Dunne Eileen M, Hong Linge, Althouse Benjamin M, Hayford Kyla, Jodar Luis, Gessner Bradford D, Theilacker Christian
Pfizer, Inc., 500 Arcola Road, Collegeville, PA, 19426, USA.
Infect Dis Ther. 2025 Aug 19. doi: 10.1007/s40121-025-01211-5.
While pneumococcal conjugate vaccines (PCVs) are typically administered to infants using a three- or four-dose regimen, children may receive less immunogenic regimens due to missed doses or alternative schedules. The level of direct protection in children vaccinated with a single dose of PCV remains unclear.
We performed a systematic review of observational studies published during 2000-2024 on vaccine effectiveness (VE) of a single dose of PCV7, PCV10, or PCV13 against vaccine-type invasive pneumococcal disease (IPD) in children. Results were stratified by vaccine and age at administration, and meta-analysis performed to generate pooled VE estimates.
Twenty-seven studies met the inclusion criteria: nine reported VE for PCV7, four for PCV10, seven for PCV13, and seven reported VE separately for more than one PCV. For PCV7, pooled VE was 64.6% (95% CI 47.3, 76.2) when administered < 12 months or age unspecified and 81.6% (95% CI 72.5, 87.7) when given ≥ 12 months. For PCV10, pooled VE was 73.0% (95% CI - 29.4, 94.4) when age at vaccination was unspecified, and one study reported 68.0% (95% CI 17.6, 87.6) VE when administered ≥ 12 months. For PCV13, pooled VE was 56.8% (95% CI 44.1, 66.6) when administered < 12 months or age unspecified, and 79.2% (95% CI 65.5, 87.5) when given ≥ 12 months.
Available evidence demonstrates that a single dose of PCV provides protection against vaccine-type IPD, especially when administered after age 12 months. While complete vaccination according to licensed schedules provides optimal protection, our findings support single-dose catch-up programs for toddlers. Potential single-dose strategies for infants in humanitarian emergencies warrant further exploration.
虽然肺炎球菌结合疫苗（PCV）通常按照三剂或四剂方案给婴儿接种，但由于漏种或采用替代接种程序，儿童可能会接受免疫原性较低的接种方案。单剂PCV接种儿童的直接保护水平尚不清楚。
我们对2000年至2024年期间发表的关于单剂PCV7、PCV10或PCV13针对儿童疫苗型侵袭性肺炎球菌疾病（IPD）疫苗效力（VE）的观察性研究进行了系统评价。结果按疫苗和接种时年龄分层，并进行荟萃分析以生成合并的VE估计值。
27项研究符合纳入标准：9项报告了PCV7的VE，4项报告了PCV10的VE，7项报告了PCV13的VE，7项分别报告了一种以上PCV的VE。对于PCV7，接种时间小于12个月或未指定年龄时，合并VE为64.6%（95%CI 47.3，76.2），接种时间≥12个月时，合并VE为81.6%（95%CI 72.5，87.7）。对于PCV10，接种时年龄未指定时，合并VE为73.0%（95%CI -29.4，94.4），一项研究报告接种时间≥12个月时VE为68.0%（95%CI 17.6，87.6）。对于PCV13，接种时间小于12个月或未指定年龄时，合并VE为56.8%（95%CI 44.1，66.6），接种时间≥12个月时，合并VE为79.2%（95%CI 65.5，87.5）。
现有证据表明，单剂PCV可预防疫苗型IPD，尤其是在12个月龄后接种时。虽然按照许可的接种程序完成全程接种可提供最佳保护，但我们的研究结果支持为幼儿实施单剂补种计划。人道主义紧急情况下针对婴儿的潜在单剂接种策略值得进一步探索。
