Department of Epidemiology, Biostatistics, and Occupational Health and.
Vaccine Study Centre, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
Pediatrics. 2020 Apr;145(4). doi: 10.1542/peds.2019-0377. Epub 2020 Mar 10.
Pneumococcal conjugate vaccines (PCVs) (pneumococcal 13-valent conjugate vaccine [PCV-13] and pneumococcal 10-valent conjugate vaccine [PCV-10]) are available for prevention of pneumococcal infections in children.
To determine the vaccine effectiveness (VE) of PCV-13 and PCV-10 in preventing invasive pneumococcal disease (IPD) and acute otitis media (AOM) in children <5 years.
Systematic searches of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Cochrane.
Eligible studies examined the direct effectiveness and/or efficacy of PCV-10 and PCV-13 in reducing the incidence of disease in healthy children <5 years.
Two reviewers independently conducted data extraction and methodologic quality assessment.
Significant effectiveness against vaccine-type IPD in children ≤5 years was reported for ≥1 dose of PCV-13 in the 3 + 1 (86%-96%) and 2 + 1 schedule (67.2%-86%) and for PCV-10 for the 3 + 1 (72.8%-100%) and 2 + 1 schedules (92%-97%). In children <12 months of age, PCV-13 VE against serotype 19A post-primary series was significant for the 3 + 1 but not the 2 + 1 schedule. PCV-10 crossprotection against 19A was significant in children ≤5 years with ≥1 dose (82.2% and 71%). Neither PCVs were found effective against serotype 3. PCV-13 was effective against AOM (86%; 95% confidence interval [CI]: 61 to 94). PCV-10 was effective against clinically defined (26.9%; 95% CI: 5.9 to 43.3) and bacteriologically confirmed AOM (43.3%; 95% CI: 1.7 to 67.3).
Because of the large heterogeneity in studies, a meta-analysis for pooled estimates was not done.
Both PCVs afford protection against pneumococcal infections, with PCV-10 protecting against 19A IPD, but this VE has not been verified in the youngest age groups.
肺炎球菌结合疫苗（PCV）（肺炎球菌 13 价结合疫苗[PCV-13]和肺炎球菌 10 价结合疫苗[PCV-10]）可用于预防儿童肺炎球菌感染。
确定 PCV-13 和 PCV-10 预防 5 岁以下儿童侵袭性肺炎球菌病（IPD）和急性中耳炎（AOM）的疫苗有效性（VE）。
系统检索 Medline、Embase、护理与联合健康文献累积索引、Web of Science 和 Cochrane。
合格的研究检查了 PCV-10 和 PCV-13 在降低 5 岁以下健康儿童疾病发病率方面的直接有效性和/或功效。
两名审查员独立进行数据提取和方法学质量评估。
在≥1 剂 3+1（86%-96%）和 2+1 方案（67.2%-86%）中，3+1 方案（72.8%-100%）和 2+1 方案（92%-97%）中报告了对≤5 岁儿童疫苗型 IPD 的显著有效性。在<12 个月龄的儿童中，PCV-13 对初级系列后血清型 19A 的 VE 在 3+1 方案中显著，但在 2+1 方案中不显著。在≥1 剂 PCV-10 中，对≤5 岁儿童的 19A 具有交叉保护作用（82.2%和 71%）。两种 PCV 均不能有效预防血清型 3。PCV-13 对 AOM 有效（86%；95%置信区间[CI]：61 至 94）。PCV-10 对临床定义的（26.9%；95%CI：5.9 至 43.3）和细菌学确诊的 AOM（43.3%；95%CI：1.7 至 67.3）有效。
由于研究之间存在很大的异质性，因此未对汇总估计值进行荟萃分析。
两种 PCV 均可提供针对肺炎球菌感染的保护，PCV-10 可预防 19A IPD，但这种 VE 尚未在年龄最小的人群中得到证实。
