Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Invasive Disease Caused by Serotype 3 in Children: A Systematic Review and Meta-analysis of Observational Studies

Sings, Heather L.
De Wals, Philippe
Gessner, Bradford D.
Isturiz, Raul
Laferriere, Craig
McLaughlin, John M.
Pelton, Stephen
Schmitt, Heinz-Josef
Suaya, Jose A.
Jodar, Luis

¹Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer, Inc., Collegeville, Pennsylvania
²Department of Social and Preventive Medicine, Laval University, Quebec City, Canada
³Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer Canada, Inc., Kirkland, Quebec
⁴Boston University Schools of Medicine and Public Health, Massachusetts
⁵Boston Medical Center, Massachusetts
⁶Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer, Inc., Paris, France
⁷Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer, Inc., New York, New York

^*Correspondence: H. L. Sings, Pneumococcal Vaccines, Pfizer Inc, 500 Arcola Rd, Collegeville, PA 19426 ([email protected]).

Received 1 August 2018; editorial decision 16 October 2018; accepted 22 October 2018; published online October 23, 2018.

Clinical Infectious Diseases 68(12):p 2135-2143, June 15, 2019. | DOI: 10.1093/cid/ciy920

Abstract

The 13-valent pneumococcal conjugate vaccine (PCV13) is the only licensed PCV with serotype 3 polysaccharide in its formulation. Postlicensure PCV13 effectiveness studies against serotype 3 invasive pneumococcal disease (IPD) in children have shown inconsistent results. We performed a systematic review and meta-analysis of observational studies to assess PCV13 vaccine effectiveness (VE) for serotype 3 IPD in children. We systematically searched PubMed, Embase, and the Cochrane library for studies published before 14 August 2017. We identified 4 published studies and 2 conference posters that provided PCV13 VE estimates stratified by serotype. The pooled PCV13 VE against serotype 3 IPD from the random-effects meta-analysis was 63.5% (95% confidence interval [CI], 37.3%–89.7%). A sensitivity analysis including conference posters gave a pooled VE estimate of 72.4% (95% CI, 56.7%–88.0%). The pooled data from case-control studies with similar methodologies and high quality support direct PCV13 protection against serotype 3 IPD in children.