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
. 2024 Sep 23;230(3):e657-e667.
doi: 10.1093/infdis/jiae125.

Effect of Pneumococcal Conjugate Vaccines on Viral Respiratory Infections: A Systematic Literature Review

Ingrid T Sepúlveda-Pachón  1 , Eileen M Dunne  2 , Germaine Hanquet  1 , Marc Baay  1 , Sonia Menon  1 , Luis Jodar  2 , Bradford D Gessner  2 , Christian Theilacker  2
Affiliations

Effect of Pneumococcal Conjugate Vaccines on Viral Respiratory Infections: A Systematic Literature Review

Ingrid T Sepúlveda-Pachón et al. J Infect Dis. .

Abstract

Background: In addition to preventing pneumococcal disease, emerging evidence indicates that pneumococcal conjugate vaccines (PCVs) might indirectly reduce viral respiratory tract infections (RTIs) by affecting pneumococcal-viral interactions.

Methods: We performed a systematic review of interventional and observational studies published during 2000-2022 on vaccine efficacy/adjusted effectiveness (VE) and overall effect of PCV7, PCV9, PCV10, or PCV13 against viral RTIs.

Results: Sixteen of 1671 records identified were included. Thirteen publications described effects of PCVs against viral RTIs in children. VE against influenza ranged between 41% and 86% (n = 4), except for the 2010-2011 influenza season. In a randomized controlled trial, PCV9 displayed efficacy against any viral RTI, human seasonal coronavirus, parainfluenza, and human metapneumovirus. Data in adults were limited (n = 3). PCV13 VE was 4%-25% against viral lower RTI, 32%-35% against coronavirus disease 2019 outcomes, 24%-51% against human seasonal coronavirus, and 13%-36% against influenza A lower RTI, with some 95% confidence intervals spanning zero. No protection was found against adenovirus or rhinovirus in children or adults.

Conclusions: PCVs were associated with protection against some viral RTI, with the strongest evidence for influenza in children. Limited evidence for adults was generally consistent with pediatric data. Restricting public health evaluations to confirmed pneumococcal outcomes may underestimate the full impact of PCVs.

Keywords: LRTI; lower tract respiratory infection; pneumococcal conjugate vaccine; pneumonia; viral.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. G. H., I. T. S., S. M., and M. B. are employees of P95 Epidemiology and Pharmacovigilance, which received funding from Pfizer to conduct the research described in this manuscript and for manuscript development. G. H. has also received personal fees from MSD, Sanofi Pasteur, Janssen, SNB, and Pfizer as speaker at an international meeting and as a member of advisory boards, outside the scope of the submitted work. E. M. D., L. J., C. T., and B. D. G. are employees of Pfizer, Inc, and may hold stocks or stock options. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flowchart.
Figure 2.
Figure 2.
Efficacy/effectiveness of pneumococcal conjugate vaccines (PCVs) against viral respiratory tract infection in children. “a” indicates efficacy; “b” indicates effectiveness; "c" similar to screening design. *Received all recommended doses for age. †Crude vaccine effectiveness calculated as 1 – case-population ratio × 100% given by the article. #PCV7 + influenza vaccine compared to influenza vaccine + placebo in participants who received all recommended doses for age. Abbreviations: CI, confidence interval; LRTI, lower respiratory tract infection; NR, not reported; PCV, pneumococcal conjugate vaccine; RCT, randomized controlled trial; RTI, respiratory tract infection; SARI, severe acute respiratory infection; VE, vaccine effectiveness.
Figure 3.
Figure 3.
Efficacy/effectiveness of 13-valent pneumococcal conjugate vaccine against viral lower respiratory tract infection in adults (outpatient and inpatient). “a” indicates effectiveness; “b” indicates efficacy. †Crude vaccine effectiveness calculated from data provided by the article. *Only inpatient setting. ◊99.3% confidence interval. ¥COVID-19 cases were diagnosed either clinically or with a stand-alone severe acute respiratory syndrome coronavirus 2 test. Abbreviations: CAP, community-acquired pneumonia; CI, confidence interval; COVID-19, coronavirus disease 2019; LRTI, lower respiratory tract infection; NC, noncomputable; RCT, randomized controlled trial; US, United States; VE, vaccine effectiveness.
See this image and copyright information in PMC

References

    1. Troeger C, Blacker B, Khalil IA, et al. . Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis 2018; 18:1191–210. - PMC - PubMed
    1. Yen CY, Wu WT, Chang CY, et al. . Viral etiologies of acute respiratory tract infections among hospitalized children—a comparison between single and multiple viral infections. J Microbiol Immunol Infect 2019; 52:902–10. - PMC - PubMed
    1. Bakaletz LO. Viral-bacterial co-infections in the respiratory tract. Curr Opin Microbiol 2017; 35:30–5. - PMC - PubMed
    1. Klein EY, Monteforte B, Gupta A, et al. . The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. Influenza Other Respir Viruses 2016; 10:394–403. - PMC - PubMed
    1. Liu Y, Ling L, Wong SH, et al. . Outcomes of respiratory viral-bacterial co-infection in adult hospitalized patients. EClinicalMedicine 2021; 37:100955. - PMC - PubMed

Publication types

MeSH terms