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Pneumococcal vaccines for sickle cell disease.
E G Davies1, C Riddington, R Lottenberg
1Host Defence Unit, Great Ormond Street Hospital, Great Ormond Street, London, UK, WC1N 3JH.
The Cochrane Database of Systematic Reviews
|February 20, 2004
Summary
Conjugate pneumococcal vaccines show promise for reducing infection risk in sickle cell disease patients, demonstrating good immunogenicity. Further trials are needed to confirm clinical effectiveness and optimal regimens.
Area of Science:
- Immunology
- Hematology
- Vaccinology
Background:
- Individuals with sickle cell disease face a heightened risk of fatal pneumococcal infections.
- Infants with sickle cell disease are particularly vulnerable, and conventional vaccines may be less effective.
- New conjugate pneumococcal vaccines offer potential for improved protection.
Purpose of the Study:
- To evaluate the efficacy of pneumococcal vaccines in reducing illness and death in sickle cell disease patients.
- To assess the effectiveness of both polysaccharide and conjugate pneumococcal vaccines.
Main Methods:
- Systematic review of randomized and quasi-randomized controlled trials.
- Searched multiple databases and contacted pharmaceutical companies and experts.
- Two independent reviewers selected studies, extracted data, and assessed quality.
Main Results:
- Five trials with 547 participants met inclusion criteria.
- Polysaccharide vaccine (PPV14) did not significantly reduce infection risk in children under three.
- Conjugate vaccines demonstrated increased immune response, including in infants, but clinical outcomes were not measured.
Conclusions:
- Conjugate pneumococcal vaccines are safe and immunogenic in general populations, including infants.
- Evidence suggests conjugate vaccines are suitable for individuals with sickle cell disease.
- Further randomized trials are necessary to determine optimal vaccination strategies and measure clinical effectiveness.