Peer-reviewed article
Clinical effectiveness and impact of 13-valent pneumococcal conjugate vaccines in preventing invasive pneumococcal disease among children with risk conditions: A systematic literature review.
Kyla Hayford, Maria J Tort, Liping Huang, Carol Forbes, Iwona Pustulka et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review examined how effective the 13-valent pneumococcal conjugate vaccine (PCV13) is at preventing serious pneumococcal infections in children with weakened immune systems or chronic health conditions. Researchers searched medical databases and found 11 studies showing the vaccine was 84-91% effective at preventing PCV13-type invasive pneumococcal disease in immunocompromised children. After PCV13 was introduced into vaccination programs, invasive pneumococcal disease dropped significantly in children with sickle cell disease (86-100% reduction) and cancer (55-80% reduction). The evidence supports vaccinating high-risk children, though the available studies were limited and varied in their findings.
Key points
- Vaccine effectiveness against PCV13-type invasive pneumococcal disease ranged from 83.8% to 91% in children with immunocompromising conditions
- Introduction of PCV13 led to 86-100% relative reduction in invasive pneumococcal disease in children with sickle cell disease compared to pre-vaccine era
- In children with cancer, PCV13 introduction was associated with 55-80% reduction in invasive pneumococcal disease
- Impact of PCV13 in children with HIV varied widely (9.1% to 81% reduction) depending on comparison period, age group and outcome measured
- Systematic review identified only 11 eligible studies despite screening 3,008 records, indicating limited evidence base
Limitations
The review found very limited evidence (only 11 studies) with heterogeneous study designs, populations, and outcomes, making it difficult to draw definitive conclusions. The document does not provide information about whether different risk groups (sickle cell disease, HIV, cancer, etc.) respond differently to vaccination, nor does it discuss barriers to vaccine access or implementation in resource-limited settings.
Abstract
Few studies have reported vaccine effectiveness (VE) and population-level impact of the 13-valent pneumococcal conjugate vaccination (PCV13) among children with immunocompromising or chronic medical conditions putting them at risk of developing pneumococcal disease. The objective of this systematic literature review (SLR) was to summarize the efficacy, effectiveness, and impact of PCV13 in the prevention of invasive pneumococcal disease (IPD) and all-cause pneumonia among children with risk conditions. Peer-reviewed studies published between January 2000 and July 2024 were identified in MEDLINE, Embase, CENTRAL, and CDSR. Of 3008 records identified, full texts of 189 studies (6.3%) were reviewed and 11 (0.4%) studies evaluating PCV13 alone or in combination with PCV7 were included. Vaccine effectiveness or impact of PCV13 was reported in children with sickle cell disease (SCD; n = 2), HIV (n = 4), post-transplant conditions (n = 1), cancer (n = 1), combined immunocompromising conditions (n = 1), combined chronic medical and immunocompromising conditions (n = 1), and congenital heart disease (n = 1). In children with immunocompromising conditions, VE against PCV13-type IPD ranged between 83.8% and 91%. Compared to the pre-PCV era, the introduction of PCV13 in pediatric immunization programs was associated with a relative reduction of IPD due to any serotype between 86% and 100% in children SCD and 55% to 80% in children with cancer. PCV impact, as measured by incidence rate reductions, among children with HIV varied by comparison period, age group and outcome and ranged from 9.1% to 81% for any IPD. These findings support PCV vaccination for children with risk conditions although evidence was limited and heterogeneous.