Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2002 Sep 30;30(5):269-81; discussion 281-3.
doi: 10.1016/s0212-6567(02)79027-6.

[Pneumococcal vaccine effectiveness in the elderly. Systematic review and meta-analysis]

[Article in Spanish]
J Puig-Barberà  1 , A Belenguer Varea, M Goterris Pinto, M J Brines Benlliure
Affiliations
Meta-Analysis

[Pneumococcal vaccine effectiveness in the elderly. Systematic review and meta-analysis]

[Article in Spanish]
J Puig-Barberà et al. Aten Primaria. .

Abstract
in English, Spanish

Aim: Estimate pneumococcal vaccine effectiveness in preventing Streptococcus pneumoniae illness in the elderly.

Design: Systematic review and meta-analysis. DATA SOURCE. MEDLINE, years 1964 to the 2000; EMBASE, from 1988 to the 2000; Cochrane Library, identified studies and previously published systematic reviews citations peruse, and contacts with field experts.

Study selection: Clinical trials, cohort and case-control studies, published in Spanish, English or French, that estimated pneumococcal disease rates in vaccinated or not vaccinated elderly.

Data extraction: The studies were valued independently by four investigators with predefined criteria of validity, such as results comparing rates of disease caused by serotypes included in the vaccine, random allocation, double blind design, included subjects pertaining to the same study base, and losses of less than 10% in clinical trials and 20% in observational studies.

Results: Eight clinical trials considered the relative risk (RR) of pneumococcal pneumonia, three did not make estimations on pneumonia originated by serotypes included in the vaccine and only one study fulfilled all the inclusion criteria. Vaccinated versus not vaccinated pneumococcal pneumonia RR was 0.86 (95%CI, 0.24 to 2.99). Vaccine effectiveness was 14% (95%CI, -199 to 76%). Ten studies performed estimations on the effectiveness of the vaccine on invasive disease by vaccine serotypes. Of these, two clinical trials and two observational studies fulfilled the required quality criteria. RR of invasive disease was of 0.68 (95%CI, 0.39-1.18); vaccine effectiveness was 32% (95%CI, 18-61%).

Conclusions: No evidence was found supporting pneumococcal vaccine effectiveness to reduce or avoid S. pneumoniae disease in the elderly.

Objetivo: Estimar la efectividad de la vacuna neumocócica para evitar enfermedad por Streptococcus pneumoniae en ancianos.

Diseño: Revisión sistemática y metaanálisis.

Fuentes de datos: MEDLINE, años 1964 a 2000; EMBASE, de 1988 a 2000; Cochrane Library, citas bibliográficas de estudios identificados, revisiones sistemáticas anteriores y contactos con otros autores.

Selección de los estudios: Ensayos clínicos, estudios de cohortes y de casos y controles, publicados en castellano, inglés o francés, que estimaron tasas de enfermedad neumocócica en ancianos vacunados y no vacunados.

Extracción de datos: Los estudios fueron valorados independientemente por 4 investigadores con criterios de validez predefinidos, tales como realizar estimaciones de tasas de enfermedad por serotipos incluidos en la vacuna, asignación aleatoria, doble enmascaramiento, pertenencia a una misma base del estudio de los sujetos incluidos y tasas de pérdida inferiores al 10% en ensayos clínicos y al 20% en los estudios observacionales.

Resultados: Ocho ensayos clínicos estimaron el riesgo relativo (RR) de neumonía neumocócica, tres no realizaron estimaciones sobre neumonía originada por serotipos incluidos en la vacuna y sólo uno de los 8 cumplió los criterios de inclusión. El RR de neumonía neumocócica de los vacunados, frente a los no vacunados, fue del 0,86 (intervalo de confianza [IC] del 95%, 0,24 a 2,99). La efectividad de la vacuna fue del 14% (IC del 95%, −199 al 76%).

Diez estudios llevaron a cabo estimaciones de la efectividad de la vacuna sobre enfermedad invasora por serotipos incluidos en la vacuna. De éstos, dos ensayos clínicos y dos estudios observacionales reunieron los criterios de calidad requeridos. El RR de enfermedad invasora fue de 0,68 (IC del 95%, 0,39 a 1,18). La efectividad de la vacuna fue del 32% (IC del 95%, −18 a 61%).

Conclusiones: No se encontraron pruebas de la efectividad de la vacuna neumocócica para reducir o evitar la enfermedad neumocócica en el anciano.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Fine M.J., Smith M.A., Carson C.A., Meffe F., Sankey S.S., Weiss-feld L.A. Efficacy of pneumococcal vaccination in adults. A meta-analysis of randomized controlled trials. Arch Intern Med. 1994;154:2666–2677. - PubMed
    1. CDC Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Morb Mortal Wkly Rep. 1997;46(RR-8):1–24. - PubMed
    1. Hutchison B.G., Oxman A.D., Shannon H.S., Lloyd S., Altmayer C.A., Thomas K. Clinical effectiveness of pneumococcal vaccine. Meta-analysis. Can Fam Physician. 1999;45:2381–2393. - PMC - PubMed
    1. Moore R.A., Wiffen P.J., Lipsky B.A. Are the pneumococcal polysaccharide vaccines effective? Meta-analysis of the prospective trials. BMC Fam Pract. 2000;1:1. - PMC - PubMed
    1. Subdirección General de Prestaciones y Evaluación de Tecnologías Sanitarias, Ministerio de Sanidad y Consumo Informe sobre la vacuna neumocócica. Med Clin (Barc) 1994;102:383–386. - PubMed

Substances

LinkOut - more resources