Non-specific effects of Pneumococcal and Haemophilus vaccines in children aged 5 years and under: a systematic review

BMJ Open. 2023 Dec 14;13(12):e077717. doi: 10.1136/bmjopen-2023-077717.

Abstract

Objective: To determine the evidence for non-specific effects of the Pneumococcal and Haemophilus influenza vaccine in children aged 5 years and under.

Data sources: A key word literature search of MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, the European Union Clinical Trials Register and ClinicalTrials.gov up to June 2023.

Study eligibility criteria: Randomised controlled trials (RCTs), quasi-RCT or cohort studies.

Participants: Children aged 5 or under.

Study appraisal and synthesis methods: Studies were independently screened by two reviewers, with a third where disagreement arose. Risk of bias assessment was performed by one reviewer and confirmed by a second. Results were tabulated and a narrative description performed.

Results: Four articles were identified and included in this review. We found a reduction in hospitalisations from influenza A (44%), pulmonary tuberculosis (42%), metapneumovirus (45%), parainfluenza virus type 1-3 (44%), along with reductions in mortality associated with pneumococcal vaccine. No data on the Haemophilus vaccine was found.

Conclusions and implications: In this systematic review, we demonstrate that there is a reduction in particular viral infections in children aged 5 years and under who received the 9-valent pneumococcal conjugate vaccine which differ from those for which the vaccine was designed to protect against. While limited studies have demonstrated a reduction in infections other than those which the vaccine was designed to protect against, substantial clinical trials are required to solidify these findings.

Prospero registration number: CRD42020146640.

Keywords: Community child health; Paediatric infectious disease & immunisation; Public health; VIROLOGY.

Publication types

  • Systematic Review
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Cohort Studies
  • Haemophilus Vaccines*
  • Humans
  • Influenza, Human* / prevention & control
  • Pneumococcal Vaccines / therapeutic use
  • Streptococcus pneumoniae

Substances

  • Haemophilus Vaccines
  • Pneumococcal Vaccines