysis to combine results where appropriate. RESULTS: Seropositivity levels (antibody concentration ?0.35?g/ml) following 3p and 2p PCV schedules were high for most serotypes (5 RCTs). Differences between schedules were generally small and tended to favour 3p schedules, particularly for serotypes 6B and 23F; between-study heterogeneity was high. Seropositivity levels following 3p+1 and 2p+1 schedules were similar but small differences favouring 3p+1 schedules were seen for serotypes 6B and 23F. We did not identify any RCTs reporting clinical outcomes for these comparisons. In 2 RCTs there was weak evidence of a reduction in carriage of S. pneumoniae serotypes included in the vaccine when 3p+0 schedules were compared to 2p+0 at 6 months of age. CONCLUSIONS: Most data about the relative effects of different PCV schedules relate to immunological outcomes. Both 3p and 2p schedules result in high levels of seropositivity. The clinical relevance of differences in immunological outcomes between schedules is not known. There is an absence of clinical outcome data from RCTs with direct comparisons of any 2p with any 3p PCV schedule.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Medical Statistics
Research Centre: Vaccine Centre
PubMed ID: 21821080
Web of Science ID: 298623000025
URI: http://researchonline.lshtm.ac.uk/id/eprint/55437

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
283Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item