Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2019

Open Access 01-12-2019 | Vaccination | Research article

Effectiveness of pneumococcal conjugate vaccination against invasive pneumococcal disease among children with and those without HIV infection: a systematic review and meta-analysis

Authors: Hossein Molavi Vardanjani, Hodjat Borna, Ali Ahmadi

Published in: BMC Infectious Diseases | Issue 1/2019

Login to get access

Abstract

Background

HIV-infected children are at a higher risk of Invasive Pneumococcal Disease (IPD) and its mortality, even in the era of antiretroviral therapy. Therefore, an effective vaccination strategy would be beneficial. To investigate the effectiveness of Pneumococcal Conjugate Vaccination (PCV) against IPD among HIV-Infected and HIV-Uninfected Children through a systematic review and meta-analysis.

Methods

Observational studies and randomized trials on 7 years old or older children were searched in the Cochrane Library, Web of Science core collection, Embase, Medline/PubMed, and Google Scholar. Critical appraisal was done using the Cochrane risk of bias tool and the Newcastle-Ottawa quality assessment form. Effectiveness and efficacy of at least one dose of PCV was investigated among children with and without HIV considering subgroups of pneumococcal serotypes. We meta-analyzed the effect sizes using random-effects modeling.

Results

Efficacy of PCV was estimated as 45.0% (31.2, 56.1) and 52.6% (25.7, 69.8) among HIV-infected and HIV-uninfected children, respectively. Effectiveness of PCV among HIV-infected children as − 6.2% (− 67.6, 32.7) was significantly lower than HIV-uninfected children 65.1% (47.3, 76.9). Effectiveness of PCV among HIV-infected children for IPDs caused by vaccine serotypes was estimated as 7.7(− 66.7, 48.9), and for IPDs caused by non-vaccine serotypes was estimated as − 402.8(− 1856, − 29.2).

Conclusion

Unlike the evidence on the efficacy of PCV against IPD among both of HIV-infected and HIV-uninfected children, its effectiveness against IPD among HIV-infected children is much less limited.

Review registration

The study protocol was registered at PROSPERO (registration ID: CRD42018108187).
Appendix
Available only for authorised users
Literature
1.
Jones N, Huebner R, Khoosal M, Crewe-Brown H, Klugman K. The impact of HIV on Streptococcus pneumoniae bacteraemia in a south African population. AIDS. 1998;12:2177–84.CrossRef
2.
Theodoratou E, McAllister DA, Reed C, Adeloye DO, Rudan I, Muhe LM, et al. Global, regional, and national estimates of pneumonia burden in HIV-infected children in 2010: a meta-analysis and modelling study. Lancet Infect Dis. 2014;14:1250–8.CrossRef
3.
Madhi SA, Petersen K, Madhi A, Wasas A, Klugman KP. Impact of human immunodeficiency virus type 1 on the disease spectrum of Streptococcus pneumoniae in south African children. Pediatr Infect Dis J. 2000;19:1141–7.CrossRef
4.
Von Mollendorf C, Von Gottberg A, Tempia S, Meiring S, De Gouveia L, Quan V, et al. Increased risk for and mortality from invasive pneumococcal disease in HIV-exposed but uninfected infants aged< 1 year in South Africa, 2009–2013. Clin Infect Dis. 2015;60:1346–56.CrossRef
5.
von Gottberg A, de Gouveia L, Tempia S, Quan V, Meiring S, von Mollendorf C, et al. Effects of vaccination on invasive pneumococcal disease in South Africa. N Engl J Med. 2014;371:1889–99.CrossRef
6.
Nunes MC, von Gottberg A, de Gouveia L, Cohen C, Kuwanda L, Karstaedt AS, et al. Persistent high burden of invasive pneumococcal disease in south African HIV-infected adults in the era of an antiretroviral treatment program. PLoS One. 2011;6:e27929.CrossRef
7.
Andrews NJ, Waight PA, George RC, Slack MP, Miller E. Impact and effectiveness of 23-valent pneumococcal polysaccharide vaccine against invasive pneumococcal disease in the elderly in England and Wales. Vaccine. 2012;30:6802–8.CrossRef
8.
Poehling KA, Talbot TR, Griffin MR, Craig AS, Whitney CG, Zell E, et al. Invasive pneumococcal disease among infants before and after introduction of pneumococcal conjugate vaccine. Jama. 2006;295:1668–74.CrossRef
9.
Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, et al. Decline in invasive pneumococcal disease after the introduction of protein–polysaccharide conjugate vaccine. N Engl J Med. 2003;348:1737–46.CrossRef
10.
Pilishvili T, Lexau C, Farley MM, Hadler J, Harrison LH, Bennett NM, et al. Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. J Infect Dis. 2010;201:32–41.CrossRef
11.
Latifi-Navid H, Latifi-Navid S, Mostafaiy B, Jamalkandi SA, Ahmadi A. Pneumococcal disease and the effectiveness of the PPV23 vaccine in adults: a two-stage Bayesian meta-analysis of observational and RCT reports. Sci Rep. 2018;8:11051.CrossRef
12.
O'Brien KL, Hochman M, Goldblatt D. Combined schedules of pneumococcal conjugate and polysaccharide vaccines: is hyporesponsiveness an issue? Lancet Infect Dis. 2007;7:597–606.CrossRef
13.
Borrow R, Heath PT, Siegrist C-A. Use of pneumococcal polysaccharide vaccine in children: what is the evidence? Curr Opin Infect Dis. 2012;25:292–303.CrossRef
14.
Warnatz K. Dissecting CXCR5+ T cell populations–on the quest for a better understanding of B cell help during T dependent antibody responses. Eur J Immunol. 2006;36:1662–4.CrossRef
15.
Madhi SA, Klugman KP, Kuwanda L, Cutland C, Käyhty H, Adrian P. Quantitative and qualitative anamnestic immune responses to pneumococcal conjugate vaccine in HIV-infected and HIV-uninfected children 5 years after vaccination. J Infect Dis. 2009;199:1168–76.CrossRef
16.
Feikin DR, Kagucia EW, Loo JD, Link-Gelles R, Puhan MA, Cherian T, et al. Serotype-specific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites. PLoS Med. 2013;10:e1001517.CrossRef
17.
Weinberger DM, Malley R, Lipsitch M. Serotype replacement in disease after pneumococcal vaccination. Lancet. 2011;378:1962–73.CrossRef
18.
Cohen C, von Mollendorf C, de Gouveia L, Lengana S, Meiring S, Quan V, et al. Effectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in south African children: a case-control study. Lancet Glob Health. 2017;5:e359–e69.CrossRef
19.
Cohen C, von Mollendorf C, de Gouveia L, Naidoo N, Meiring S, Quan V, et al. Effectiveness of 7-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in HIV-infected and -uninfected children in South Africa: a matched case-control study. Clin Infect Dis. 2014;59:808–18.CrossRef
20.
Klugman KP, Madhi SA, Huebner RE, Kohberger R, Mbelle N, Pierce N. A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection. N Engl J Med. 2003;349:1341–8.CrossRef
21.
Jallow S, Madhi SA. Pneumococcal conjugate vaccine in HIV-infected and HIV-exposed, uninfected children. Expert Review Vaccines. 2017;16:453–65.CrossRef
22.
Bliss SJ, O'Brien KL, Janoff EN, Cotton MF, Musoke P, Coovadia H, et al. The evidence for using conjugate vaccines to protect HIV-infected children against pneumococcal disease. Lancet Infect Dis. 2008;8:67–80.CrossRef
23.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:e1000100.CrossRef
24.
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Bmj. 2011;343:d5928.CrossRef
25.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.CrossRef
26.
Madhi SA, Adrian P, Kuwanda L, Jassat W, Jones S, Little T, et al. Long-term immunogenicity and efficacy of a 9-valent conjugate pneumococcal vaccine in human immunodeficient virus infected and non-infected children in the absence of a booster dose of vaccine. Vaccine. 2007;25:2451–7.CrossRef
27.
Madhi SA, Kuwanda L, Cutland C, Klugman KP. The impact of a 9-valent pneumococcal conjugate vaccine on the public health burden of pneumonia in HIV-infected and -uninfected children. Clin Infect Dis. 2005;40:1511–8.CrossRef
28.
von Mollendorf C, Cohen C, de Gouveia L, Naidoo N, Meiring S, Quan V, et al. Risk factors for invasive pneumococcal disease among children less than 5 years of age in a high HIV prevalence setting, South Africa, 2010 to 2012. Pediatr Infect Dis J. 2015;34:27–34.CrossRef
29.
Steenhoff AP, Wood SM, Rutstein RM, Wahl A, McGowan KL, Shah SS. Invasive pneumococcal disease among human immunodeficiency virus-infected children, 1989-2006. Pediatr Infect Dis J. 2008;27:886–91.CrossRef
30.
Nzenze SA, Madhi SA, Shiri T, Klugman KP, de Gouveia L, Moore DP, et al. Imputing the direct and indirect effectiveness of childhood pneumococcal conjugate vaccine against invasive pneumococcal disease by surveying temporal changes in nasopharyngeal pneumococcal colonization. Am J Epidemiol. 2017;186:435–44.CrossRef
31.
Halloran ME, Haber M, Longini IM Jr, Struchiner CJ. Direct and indirect effects in vaccine efficacy and effectiveness. Am J Epidemiol. 1991;133:323–31.CrossRef
32.
Fine P, Eames K, Heymann DL. “Herd immunity”: a rough guide. Clin Infect Dis. 2011;52:911–6.CrossRef
33.
Shiri T, Datta S, Madan J, Tsertsvadze A, Royle P, Keeling MJ, et al. Indirect effects of childhood pneumococcal conjugate vaccination on invasive pneumococcal disease: a systematic review and meta-analysis. Lancet Glob Health. 2017;5:e51–e9.CrossRef
34.
Sigurdsson S, Erlendsdóttir H, Quirk SJ, Kristjánsson J, Hauksson K, Andrésdóttir BDI, et al. Pneumococcal vaccination: direct and herd effect on carriage of vaccine types and antibiotic resistance in Icelandic children. Vaccine. 2017;35:5242–8.CrossRef
35.
Smith C, Ding L, Gorbach P, Franco E, Kahn J. Who’s not protected in the herd? Factors associated with vaccine-type HPV in unvaccinated women. J Pediatr Adolesc Gynecol. 2017;31:89-93.CrossRef
36.
Balsells E, Guillot L, Nair H, Kyaw MH. Serotype distribution of Streptococcus pneumoniae causing invasive disease in children in the post-PCV era: a systematic review and meta-analysis. PLoS One. 2017;12:e0177113.CrossRef
37.
Muñoz-Almagro C, Jordan I, Gene A, Latorre C, Garcia-Garcia JJ, Pallares R. Emergence of invasive pneumococcal disease caused by nonvaccine serotypes in the era of 7-valent conjugate vaccine. Clin Infect Dis. 2008;46:174–82.CrossRef
38.
Weatherholtz R, Millar EV, Moulton LH, Reid R, Rudolph K, Santosham M, et al. Invasive pneumococcal disease a decade after pneumococcal conjugate vaccine use in an American Indian population at high risk for disease. Clin Infect Dis. 2010;50:1238–46.CrossRef
39.
Pilishvili T, Zell ER, Farley MM, Schaffner W, Lynfield R, Nyquist A-C, et al. Risk factors for invasive pneumococcal disease in children in the era of conjugate vaccine use. Pediatrics. 2010;126:e9-17.CrossRef
40.
Singleton RJ, Hennessy TW, Bulkow LR, Hammitt LL, Zulz T, Hurlburt DA, et al. Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. Jama. 2007;297:1784–92.CrossRef
41.
Bamford A, Kelleher P, Lyall H, Haston M, Zancolli M, Goldblatt D, et al. Serological response to 13-valent pneumococcal conjugate vaccine in children and adolescents with perinatally acquired HIV infection. AIDS (London, England). 2014;28:2033.CrossRef
42.
King JC Jr, Borkowsky W, Mahidhara N, Madore D, Shapiro ED, Rutstein RM, et al. Group-specific antibody levels surrounding invasive pneumococcal illness in children infected with human immunodeficiency virus. J Infect Dis. 2000;181:1817–21.CrossRef
43.
Goldblatt D, Southern J, Ashton L, Richmond P, Burbidge P, Tasevska J, et al. Immunogenicity and boosting after a reduced number of doses of a pneumococcal conjugate vaccine in infants and toddlers. Pediatr Infect Dis J. 2006;25:312–9.CrossRef
44.
van Gils EJ, Veenhoven RH, Hak E, Rodenburg GD, Bogaert D, Ijzerman EP, et al. Effect of reduced-dose schedules with 7-valent pneumococcal conjugate vaccine on nasopharyngeal pneumococcal carriage in children: a randomized controlled trial. Jama. 2009;302:159–67.CrossRef
45.
Vestrheim DF, Løvoll Ø, Aaberge IS, Caugant DA, Høiby EA, Bakke H, et al. Effectiveness of a 2+ 1 dose schedule pneumococcal conjugate vaccination programme on invasive pneumococcal disease among children in Norway. Vaccine. 2008;26:3277–81.CrossRef
46.
Miller E, Andrews NJ, Waight PA, Slack MP, George RC. Herd immunity and serotype replacement 4 years after seven-valent pneumococcal conjugate vaccination in England and Wales: an observational cohort study. Lancet Infect Dis. 2011;11:760–8.CrossRef
47.
Miller E, Andrews NJ, Waight PA, Slack MP, George RC. Effectiveness of the new serotypes in the 13-valent pneumococcal conjugate vaccine. Vaccine. 2011;29:9127–31.CrossRef
48.
Avni T, Mansur N, Leibovici L, Paul M. PCR using blood for diagnosis of invasive pneumococcal disease: systematic review and meta-analysis. J Clin Microbiol. 2010;48:489–96.CrossRef
49.
Musher DM, Montoya R, Wanahita A. Diagnostic value of microscopic examination of gram-stained sputum and sputum cultures in patients with bacteremic pneumococcal pneumonia. Clin Infect Dis. 2004;39:165–9.CrossRef
50.
Nunes MC, Madhi SA. Safety, immunogenicity and efficacy of pneumococcal conjugate vaccine in HIV-infected individuals. Hum Vaccin Immunother. 2012;8:161–73.CrossRef
51.
Madhi SA, Kuwanda L, Cutland C, Holm A, Käyhty H, Klugman KP. Quantitative and qualitative antibody response to pneumococcal conjugate vaccine among African human immunodeficiency virus-infected and uninfected children. Pediatr Infect Dis J. 2005;24:410–6.CrossRef
52.
Spoulou VI, Tsoumas DL, Papaevangelou VG, Mostrou GI, Theodoridou MC. Immunogenicity and immunological memory induced by a 7-valent pneumococcal CRM197 conjugate vaccine in symptomatic HIV-1 infected children. Vaccine. 2005;23:5289–93.CrossRef
Metadata
Title
Effectiveness of pneumococcal conjugate vaccination against invasive pneumococcal disease among children with and those without HIV infection: a systematic review and meta-analysis
Authors
Hossein Molavi Vardanjani
Hodjat Borna
Ali Ahmadi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2019
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-019-4325-4

Other articles of this Issue 1/2019

BMC Infectious Diseases 1/2019 Go to the issue

Research article

Molecular characteristics and virulence gene profiles of Staphylococcus aureus isolates in Hainan, China

Research article

Seroprevalence of Toxoplasma gondii among pregnant women attending antenatal clinics at Hawassa University comprehensive specialized and Yirgalem General Hospitals, in Southern Ethiopia

Research article

Prevalence of intestinal parasites and associated risk factors among inmates of Mekelle prison, Tigrai Region, Northern Ethiopia, 2017

Case report

Multiple food-borne trematodiases with profound systemic involvement: a case report and literature review

Research article

Geographic surveillance of community associated MRSA infections in children using electronic health record data

Research article

Risk factors of 90-day rehospitalization following discharge of pediatric patients hospitalized with mycoplasma Pneumoniae pneumonia

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits