EFFECTIVENESS OF PNEUMOCOCCAL CONJUGATE VACCINES IN PREVENTING PNEUMONIA IN CHILDREN — A TARGETED LITERATURE REVIEW
Author(s)
Min Huang, PhD1, Zinan Yi, PhD1, Jipan Xie, MD, PhD2, Weiguang Xue, MSc3, Yanwen Xie, MSc4, Xin Chen, MPH5, Walter A. Orenstein, MD6, Audrey Yu, None2, Minda X. Lai, None2, Elamin Elbasha, BSc, MA, PhD7, Matthew S. Kelly, MD, MPH8.
1Merck & Co. Inc, North Wales, PA, USA, 2XL Source, Inc., Los Angeles, CA, USA, 3Analysis Group LTD., London, United Kingdom, 4Analysis Group, Inc., Los Angeles, CA, USA, 5Beijing Branch, Analysis Group International Consulting Co., Ltd., Beijing, China, 6School of Medicine, Emory University, Atlanta, GA, USA, 7Merck & Co. Inc, West Point, PA, USA, 8Arkansas Children’s Hospital, Little Rock, AR, USA.
1Merck & Co. Inc, North Wales, PA, USA, 2XL Source, Inc., Los Angeles, CA, USA, 3Analysis Group LTD., London, United Kingdom, 4Analysis Group, Inc., Los Angeles, CA, USA, 5Beijing Branch, Analysis Group International Consulting Co., Ltd., Beijing, China, 6School of Medicine, Emory University, Atlanta, GA, USA, 7Merck & Co. Inc, West Point, PA, USA, 8Arkansas Children’s Hospital, Little Rock, AR, USA.
OBJECTIVES: This study aimed to synthesize evidence on vaccine effectiveness (VE) of pneumococcal conjugate vaccines (PCVs) against pneumonia in children.
METHODS: A targeted literature review (TLR) was conducted to identify original studies estimating the reduction in incidence or risk of any pneumonia in children <5 years who were vaccinated with a PCV compared with those unvaccinated or under-vaccinated, excluding studies limited to invasive pneumonia. VEs were summarized separately for pneumococcal pneumonia and all-cause pneumonia.
RESULTS: The TLR identified 15 studies — three randomized controlled trials, five case-control studies, and seven cohort studies. Four studies focused on 7-valent PCV (PCV7), four on PCV10, five on PCV13, and three on PCV7/PCV13. Most studies estimated VE using 1 minus the incidence rate ratio, hazard ratio, or odds ratio. Three studies reported VEs for pneumococcal pneumonia, and 14 studies reported VEs for all-cause pneumonia, including 3 studies that reported VEs for bacterial pneumonia. The median (range) reported VE against pneumococcal pneumonia was 75.2% (61.0-84.6%) for PCV13 and 83.4% (77.0-89.8%) for PCV7/PCV13. The median (range) reported VE estimate against all-cause pneumonia was 24.8% (6.0-78.0%) for PCV7, 27.0% (8.7-56.0%) for PCV10, 19.0% (18.0-30.0%) for PCV13, and 16.2% (12.2-20.1%) for PCV7/PCV13. Among studies reporting multiple pneumonia outcomes, VEs were generally higher for consolidated or bacterial pneumonia than for broader pneumonia outcomes. VEs were higher in fully vaccinated vs. incompletely vaccinated children (median difference: 9.0% across all PCVs), and in infants (<12 months) vs. older children (median difference: 8.1%).
CONCLUSIONS: This review supports the effectiveness of PCVs in preventing pneumonia, particularly pneumococcal pneumonia. Higher VE was generally observed among fully vaccinated children and in infants, although evidence was limited for these subgroups. Substantial variability across studies contributes to uncertainty in VE estimates. Future research using standardized methodologies is needed to address evidence gaps.
METHODS: A targeted literature review (TLR) was conducted to identify original studies estimating the reduction in incidence or risk of any pneumonia in children <5 years who were vaccinated with a PCV compared with those unvaccinated or under-vaccinated, excluding studies limited to invasive pneumonia. VEs were summarized separately for pneumococcal pneumonia and all-cause pneumonia.
RESULTS: The TLR identified 15 studies — three randomized controlled trials, five case-control studies, and seven cohort studies. Four studies focused on 7-valent PCV (PCV7), four on PCV10, five on PCV13, and three on PCV7/PCV13. Most studies estimated VE using 1 minus the incidence rate ratio, hazard ratio, or odds ratio. Three studies reported VEs for pneumococcal pneumonia, and 14 studies reported VEs for all-cause pneumonia, including 3 studies that reported VEs for bacterial pneumonia. The median (range) reported VE against pneumococcal pneumonia was 75.2% (61.0-84.6%) for PCV13 and 83.4% (77.0-89.8%) for PCV7/PCV13. The median (range) reported VE estimate against all-cause pneumonia was 24.8% (6.0-78.0%) for PCV7, 27.0% (8.7-56.0%) for PCV10, 19.0% (18.0-30.0%) for PCV13, and 16.2% (12.2-20.1%) for PCV7/PCV13. Among studies reporting multiple pneumonia outcomes, VEs were generally higher for consolidated or bacterial pneumonia than for broader pneumonia outcomes. VEs were higher in fully vaccinated vs. incompletely vaccinated children (median difference: 9.0% across all PCVs), and in infants (<12 months) vs. older children (median difference: 8.1%).
CONCLUSIONS: This review supports the effectiveness of PCVs in preventing pneumonia, particularly pneumococcal pneumonia. Higher VE was generally observed among fully vaccinated children and in infants, although evidence was limited for these subgroups. Substantial variability across studies contributes to uncertainty in VE estimates. Future research using standardized methodologies is needed to address evidence gaps.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO182
Topic
Clinical Outcomes, Epidemiology & Public Health
Topic Subcategory
Clinical Outcomes Assessment
Disease
Pediatrics, Vaccines