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. 2017 Oct 31;12(10):e0186903.
doi: 10.1371/journal.pone.0186903. eCollection 2017.

The full benefits of adult pneumococcal vaccination: A systematic review

Elizabeth T Cafiero-Fonseca  1   2 , Andrew Stawasz  1 , Sydney T Johnson  1   3 , Reiko Sato  4 , David E Bloom  1   5
Affiliations

The full benefits of adult pneumococcal vaccination: A systematic review

Elizabeth T Cafiero-Fonseca et al. PLoS One. .

Abstract

Background: Pneumococcal disease causes substantial morbidity and mortality, including among adults. Adult pneumococcal vaccines help to prevent these burdens, but they are underused. Accounting for the full benefits of adult pneumococcal vaccination may promote more rational resource allocation decisions with respect to adult pneumococcal vaccines.

Objectives: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to assess the extent to which the literature has empirically captured (e.g., through measurement or modeling) the full benefits of adult pneumococcal vaccination.

Methods: We systematically searched PubMed and Embase to identify studies published between January 1, 2010 and April 10, 2016 that examine adult pneumococcal vaccination. We included articles if they captured any health or economic benefit of an adult pneumococcal vaccine administered to adults age ≥ 50 or ≥ 18 in risk groups. Finally, we summarized the literature by categorizing the types of benefits captured, the perspective taken, and the strength of the evidence presented. Our protocol is number 42016038335 in the PROSPERO International prospective register of systematic reviews.

Results: We identified 5,857 papers and included 150 studies for analysis. While most capture health gains and healthcare cost savings, far fewer studies consider additional benefit categories, such as productivity gains. However, the studies with a broader approach still exhibit significant limitations; for example, many present only abstracts, while others offer no new measurements. Studies that examine the 13-valent pneumococcal conjugate vaccine focus more on broad economic benefits, but still have limitations.

Conclusions: This review highlights the need for more robust empirical accounting of the full benefits of adult pneumococcal vaccination. Literature outside this realm indicates that these broad benefits may be substantial. Failing to investigate the full benefits may lead society to undervalue vaccines' contributions and therefore underinvest in their development and adoption.

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Conflict of interest statement

Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: RS is an employee of Pfizer Inc., which manufactures and markets the 13-valent pneumococcal conjugate vaccine. DEB, ECF, and STJ are consultants of Data for Decisions, LLC. AS is an employee of Data for Decisions, LLC. Additionally, Pfizer Inc. to Data for Decisions, LLC funded this systematic review. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow diagram of study selection.
See this image and copyright information in PMC

References

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    1. Centers for Disease Control and Prevention. Pneumococcal disease In: Hamborsky J, Kroger A, Wolfe S, editors. Epidemiology and prevention of vaccine-preventable diseases. 13th ed. Washington, DC: Public Health Foundation; 2015. pp. 279–296.

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