Materiały źródłowe

• #1 Prior pneumococcal vaccination improves in-hospital mortality among elderly population hospitalized due to community-acquired pneumonia | BMC Pulmonary Medicine | Full Text

  https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02928-8

  Pneumococcal vaccination is a preventive method to reduce pneumonia related mortality. […] This study was conducted to assess the effects of prior pneumococcal vaccination in elderly pneumonia patients. […] The vaccinated group demonstrated a significant reduction in 30-day mortality (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.410.81; P0.01) and in-hospital mortality (HR 0.53, 95% CI0.370.78; P0.001) compared to the unvaccinated group in multivariate analysis. […] Among elderly hospitalized CAP patients, prior pneumococcal vaccination was associated with improved in-hospital mortality and 30-day mortality. […] Using the cross-sectional nationwide data on the elderly population hospitalized due to CAP in South Korea, we showed that prior vaccination was associated with improved in-hospital mortality and 30-day mortality. […] Prior pneumococcal vaccination in elderly populations is effective in improving in-hospital and 30-day mortalities among those hospitalized for pneumonia, however, it does not affect the length of admission duration.

• #2 Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.02.12.22270888v1.full-text

  The pneumococcal conjugate vaccines (PCVs) protect against diseases caused by Streptococcus pneumoniae, such as meningitis, bacteremia, and pneumonia. […] We found that LASSO achieved accurate and precise estimation, even in complex simulation scenarios where the association between outcome and all control variables was non-causal. […] The efficacy measured in RCTs is different from the actual vaccine impact on a population level that is, the reduction of disease burden in a population consisting of vaccinated and unvaccinated individuals in comparison with an otherwise similar but universally unvaccinated population after PCV introduction. […] Addressing the limitation of RCTs in vaccine impact estimation means finding a suitable unvaccinated comparison population, which is difficult, if not impossible, to identify.

• #3 Predicting vaccine effectiveness against invasive pneumococcal disease in children using immunogenicity data

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9640717/

  The strength of the immune response, as measured by antibody concentrations, varies between pneumococcal conjugate vaccines (PCVs). […] Linking immunogenicity and effectiveness is necessary to assess whether changes in immune response from currently recommended PCVs to next-generation vaccines could impact effectiveness. […] The results were compared to published aggregate values for vaccine effectiveness. The aggregate median predicted vaccine effectiveness values were similar to previously reported observed values for the United Kingdom (93% versus 90%), Australia (71% versus 70%), and Germany (91% versus 90%). […] These results demonstrate that IgG concentrations of next-generation PCVs can be used to generate reliable estimates of vaccine effectiveness for serotypes shared with established PCVs.

• #4 Predicting vaccine effectiveness against invasive pneumococcal disease in children using immunogenicity data | npj Vaccines

  https://www.nature.com/articles/s41541-022-00538-1

  The strength of the immune response, as measured by antibody concentrations, varies between pneumococcal conjugate vaccines (PCVs). […] Linking immunogenicity and effectiveness is necessary to assess whether changes in immune response from currently recommended PCVs to next-generation vaccines could impact effectiveness. […] The results were compared to published aggregate values for vaccine effectiveness. The aggregate median predicted vaccine effectiveness values were similar to previously reported observed values for the United Kingdom (93% versus 90%), Australia (71% versus 70%), and Germany (91% versus 90%). […] These results demonstrate that IgG concentrations of next-generation PCVs can be used to generate reliable estimates of vaccine effectiveness for serotypes shared with established PCVs.

• #5 Predicting vaccine effectiveness against invasive pneumococcal disease in children using immunogenicity data

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9640717/

  The objective of this work was to assess the utility of this method for predicting the serotype-specific effectiveness of next-generation PCVs. […] The current standard practice is to use the aggregate Cp value of 0.35g/mL, derived for PCV7 serotypes, to predict and compare VE for not only the original seven serotypes, but also additional serotypes whose efficacy has not been shown in trials. […] Therefore, the serotype-specific estimates for Cp and VE obtained using the method described here provides a more accurate prediction of the probable protection afforded by PCV13 for the serotypes in common with PCV7. […] This modeling method has the potential to better estimate the effectiveness of next-generation PCVs against the serotypes shared with the current PCV, and, thus, to better inform public health decisions.

• #6 Predicting vaccine effectiveness against invasive pneumococcal disease in children using immunogenicity data | npj Vaccines

  https://www.nature.com/articles/s41541-022-00538-1

  The objective of this work was to assess the utility of this method for predicting the serotype-specific effectiveness of next-generation PCVs. […] The predicted aggregate VE values are shown in Table 3. The median values for each prediction were close to the previously observed values for the United Kingdom (93% predicted versus 90% reported), Australia (71% versus 70%), and Germany (91% versus 90%). […] Therefore, the serotype-specific estimates for Cp and VE obtained using the method described here provides a more accurate prediction of the probable protection afforded by PCV13 for the serotypes in common with PCV7. […] Using currently available population-level data, the method can predict serotype-specific effectiveness in next-generation PCVs.

• #7 Implications of Cross-Reactivity and Cross-Protection for Pneumococcal Vaccine Development

  https://www.mdpi.com/2076-393X/12/9/974

  Pneumococcal vaccines are a cornerstone for the prevention of pneumococcal diseases, reducing morbidity and mortality in children and adults worldwide. […] Therefore, it is important to understand whether cross-reactive antibodies offer clinical protection against pneumococcal disease. […] Pneumococcal vaccines have demonstrated effectiveness in preventing IPD and, to a lesser extent, non-invasive disease, including non-bacteremic pneumonia and acute otitis media (AOM). […] However, pneumococcal disease still causes considerable morbidity and mortality, particularly among infants < 2 years of age and older adults. [...] The likelihood that a colonizing serotype will cause invasive disease, or serotype invasiveness, is quantified as a case-to-carrier ratio. [...] Cross-reactivity describes the phenomenon in which immune recognition molecules, such as antibodies, directed against one specific antigen bind to a different antigen.

• #8 Implications of Cross-Reactivity and Cross-Protection for Pneumococcal Vaccine Development

  https://www.mdpi.com/2076-393X/12/9/974

  Cross-protection is considered to be present when an immune response elicited with an organism or vaccine results in measurable protection against disease or infection by non-vaccine strains. […] The evaluation of vaccine-induced immunity often focuses on antibody responses, for which well-characterized, scalable assays are generally more technically feasible than for cellular/functional responses. […] Cross-reactive antibodies following pneumococcal vaccination are most commonly found between the closely related serotypes that are categorized in one serogroup. […] The specific conjugate chemistry used in a particular vaccine may contribute to cross-reactivity and cross-protection. […] The presence of such functional opsonic antibodies against a cross-reactive serotype may be a surrogate marker for cross-protection. […] Despite challenges, cross-opsonization stands as the most reliable surrogate of cross-protection. […] It seems inevitable that there will continue to be surprises regarding the relative importance of cross-protection among antigenically related pneumococcal serotypes.

• #9 Implications of Cross-Reactivity and Cross-Protection for Pneumococcal Vaccine Development

  https://www.mdpi.com/2076-393X/12/9/974

  Cross-protection is considered to be present when an immune response elicited with an organism or vaccine results in measurable protection against disease or infection by non-vaccine strains. […] The evaluation of vaccine-induced immunity often focuses on antibody responses, for which well-characterized, scalable assays are generally more technically feasible than for cellular/functional responses. […] Cross-reactive antibodies following pneumococcal vaccination are most commonly found between the closely related serotypes that are categorized in one serogroup. […] The specific conjugate chemistry used in a particular vaccine may contribute to cross-reactivity and cross-protection. […] The presence of such functional opsonic antibodies against a cross-reactive serotype may be a surrogate marker for cross-protection. […] Despite challenges, cross-opsonization stands as the most reliable surrogate of cross-protection. […] It seems inevitable that there will continue to be surprises regarding the relative importance of cross-protection among antigenically related pneumococcal serotypes.

• #10 Prior pneumococcal vaccination improves in-hospital mortality among elderly population hospitalized due to community-acquired pneumonia | BMC Pulmonary Medicine | Full Text

  https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02928-8

  Pneumococcal vaccination is a preventive method to reduce pneumonia related mortality. […] This study was conducted to assess the effects of prior pneumococcal vaccination in elderly pneumonia patients. […] The vaccinated group demonstrated a significant reduction in 30-day mortality (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.410.81; P0.01) and in-hospital mortality (HR 0.53, 95% CI0.370.78; P0.001) compared to the unvaccinated group in multivariate analysis. […] Among elderly hospitalized CAP patients, prior pneumococcal vaccination was associated with improved in-hospital mortality and 30-day mortality. […] Using the cross-sectional nationwide data on the elderly population hospitalized due to CAP in South Korea, we showed that prior vaccination was associated with improved in-hospital mortality and 30-day mortality. […] Prior pneumococcal vaccination in elderly populations is effective in improving in-hospital and 30-day mortalities among those hospitalized for pneumonia, however, it does not affect the length of admission duration.

• #11 Prior pneumococcal vaccination improves in-hospital mortality among elderly population hospitalized due to community-acquired pneumonia | BMC Pulmonary Medicine | Full Text

  https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02928-8

  Pneumococcal vaccination is a preventive method to reduce pneumonia related mortality. […] This study was conducted to assess the effects of prior pneumococcal vaccination in elderly pneumonia patients. […] The vaccinated group demonstrated a significant reduction in 30-day mortality (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.410.81; P0.01) and in-hospital mortality (HR 0.53, 95% CI0.370.78; P0.001) compared to the unvaccinated group in multivariate analysis. […] Among elderly hospitalized CAP patients, prior pneumococcal vaccination was associated with improved in-hospital mortality and 30-day mortality. […] Using the cross-sectional nationwide data on the elderly population hospitalized due to CAP in South Korea, we showed that prior vaccination was associated with improved in-hospital mortality and 30-day mortality. […] Prior pneumococcal vaccination in elderly populations is effective in improving in-hospital and 30-day mortalities among those hospitalized for pneumonia, however, it does not affect the length of admission duration.

• #12 Real-world effectiveness of pneumococcal vaccination in older adults: Cohort study using the UK Clinical Practice Research Datalink | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0275642

  The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for UK older adults, but how age moderates effectiveness is unclear. […] After adjustment for confounding using the prior event rate ratio (PERR) method, PPV23 was estimated to be effective against CAP for two years after vaccination in all age sub-groups with hazard ratios (95% confidence intervals) of 0.86 (0.80 to 0.93), 0.74 (0.65 to 0.85) and 0.65 (0.57 to 0.74) in patients aged 65-74, 75-79 and 80+ respectively in the 2005 cohort. […] PPV23 is moderately effective at reducing CAP among UK patients aged 65y, in the two years after vaccination. Vaccine effectiveness is maintained, and may increase, in the oldest age groups in step with increasing susceptibility to CAP. […] The finding that effectiveness may increase with age in the two years following vaccination with PPV23 demonstrates an important role mitigating against age-related susceptibility to infection with CAP. […] Crucially, we found that the vaccine remained effective, and may even increase in effectiveness, at older ages, supporting the targeting of the oldest old and most frail patients for PPV23 vaccination in order to reduce the burden of pneumococcal disease.

• #13 Real-world effectiveness of pneumococcal vaccination in older adults: Cohort study using the UK Clinical Practice Research Datalink | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0275642

  The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for UK older adults, but how age moderates effectiveness is unclear. […] After adjustment for confounding using the prior event rate ratio (PERR) method, PPV23 was estimated to be effective against CAP for two years after vaccination in all age sub-groups with hazard ratios (95% confidence intervals) of 0.86 (0.80 to 0.93), 0.74 (0.65 to 0.85) and 0.65 (0.57 to 0.74) in patients aged 65-74, 75-79 and 80+ respectively in the 2005 cohort. […] PPV23 is moderately effective at reducing CAP among UK patients aged 65y, in the two years after vaccination. Vaccine effectiveness is maintained, and may increase, in the oldest age groups in step with increasing susceptibility to CAP. […] The finding that effectiveness may increase with age in the two years following vaccination with PPV23 demonstrates an important role mitigating against age-related susceptibility to infection with CAP. […] Crucially, we found that the vaccine remained effective, and may even increase in effectiveness, at older ages, supporting the targeting of the oldest old and most frail patients for PPV23 vaccination in order to reduce the burden of pneumococcal disease.

• #14 Systematic Review and Meta-Analysis of the Efficacy and Effectiveness of Pneumococcal Vaccines in Adults

  https://www.mdpi.com/2076-0817/12/5/732

  Recent data continue to support that both PCV13 and PPSV23 are effective against VT-IPD in adults. […] This review supports findings from a similar review conducted earlier by NIPH that reported vaccine effectiveness from PCV13 and PPSV23 against VT- pneumonia, and PPSV23 against PPSV23-type IPD. […] Our review showed that PCV13 and PPSV23 are both effective against VT-IPD and VT-pneumococcal pneumonia in adults.

• #15 Estimated impact of the pneumococcal conjugate vaccine on pneumonia mortality in South Africa, 1999 through 2016: An ecological modelling study | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003537

  Data on the national-level impact of pneumococcal conjugate vaccine (PCV) introduction on mortality are lacking from Africa. […] This study found that the introduction of PCV was associated with substantial reduction in all-cause pneumonia deaths in children aged 1 month to 19 years. […] The model predicted an effect of PCV in age groups who were eligible for vaccination (1 months to 4 years), and an indirect effect in those too old (8 to 18 years) to be vaccinated. […] These findings support sustaining pneumococcal vaccination to reduce pneumonia-related mortality in children. […] We estimated that pneumonia mortality reduced between 23% and 33% in children younger than 19 years, with an estimated 18,000 deaths prevented between 2009 and 2016. […] Compared to the number of deaths expected in the absence of vaccination, there was a notable reduction in pneumonia mortality for all children 19 years following introduction of PCV.

• #16 Estimated impact of the pneumococcal conjugate vaccine on pneumonia mortality in South Africa, 1999 through 2016: An ecological modelling study | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003537

  Data on the national-level impact of pneumococcal conjugate vaccine (PCV) introduction on mortality are lacking from Africa. […] This study found that the introduction of PCV was associated with substantial reduction in all-cause pneumonia deaths in children aged 1 month to 19 years. […] The model predicted an effect of PCV in age groups who were eligible for vaccination (1 months to 4 years), and an indirect effect in those too old (8 to 18 years) to be vaccinated. […] These findings support sustaining pneumococcal vaccination to reduce pneumonia-related mortality in children. […] We estimated that pneumonia mortality reduced between 23% and 33% in children younger than 19 years, with an estimated 18,000 deaths prevented between 2009 and 2016. […] Compared to the number of deaths expected in the absence of vaccination, there was a notable reduction in pneumonia mortality for all children 19 years following introduction of PCV.

• #17 Estimated impact of the pneumococcal conjugate vaccine on pneumonia mortality in South Africa, 1999 through 2016: An ecological modelling study | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003537

  In total, an estimated 18,422 pneumonia-related deaths were prevented by PCV from 2009 to 2016 in children 19 years. […] This study estimated that the introduction of PCV in South Africa resulted in a notable reduction of all-cause pneumonia mortality in children eligible for vaccination, as well as those not eligible for vaccination, which is in-line with previous projections.

• #18 Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.02.12.22270888v1.full-text

  The pneumococcal conjugate vaccines (PCVs) protect against diseases caused by Streptococcus pneumoniae, such as meningitis, bacteremia, and pneumonia. […] We found that LASSO achieved accurate and precise estimation, even in complex simulation scenarios where the association between outcome and all control variables was non-causal. […] The efficacy measured in RCTs is different from the actual vaccine impact on a population level that is, the reduction of disease burden in a population consisting of vaccinated and unvaccinated individuals in comparison with an otherwise similar but universally unvaccinated population after PCV introduction. […] Addressing the limitation of RCTs in vaccine impact estimation means finding a suitable unvaccinated comparison population, which is difficult, if not impossible, to identify.

• #19 Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.02.12.22270888v1.full-text

  The pneumococcal conjugate vaccines (PCVs) protect against diseases caused by Streptococcus pneumoniae, such as meningitis, bacteremia, and pneumonia. […] We found that LASSO achieved accurate and precise estimation, even in complex simulation scenarios where the association between outcome and all control variables was non-causal. […] The efficacy measured in RCTs is different from the actual vaccine impact on a population level that is, the reduction of disease burden in a population consisting of vaccinated and unvaccinated individuals in comparison with an otherwise similar but universally unvaccinated population after PCV introduction. […] Addressing the limitation of RCTs in vaccine impact estimation means finding a suitable unvaccinated comparison population, which is difficult, if not impossible, to identify.

• #20 Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.02.12.22270888v1.full-text

  The primary endpoint in this study was all-cause pneumonia hospitalization, an established indicator for PCVs impact. […] We show that LASSO regression can achieve accurate counterfactual prediction for vaccine impact inference and offer a more thorough understanding about the PCVs impact on pneumococcal diseases in different age-groups and in different countries. […] The results from the simulation study showed that LASSO regression was able to estimate the pre-determined vaccine impact accurately and precisely, and its performance remained stable even under more complex data simulation procedures, such as the one without any causal variables. […] Overall, we found that LASSO regression allowed for accurate and precise estimation of vaccine impact and performs comparably to established methods, such as SC.

• #21 Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.02.12.22270888v1.full-text

  Our results showed that applying LASSO regression to pneumonia hospitalization data was sensitive to removing bronchitis and bronchiolitis from the pool of control variables subject to selection by LASSO. […] The validation using simulated data under a variety of scenarios and an application using epidemiological data in four countries in this study demonstrated LASSO regressions ability to estimate PCV impact.

• #22 Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 21-valent Pneumococcal Conjugate Vaccine (PCV21) Use among Adults Aged 50–64 Years Who Currently Do Not Have a Risk-Based Pneumococcal Vaccine Indication | ACIP | CDC

  https://www.cdc.gov/acip/grade/pcv21-non-risk-based-adults-50-64.html

  The certainty of evidence for use of PCV21 for adults aged 5064 years who currently do not have a risk-based pneumococcal vaccine indication was determined to be moderate for VT-IPD, VT-NBPP, and VT-pneumococcal mortality. […] The certainty of evidence for SAEs following immunization was determined to be moderate; assessment on imprecision was downgraded to serious because few vaccine-related serious adverse events were reported in studies with small sample sizes. […] On June 27, 2024, ACIP recommended the use of PCV21 as an option for adults aged 19 years who currently have a recommendation to receive a dose of PCV.

• #23 Grading of Recommendations, Assessment, Development, and Evaluation (GRADE): 21-valent Pneumococcal Conjugate Vaccine (PCV21) Use among Adults Aged 50–64 Years Who Currently Do Not Have a Risk-Based Pneumococcal Vaccine Indication | ACIP | CDC

  https://www.cdc.gov/acip/grade/pcv21-non-risk-based-adults-50-64.html

  The certainty of evidence for use of PCV21 for adults aged 5064 years who currently do not have a risk-based pneumococcal vaccine indication was determined to be moderate for VT-IPD, VT-NBPP, and VT-pneumococcal mortality. […] The certainty of evidence for SAEs following immunization was determined to be moderate; assessment on imprecision was downgraded to serious because few vaccine-related serious adverse events were reported in studies with small sample sizes. […] On June 27, 2024, ACIP recommended the use of PCV21 as an option for adults aged 19 years who currently have a recommendation to receive a dose of PCV.

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