Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis

Abstract Background Pneumococcal disease, caused by Streptococcus pneumoniae, imposes a significant global health burden, particularly affecting vulnerable groups such as the elderly and immunocompromised. The 23-valent pneumococcal polysaccharide vaccine (PPV23) is designed to protect against 23 se...

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Main Authors: Muhammed Shabil, Shilpa Gaidhane, Suhas Ballal, Sanjay Kumar, Mahakshit Bhat, Shilpa Sharma, M. Ravi Kumar, Sarvesh Rustagi, Mahalaqua Nazli Khatib, Nishant Rai, Sanjit Sah, Edward Mawejje, Ganesh Bushi, Kiran Bhopte, Rachna Kathuria, Ambanna Yappalparvi
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Pneumonia
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Online Access:https://doi.org/10.1186/s41479-024-00149-5
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author Muhammed Shabil
Shilpa Gaidhane
Suhas Ballal
Sanjay Kumar
Mahakshit Bhat
Shilpa Sharma
M. Ravi Kumar
Sarvesh Rustagi
Mahalaqua Nazli Khatib
Nishant Rai
Sanjit Sah
Edward Mawejje
Ganesh Bushi
Kiran Bhopte
Rachna Kathuria
Ambanna Yappalparvi
author_facet Muhammed Shabil
Shilpa Gaidhane
Suhas Ballal
Sanjay Kumar
Mahakshit Bhat
Shilpa Sharma
M. Ravi Kumar
Sarvesh Rustagi
Mahalaqua Nazli Khatib
Nishant Rai
Sanjit Sah
Edward Mawejje
Ganesh Bushi
Kiran Bhopte
Rachna Kathuria
Ambanna Yappalparvi
author_sort Muhammed Shabil
collection DOAJ
description Abstract Background Pneumococcal disease, caused by Streptococcus pneumoniae, imposes a significant global health burden, particularly affecting vulnerable groups such as the elderly and immunocompromised. The 23-valent pneumococcal polysaccharide vaccine (PPV23) is designed to protect against 23 serotypes of Streptococcus pneumoniae. However, there is ongoing debate about its effectiveness in reducing all-cause mortality. This systematic review and meta-analysis aimed to evaluate the efficacy of PPV23 in reducing all-cause and pneumonia-related mortality among adults. Methods A systematic search was conducted across PubMed, Embase, and Web of Science, focusing on studies that evaluated the mortality outcomes of adults vaccinated with PPV23 compared to non-vaccinated adults. Both randomized controlled trials (RCTs) and observational studies were included, while case reports, case series, and non-human studies were excluded. Data extraction and quality assessment were facilitated by Nested Knowledge software, using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for RCTs. Results The search yielded 826 records, with 19 studies meeting the inclusion criteria. The pooled analysis of four RCTs showed no significant reduction in all-cause mortality (RR = 1.030; 95% CI: 0.945, 1.122). However, analysis of pneumonia-related mortality across various studies indicated a significant reduction (HR = 0.504; 95% CI: 0.316, 0.693). Moderate to high heterogeneity was noted in mortality studies, and a potential publication bias was identified. Conclusion The findings suggest that while PPV23 may not significantly reduce all-cause mortality, it is effective in reducing pneumonia-related mortality among adults, particularly in those at higher risk. These results support the continued use of PPV23 in targeted adult populations, emphasizing the need for more primary studies to explore its effectiveness across diverse groups.
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series Pneumonia
spelling doaj-art-2dadcd53349543b8840ae22c1d39a6982025-08-20T02:39:35ZengBMCPneumonia2200-61332024-12-0116111010.1186/s41479-024-00149-5Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysisMuhammed Shabil0Shilpa Gaidhane1Suhas Ballal2Sanjay Kumar3Mahakshit Bhat4Shilpa Sharma5M. Ravi Kumar6Sarvesh Rustagi7Mahalaqua Nazli Khatib8Nishant Rai9Sanjit Sah10Edward Mawejje11Ganesh Bushi12Kiran Bhopte13Rachna Kathuria14Ambanna Yappalparvi15University Center for Research and Development, Chandigarh UniversityOne Health Centre, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher EducationDepartment of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to be University)Department of Allied Healthcare and Sciences, Vivekananda Global UniversityDepartment of Medicine, National Institute of Medical Sciences, NIMS University RajasthanChandigarh Pharmacy College, Chandigarh Group of Colleges-JhanjeriDepartment of Chemistry, Raghu Engineering CollegeSchool of Applied and Life Sciences, Uttaranchal UniversityDivision of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher EducationDepartment of Biotechnology, Graphic Era, Deemed to be University, Clement Town DehradunDepartment of Paediatrics, Hospital and Research Centre, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil VidyapeethSchool of Public Health, Makerere University College of Health SciencesCenter for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospital, Saveetha UniversityIES Institute of Pharmacy, IES UniversityNew Delhi Institute of Management, Tughlakabad Institutional AreaSchool of Pharmaceutical Sciences, Lovely Professional UniversityAbstract Background Pneumococcal disease, caused by Streptococcus pneumoniae, imposes a significant global health burden, particularly affecting vulnerable groups such as the elderly and immunocompromised. The 23-valent pneumococcal polysaccharide vaccine (PPV23) is designed to protect against 23 serotypes of Streptococcus pneumoniae. However, there is ongoing debate about its effectiveness in reducing all-cause mortality. This systematic review and meta-analysis aimed to evaluate the efficacy of PPV23 in reducing all-cause and pneumonia-related mortality among adults. Methods A systematic search was conducted across PubMed, Embase, and Web of Science, focusing on studies that evaluated the mortality outcomes of adults vaccinated with PPV23 compared to non-vaccinated adults. Both randomized controlled trials (RCTs) and observational studies were included, while case reports, case series, and non-human studies were excluded. Data extraction and quality assessment were facilitated by Nested Knowledge software, using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for RCTs. Results The search yielded 826 records, with 19 studies meeting the inclusion criteria. The pooled analysis of four RCTs showed no significant reduction in all-cause mortality (RR = 1.030; 95% CI: 0.945, 1.122). However, analysis of pneumonia-related mortality across various studies indicated a significant reduction (HR = 0.504; 95% CI: 0.316, 0.693). Moderate to high heterogeneity was noted in mortality studies, and a potential publication bias was identified. Conclusion The findings suggest that while PPV23 may not significantly reduce all-cause mortality, it is effective in reducing pneumonia-related mortality among adults, particularly in those at higher risk. These results support the continued use of PPV23 in targeted adult populations, emphasizing the need for more primary studies to explore its effectiveness across diverse groups.https://doi.org/10.1186/s41479-024-00149-5PneumoniaPPV23VaccinationMeta-analysisMortality
spellingShingle Muhammed Shabil
Shilpa Gaidhane
Suhas Ballal
Sanjay Kumar
Mahakshit Bhat
Shilpa Sharma
M. Ravi Kumar
Sarvesh Rustagi
Mahalaqua Nazli Khatib
Nishant Rai
Sanjit Sah
Edward Mawejje
Ganesh Bushi
Kiran Bhopte
Rachna Kathuria
Ambanna Yappalparvi
Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis
Pneumonia
Pneumonia
PPV23
Vaccination
Meta-analysis
Mortality
title Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis
title_full Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis
title_fullStr Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis
title_full_unstemmed Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis
title_short Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis
title_sort mortality reduction with 23 valent pneumococcal polysaccharide vaccine a systematic review and meta analysis
topic Pneumonia
PPV23
Vaccination
Meta-analysis
Mortality
url https://doi.org/10.1186/s41479-024-00149-5
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