Berild Jacob Dag, Winje Brita Askeland, Vestrheim Didrik Frimann, Slotved Hans-Christian, Valentiner-Branth Palle, Roth Adam, Storsäter Jann
Department of Vaccine Preventable Diseases, Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, 0213 Oslo, Norway.
Department of Bacteria, Parasites and Fungi, Statens Serum Institute, 2300 Copenhagen, Denmark.
Pathogens. 2020 Apr 3;9(4):259. doi: 10.3390/pathogens9040259.
Adult vaccination is high on the agenda in many countries. Two different vaccines are available for the prevention of pneumococcal disease in adults: a 23-valent polysaccharide vaccine (PPV23), and a 13-valent conjugated vaccine (PCV13). The objective of this review is to update the evidence base for vaccine efficacy and effectiveness of PPV23 and PCV13 against invasive pneumococcal disease and pneumonia among an unselected elderly population. We systematically searched for clinical trials and observational studies published between January 1 2016 and April 17 2019 in Pubmed, Embase, Cinahl, Web of Science, Epistemonikos and Cochrane databases. Risk of bias was assessed using Cochrane Risk of Bias tool for and the Newcastle-Ottawa Scale. Results were stratified by vaccine type and outcome. We identified nine studies on PCV13 and six on PPV23. No new randomized clinical trials were identified. Due to different outcomes, it was not possible to do a meta-analysis. New high-quality observational studies indicate protective vaccine effectiveness for both vaccines against vaccine type pneumonia. Our estimates for the protective vaccine efficacy and effectiveness (VE) of PPV23 on pneumonia and pneumococcal pneumonia overlap with results from previously published reviews. Some of the results indicate that the effectiveness of the PPV23 is best in younger age groups, and that it decreases over time.
成人疫苗接种在许多国家都被提上了重要议程。有两种不同的疫苗可用于预防成人肺炎球菌疾病：一种是23价多糖疫苗（PPV23），另一种是13价结合疫苗（PCV13）。本综述的目的是更新PPV23和PCV13在未筛选的老年人群中预防侵袭性肺炎球菌疾病和肺炎的疫苗效力和效果的证据基础。我们系统检索了2016年1月1日至2019年4月17日期间发表在PubMed、Embase、Cinahl、科学网、Epistemonikos和Cochrane数据库中的临床试验和观察性研究。使用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表评估偏倚风险。结果按疫苗类型和结局进行分层。我们确定了9项关于PCV13的研究和6项关于PPV23的研究。未发现新的随机临床试验。由于结局不同，无法进行荟萃分析。新的高质量观察性研究表明，这两种疫苗对疫苗型肺炎均具有保护性疫苗效果。我们对PPV23在肺炎和肺炎球菌肺炎方面的保护性疫苗效力和效果（VE）的估计与先前发表的综述结果重叠。一些结果表明，PPV23的效果在较年轻年龄组中最佳，并且会随着时间推移而降低。
