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Comparing pneumococcal conjugate vaccine schedules based on 3 and 2 primary doses: systematic review and

Pippa Scott1, Anne W S Rutjes, Lilian Bermetz

  • 1Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland.

Vaccine
|August 9, 2011
PubMed

Insights

Pneumococcal conjugate vaccine (PCV) schedules with 3 primary doses generally show higher antibody levels than 2-dose schedules. Clinical outcomes are not yet well-established for PCV schedule comparisons.

Area of Science:

  • Immunology
  • Vaccinology
  • Public Health

Background:

  • Pneumococcal conjugate vaccines (PCV) were initially implemented with 3 primary infant doses and a booster.
  • Understanding the impact of different PCV dosing schedules is crucial for optimizing vaccine efficacy and public health strategies.

Purpose of the Study:

  • To systematically review and meta-analyze evidence on the effects of different pneumococcal conjugate vaccine (PCV) schedules.
  • To compare immunological, nasopharyngeal carriage, and clinical outcomes between various PCV dosing regimens.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs), cohort, and case-control studies.
  • Searched 12 databases and trial registers up to March 2010 for studies comparing PCV schedules with 2 or 3 primary doses, with or without a booster.
  • Extracted data on clinical, carriage, and immunological outcomes; meta-analysis used where appropriate.

Main Results:

  • Both 3-dose (3p) and 2-dose (2p) PCV schedules induce high seropositivity levels for most serotypes.
  • Differences in seropositivity between 3p and 2p schedules were generally small, favoring 3p, particularly for serotypes 6B and 23F.
  • Limited evidence suggests a potential reduction in nasopharyngeal carriage with 3p+0 compared to 2p+0 schedules; no RCTs reported clinical outcomes for direct PCV schedule comparisons.

Conclusions:

  • Current data predominantly focus on immunological outcomes of PCV schedules, with both 2p and 3p regimens yielding high seropositivity.
  • The clinical significance of observed immunological differences between PCV schedules remains unknown.
  • A significant gap exists in RCT data directly comparing the clinical outcomes of different 2p versus 3p PCV schedules.
Abstract

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