PDF(Pubmed)
Abstract：
UNASSIGNED: Vaccination of infants with pneumococcal conjugate vaccines (PCV) is recommended by the World Health Organization. Evidence is mixed regarding the differences in immunogenicity and efficacy of the different pneumococcal vaccines.
UNASSIGNED: In this systematic-review and network meta-analysis, we searched the Cochrane Library, Embase, Global Health, Medline, clinicaltrials.gov and trialsearch.who.int up to February 17, 2023 with no language restrictions. Studies were eligible if they presented data comparing the immunogenicity of either PCV7, PCV10 or PCV13 in head-to-head randomised trials of young children under 2 years of age, and provided immunogenicity data for at least one time point after the primary vaccination series or the booster dose. Publication bias was assessed via Cochrane\'s Risk Of Bias due to Missing Evidence tool and comparison-adjusted funnel plots with Egger\'s test. Individual participant level data were requested from publication authors and/or relevant vaccine manufacturers. Outcomes included the geometric mean ratio (GMR) of serotype-specific IgG and the relative risk (RR) of seroinfection. Seroinfection was defined for each individual as a rise in antibody between the post-primary vaccination series time point and the booster dose, evidence of presumed subclinical infection. Seroefficacy was defined as the RR of seroinfection. We also estimated the relationship between the GMR of IgG one month after priming and the RR of seroinfection by the time of the booster dose. The protocol is registered with PROSPERO, ID CRD42019124580.
UNASSIGNED: 47 studies were eligible from 38 countries across six continents. 28 and 12 studies with data available were included in immunogenicity and seroefficacy analyses, respectively. GMRs comparing PCV13 vs PCV10 favoured PCV13 for serotypes 4, 9V, and 23F at 1 month after primary vaccination series, with 1.14- to 1.54- fold significantly higher IgG responses with PCV13. Risk of seroinfection prior to the time of booster dose was lower for PCV13 for serotype 4, 6B, 9V, 18C and 23F than for PCV10. Significant heterogeneity and inconsistency were present for most serotypes and for both outcomes. Two-fold higher antibody after primary vaccination was associated with a 54% decrease in risk of seroinfection (RR 0.46, 95% CI 0.23-0.96).
UNASSIGNED: Serotype-specific differences were found in immunogenicity and seroefficacy between PCV13 and PCV10. Higher antibody response after vaccination was associated with a lower risk of subsequent infection. These findings could be used to compare PCVs and optimise vaccination strategies.
UNASSIGNED: The NIHR Health Technology Assessment Programme.
UNASSIGNED: In this systematic-review and network meta-analysis, we searched the Cochrane Library, Embase, Global Health, Medline, clinicaltrials.gov and trialsearch.who.int up to February 17, 2023 with no language restrictions. Studies were eligible if they presented data comparing the immunogenicity of either PCV7, PCV10 or PCV13 in head-to-head randomised trials of young children under 2 years of age, and provided immunogenicity data for at least one time point after the primary vaccination series or the booster dose. Publication bias was assessed via Cochrane\'s Risk Of Bias due to Missing Evidence tool and comparison-adjusted funnel plots with Egger\'s test. Individual participant level data were requested from publication authors and/or relevant vaccine manufacturers. Outcomes included the geometric mean ratio (GMR) of serotype-specific IgG and the relative risk (RR) of seroinfection. Seroinfection was defined for each individual as a rise in antibody between the post-primary vaccination series time point and the booster dose, evidence of presumed subclinical infection. Seroefficacy was defined as the RR of seroinfection. We also estimated the relationship between the GMR of IgG one month after priming and the RR of seroinfection by the time of the booster dose. The protocol is registered with PROSPERO, ID CRD42019124580.
UNASSIGNED: 47 studies were eligible from 38 countries across six continents. 28 and 12 studies with data available were included in immunogenicity and seroefficacy analyses, respectively. GMRs comparing PCV13 vs PCV10 favoured PCV13 for serotypes 4, 9V, and 23F at 1 month after primary vaccination series, with 1.14- to 1.54- fold significantly higher IgG responses with PCV13. Risk of seroinfection prior to the time of booster dose was lower for PCV13 for serotype 4, 6B, 9V, 18C and 23F than for PCV10. Significant heterogeneity and inconsistency were present for most serotypes and for both outcomes. Two-fold higher antibody after primary vaccination was associated with a 54% decrease in risk of seroinfection (RR 0.46, 95% CI 0.23-0.96).
UNASSIGNED: Serotype-specific differences were found in immunogenicity and seroefficacy between PCV13 and PCV10. Higher antibody response after vaccination was associated with a lower risk of subsequent infection. These findings could be used to compare PCVs and optimise vaccination strategies.
UNASSIGNED: The NIHR Health Technology Assessment Programme.
摘要：
■世界卫生组织推荐给婴儿接种肺炎球菌结合疫苗（PCV）。关于不同肺炎球菌疫苗的免疫原性和功效差异的证据参差不齐。
■在本系统综述和网络荟萃分析中，我们搜查了Cochrane图书馆,Embase,全球卫生,Medline,clinicaltrials.gov和试验搜索。谁。截至2023年2月17日，没有语言限制。如果他们提供了比较2岁以下幼儿的头对头随机试验中PCV7，PCV10或PCV13免疫原性的数据，并提供在初次疫苗接种系列或加强剂量后至少一个时间点的免疫原性数据。通过Cochrane的证据缺失导致的偏差风险工具和使用Egger检验的比较调整漏斗图评估发布偏差。向出版物作者和/或相关疫苗制造商要求个体参与者水平的数据。结果包括血清型特异性IgG的几何平均比（GMR）和血清感染的相对风险（RR）。血清感染定义为每个个体在初次疫苗接种后系列时间点和加强剂量之间的抗体升高。推测亚临床感染的证据。血清功效定义为血清感染的RR。我们还估计了启动后一个月IgG的GMR与加强剂量时血清感染的RR之间的关系。协议注册到PROSPERO,IDCRD42019124580。
■来自六大洲38个国家的47项研究符合资格。28和12项具有可用数据的研究包括在免疫原性和血清功效分析中，分别。比较PCV13与PCV10的GMR有利于PCV13的血清型4，9V，在初次疫苗接种系列后1个月和23F，与PCV13的1.14-至1.54-倍显著更高的IgG应答。PCV13血清型4、6B的加强剂量前血清感染的风险较低，9V,18C和23F比PCV10。大多数血清型和两种结果均存在显着的异质性和不一致性。初次接种后抗体升高2倍与血清感染风险降低54%相关(RR0.46,95%CI0.23-0.96)。
■在PCV13和PCV10之间的免疫原性和血清功效方面发现血清型特异性差异。疫苗接种后较高的抗体反应与随后感染的较低风险相关。这些发现可用于比较PCV和优化疫苗接种策略。
■NIHR卫生技术评估计划。
■在本系统综述和网络荟萃分析中，我们搜查了Cochrane图书馆,Embase,全球卫生,Medline,clinicaltrials.gov和试验搜索。谁。截至2023年2月17日，没有语言限制。如果他们提供了比较2岁以下幼儿的头对头随机试验中PCV7，PCV10或PCV13免疫原性的数据，并提供在初次疫苗接种系列或加强剂量后至少一个时间点的免疫原性数据。通过Cochrane的证据缺失导致的偏差风险工具和使用Egger检验的比较调整漏斗图评估发布偏差。向出版物作者和/或相关疫苗制造商要求个体参与者水平的数据。结果包括血清型特异性IgG的几何平均比（GMR）和血清感染的相对风险（RR）。血清感染定义为每个个体在初次疫苗接种后系列时间点和加强剂量之间的抗体升高。推测亚临床感染的证据。血清功效定义为血清感染的RR。我们还估计了启动后一个月IgG的GMR与加强剂量时血清感染的RR之间的关系。协议注册到PROSPERO,IDCRD42019124580。
■来自六大洲38个国家的47项研究符合资格。28和12项具有可用数据的研究包括在免疫原性和血清功效分析中，分别。比较PCV13与PCV10的GMR有利于PCV13的血清型4，9V，在初次疫苗接种系列后1个月和23F，与PCV13的1.14-至1.54-倍显著更高的IgG应答。PCV13血清型4、6B的加强剂量前血清感染的风险较低，9V,18C和23F比PCV10。大多数血清型和两种结果均存在显着的异质性和不一致性。初次接种后抗体升高2倍与血清感染风险降低54%相关(RR0.46,95%CI0.23-0.96)。
■在PCV13和PCV10之间的免疫原性和血清功效方面发现血清型特异性差异。疫苗接种后较高的抗体反应与随后感染的较低风险相关。这些发现可用于比较PCV和优化疫苗接种策略。
■NIHR卫生技术评估计划。
