The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.
The 23-Valent Pneumococcal Polysaccharide Vaccine. Part I. Efficacy of PPV in the Elderly: A Comparison of Meta-Analyses
Abstract
A 23-valent polysaccharide pneumococcal vaccine (PPV) has been available in the UK for more than 20 years and is currently recommended for use in high-risk groups (HRG) of 2+ years of age. The degree of protection afforded by the PPV remains a critical issue, although a number of randomised clinical trials and case-control studies (CCS) have been published. The aim of this work is to review the estimates on the efficacy of PPV against pneumococcal pneumonia and invasive pneumococcal disease (IPD) in the elderly and to perform a meta-analysis in order to obtain a pooled estimate of the level of protection in high and low risk individuals. These two groups of individuals are at the centre of the current debate on whether or not to extend the vaccination programme to all elderly individuals 65+. Only randomised and quasi-randomised studies are included in the analysis and results are compared with previous meta-analyses. The effect of the inclusion of observational studies is investigated in the sensitivity analysis. When taken with the results of other meta-analyses and observational studies, it appears that PPV offers protection against IPD in the general elderly population (VE = 65%; 95% CI: -49-92%) whereas it has a moderate effect in the high-risk elderly (VE = 20%; 95% CI: -188-78%). The vaccine has little or no effect against pneumonia (VE = 16% in the general elderly and -20% in HRG).
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In the citing paper
“The immune system changes with age in nearly every aspect, generally resulting in a decline in pathogen immunity with increased age.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [3]
In the citing paper
“ageing is associated with high morbidity and mortality rates for various infections and significant reductions in vaccine efficacy1-6”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [3]
In the citing paper
“A 23-valent polysaccharide vaccine against Streptococcus pneumoniae has been used for many years in the older population. Meta-analyses reported efficacy against invasive disease, but the efficacy against pneumonia is frequently in doubt, as results from clinical studies are inconclusive [167].”
From Aging of the immune system: Focus on inflammation and vaccination (2016) · cites this paper as [167]
Citations
Cites
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582
Zhang, Q., Wang, C., Zheng, M., Li, Y., Li, J., Zhang, L., Shang, X., & Yan, C. (2014) · Cerebrovascular Diseases · doi:10.1159/000369778 · Cited by 11,609
Dong, Y., Hao, L., Shi, Z., Wang, G., Zhang, Z., & Han, C. (2013) · Urologia Internationalis · doi:10.1159/000351405 · Cited by 4,557
The Protective Efficacy of Polyvalent Pneumococcal Polysaccharide Vaccine
Shapiro, E. D., Berg, A. T., AUSTRIAN, R. C., Schroeder, D., Parcells, V., Margolis, A., Adair, R. K., & Clemens, J. D. (1991) · New England Journal of Medicine · doi:10.1056/nejm199111213252101 · Cited by 1,050
(1997) · PsycEXTRA Dataset · doi:10.1037/e547512006-001 · Cited by 999
Users' Guides to the Medical Literature
Oxman, A. D. (1994) · JAMA · doi:10.1001/jama.1994.03520170077040 · Cited by 925
Pneumococcal polysaccharide vaccine efficacy. An evaluation of current recommendations
Butler, J. C. (1993) · JAMA · doi:10.1001/jama.270.15.1826 · Cited by 674
Oxman, A. D. (1994) · JAMA · doi:10.1001/jama.272.17.1367 · Cited by 486
7. Prevention of Pneumococcal Pneumonia by Vaccination
AUSTRIAN, R. C., Douglas, R. M., Schiffman, G., Coetzee, A., KOORNHOF, H. J., Hayden-Smith, S., & Reid, R. D. W. (1985) · University of Pennsylvania Press eBooks · doi:10.9783/9781512800135-009 · Cited by 401
Research works printed but not linked: 3
- Salisbury DM, Begg NT. Immunisation against infectious disease, Bicentenary Edition. London: HMSO, 1996.
- Johan Giesecke. Modern Infectious Disease Epidemiology. London: Edward Arnold, 1994.
- Gaillat J, Zmirou D, Mallaret MR, Rouhan D, Bru JP, Stahl JP et al. Essai clinique du vaccin antipneumococcique chez des personnes agees vivant en institution. Rev Epidem Sante Publ 1985; 33: 437-444.
Cited by
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Guidelines for the management of adult lower respiratory tract infections - Full version
Woodhead, M. A., Blasi, F., Ewig, S., Garau, J., Huchon, G., Ieven, M. M., Örtqvist, Å., Schaberg, T., Torres, A., van der Heijden, G. J. M. G., et al. (2011) · Clinical Microbiology and Infection · doi:10.1111/j.1469-0691.2011.03672.x · Cited by 949
“Melegaro and Edmunds [538] To study the efficacy of PPV in adults above 50 years of age SR 1A)”
Grijalva, C. G., Nuorti, J. P., Arbogast, P. G., Martin, S. W., Edwards, K. M., & Griffin, M. R. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60564-9 · Cited by 666
B-cell responses to vaccination at the extremes of age
Siegrist, C.-A., & Aspinall, R. (2009) · Nature Reviews Immunology · doi:10.1038/nri2508 · Cited by 659
“Similarly, responses to pneumococcal polysaccharide”
Immunisation against infectious disease
SALISBURY, D. M., Ramsay, M. E., & Noakes, K. (2006) · Stationery Office eBooks · Cited by 636
Guidelines for the management of adult lower respiratory tract infections - Summary
Woodhead, M. A., Blasi, F., Ewig, S., Garau, J., Huchon, G., Ieven, M. M., Örtqvist, Å., Schaberg, T., Torres, A., van der Heijden, G. J. M. G., et al. (2011) · Clinical Microbiology and Infection · doi:10.1111/j.1469-0691.2011.03602.x · Cited by 473
“adults [442–473].”
Metadata
- Authors
- Melegaro, A., & Edmunds, W. J.
- Affiliations
- University of Warwick (GB)
- City, University of London (GB)
- Corresponding author
- Melegaro, Alessia
- ORCID
- Melegaro, Alessia
- Venue
- European Journal of Epidemiology
- Published
- 2004-04
- Volume
- 19
- Issue
- 4
- Pages
- 353-363
- ISSN
- 0393-2990 (ISSN-L)
- 1573-7284
- OpenAlex
- W2010088615
- Cited by
- 185
- References
- 39
- Citations by year
- 2026: 2 · 2025: 2 · 2022: 3 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 11 · 2015: 9 · 2014: 8 · 2013: 13 · 2012: 15
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- European Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della Ricerca - Bocconi (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Life Sciences › Immunology and Microbiology › Microbiology › Microbial infections and disease research
- Keywords
- 23-valent pneumococcal polysaccharide vaccine, vaccine efficacy, older adults, invasive pneumococcal disease, pneumococcal pneumonia, high-risk groups
- MeSH terms
- Aged, Humans, Pneumococcal Infections, Pneumonia, Pneumococcal, Confidence Intervals, Odds Ratio, Randomized Controlled Trials as Topic, Risk Assessment, Pneumococcal Vaccines
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