Clinical Epidemiology, Pfizer Inc, Paris, France.
Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA.
Expert Rev Vaccines. 2019 Dec;18(12):1243-1270. doi: 10.1080/14760584.2019.1675521.
: By preventing nasopharyngeal carriage acquisition among vaccinated persons, and thus reducing transmission, pneumococcal conjugate vaccines (PCVs) provide protection against pneumococcal vaccine serotypes among unvaccinated individuals. This systematic review assessed PCVs containing serotype 19A or cross-reactive 19F for 19A carriage effects.: Peer-reviewed literature was searched for manuscripts published between 1/1/2000 and 06/18/2018 assessing the impact of PCV on 19A carriage.: Fifty-five, 12, and 32 articles were identified for PCV7, PCV10, and PCV13, respectively. In two of four PCV7 randomized controlled trials (RCTs), 19A carriage was significantly higher in PCV7-vaccinated vs control subjects; in two of two PCV10 RCTs, there was no significant difference in 19A carriage and acquisition between PCV10-vaccinated (2 + 1 schedule) vs control subjects, apart from one timepoint (3 + 1 schedule); and one of one RCTs of PCV13 showed significant decreases in 19A carriage and acquisition in PCV13- vs PCV7-vaccinated (3 + 1 schedule) children. These findings were consistent with observational studies in which an increase or no change in 19A carriage was observed in 91% and 67% of PCV7 and PCV10 studies, respectively, whereas 87% of PCV13 studies documented a decrease. Countries in which serotype 19A transmission is substantial should consider the use of vaccines containing serotype 19A.
: 通过在接种人群中预防鼻咽携带的获得，从而减少传播，肺炎球菌结合疫苗（PCV）为未接种人群提供了针对疫苗血清型 19A 的保护。本系统评价评估了含有血清型 19A 或交叉反应性 19F 的 PCV 对 19A 携带的影响。: 检索了 2000 年 1 月 1 日至 2018 年 6 月 18 日期间发表的评估 PCV 对 19A 携带影响的同行评议文献。: 分别为 PCV7、PCV10 和 PCV13 确定了 55、12 和 32 篇文章。在四项 PCV7 随机对照试验（RCT）中的两项中，PCV7 疫苗接种者的 19A 携带率明显高于对照组；在两项 PCV10 RCT 中，除了一个时间点（3+1 方案）外，PCV10 疫苗接种者（2+1 方案）与对照组之间的 19A 携带和获得没有显著差异；一项 PCV13 RCT 表明，PCV13 组的 19A 携带和获得明显减少。这些发现与观察性研究一致，其中在 91%和 67%的 PCV7 和 PCV10 研究中观察到 19A 携带增加或无变化，而 87%的 PCV13 研究记录到减少。血清型 19A 传播量较大的国家应考虑使用含有血清型 19A 的疫苗。
