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Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: A Systematic Review.
PLoS One. 2015; 10(8):e0135270.Plos

Abstract

INTRODUCTION

Pneumococcal conjugate vaccine (PCV) is included in the World Health Organization's routine immunization schedule and is recommended by WHO for vaccination in high-risk children up to 60 months. However, many countries do not recommend vaccination in older age groups, nor have donors committed to supporting extended age group vaccination. To better inform decision-making, this systematic review examines the direct impact of extended age group vaccination in children over 12 months in low and middle income countries.

METHODS

An a priori protocol was used. Using pre-specified terms, a search was conducted using PubMed, LILACS, Cochrane Infectious Diseases Group Specialized Register, Cochrane Central Register of Controlled Trials, CAB Abstracts, clinicaltrials.gov and the International Symposium on Pneumococci and Pneumococcal Diseases abstracts. The primary outcome was disease incidence, with antibody titers and nasopharyngeal carriage included as secondary outcomes.

RESULTS

Eighteen studies reported on disease incidence, immune response, and nasopharyngeal carriage. PCV administered after 12 months of age led to significant declines in invasive pneumococcal disease. Immune response to vaccine type serotypes was significantly higher for those vaccinated at older ages than the unimmunized at the established 0.2 ug/ml and 0.35 ug/ml thresholds. Vaccination administered after one year of age significantly reduced VT carriage with odds ratios ranging from 0.213 to 0.69 over four years. A GRADE analysis indicated that the studies were of high quality.

DISCUSSION

PCV administration in children over 12 months leads to significant protection. The direct impact of PCV administration, coupled with the large cohort of children missed in first year vaccination, indicates that countries should initiate or expand PCV immunization for extended age group vaccinations. Donors should support implementation of PCV as part of delayed or interrupted immunization for older children. For countries to effectively implement extended age vaccinations, access to affordably-priced PCV is critical.

Authors+Show Affiliations

Médecins Sans Frontières, Access Campaign, Geneva, Switzerland.School of Public Health, Boston University, Boston, Massachusetts, United States of America.Médecins Sans Frontières, Access Campaign, New York, New York, United States of America.Médecins Sans Frontières, Access Campaign, Geneva, Switzerland; Division of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26332848

Citation

Bonner, Kimberly, et al. "Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: a Systematic Review." PloS One, vol. 10, no. 8, 2015, pp. e0135270.
Bonner K, Welch E, Elder K, et al. Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: A Systematic Review. PLoS One. 2015;10(8):e0135270.
Bonner, K., Welch, E., Elder, K., & Cohn, J. (2015). Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: A Systematic Review. PloS One, 10(8), e0135270. https://doi.org/10.1371/journal.pone.0135270
Bonner K, et al. Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: a Systematic Review. PLoS One. 2015;10(8):e0135270. PubMed PMID: 26332848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: A Systematic Review. AU - Bonner,Kimberly, AU - Welch,Emily, AU - Elder,Kate, AU - Cohn,Jennifer, Y1 - 2015/09/02/ PY - 2015/01/09/received PY - 2015/07/20/accepted PY - 2015/9/3/entrez PY - 2015/9/4/pubmed PY - 2016/5/18/medline SP - e0135270 EP - e0135270 JF - PloS one JO - PLoS One VL - 10 IS - 8 N2 - INTRODUCTION: Pneumococcal conjugate vaccine (PCV) is included in the World Health Organization's routine immunization schedule and is recommended by WHO for vaccination in high-risk children up to 60 months. However, many countries do not recommend vaccination in older age groups, nor have donors committed to supporting extended age group vaccination. To better inform decision-making, this systematic review examines the direct impact of extended age group vaccination in children over 12 months in low and middle income countries. METHODS: An a priori protocol was used. Using pre-specified terms, a search was conducted using PubMed, LILACS, Cochrane Infectious Diseases Group Specialized Register, Cochrane Central Register of Controlled Trials, CAB Abstracts, clinicaltrials.gov and the International Symposium on Pneumococci and Pneumococcal Diseases abstracts. The primary outcome was disease incidence, with antibody titers and nasopharyngeal carriage included as secondary outcomes. RESULTS: Eighteen studies reported on disease incidence, immune response, and nasopharyngeal carriage. PCV administered after 12 months of age led to significant declines in invasive pneumococcal disease. Immune response to vaccine type serotypes was significantly higher for those vaccinated at older ages than the unimmunized at the established 0.2 ug/ml and 0.35 ug/ml thresholds. Vaccination administered after one year of age significantly reduced VT carriage with odds ratios ranging from 0.213 to 0.69 over four years. A GRADE analysis indicated that the studies were of high quality. DISCUSSION: PCV administration in children over 12 months leads to significant protection. The direct impact of PCV administration, coupled with the large cohort of children missed in first year vaccination, indicates that countries should initiate or expand PCV immunization for extended age group vaccinations. Donors should support implementation of PCV as part of delayed or interrupted immunization for older children. For countries to effectively implement extended age vaccinations, access to affordably-priced PCV is critical. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/26332848/Impact_of_Pneumococcal_Conjugate_Vaccine_Administration_in_Pediatric_Older_Age_Groups_in_Low_and_Middle_Income_Countries:_A_Systematic_Review_ L2 - https://dx.plos.org/10.1371/journal.pone.0135270 DB - PRIME DP - Unbound Medicine ER -