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Effectiveness of 2+1 PCV7 vaccination schedules in children under 2 years: A meta-analysis of impact studies

机译：2 + 1岁以下儿童2 + 1 PCV7疫苗接种计划的有效性：影响研究的荟萃分析

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摘要

Although a case control study suggested high effectiveness of the 2 + 1 PCV-7 vaccination, schedule against invasive pneumococcal disease (IPD) in children the results of impact studies in, different countries yield considerable differences in the magnitude of the effects. A systematic, literature review was conducted to identify all relevant studies on IPD incidence reduction after onset, of PCV7 vaccination programmes in children younger than 2 years of age given in the 2 + 1 schedule. The incidence rate ratio between IPI incidences for vaccine serotypes before and after beginning of the, vaccination programme was calculated for each study. Heterogeneity was assessed and attempts to, identify causes for heterogeneity were made. In the literature search 4 studies which fulfilled inclusion, criteria were identified. The summary estimates yielded an IRR 0.10 [0.04; 0.30] suggesting a 90%, incidence reduction. Heterogeneity was high with I-2 = 93%. Heterogeneity might be explained by, differences in vaccination rates, the way vaccination rates were assessed, matching of the periods of, vaccination and case ascertainment, time between onset of the vaccination programme and onset of, case ascertainment during the vaccination period and the length of the observation period after onset, of the vaccination programme. A study which started 3 years after onset of the vaccination programme, with vaccination rates >= 80% throughout the ascertainment period of the incidence rates reported a, 98% reduction in the incidence rates. A meta-analysis on IRR studies on reductions of the IPD, incidence in children <2 years of age suggested high effectiveness of the 2 + 1 vaccination schedule for PCV 7
机译：尽管一项病例对照研究表明2 + 1 PCV-7疫苗的有效性很高，但针对儿童侵袭性肺炎球菌疾病（IPD）的时间表影响研究的结果在不同的国家/地区产生的影响程度差异很大。进行了系统的文献综述，以鉴定在2 + 1时间表中针对2岁以下儿童中PCV7疫苗接种计划发作后IPD发病率降低的所有相关研究。在每项研究的开始之前和之后，针对疫苗血清型IPI发生率之间的发生率比率进行了计算。评估了异质性，并试图找出异质性的原因。在文献检索中完成纳入的4项研究中，确定了标准。汇总估算得出的内部收益率为0.10 [0.04; 0.30]表示发病率降低了90％。 I-2 = 93％时异质性很高。异质性可以通过以下方式解释：接种率的差异，评估接种率的方式，接种时间和疫苗确诊时间的匹配，疫苗接种计划开始和发病之间的时间，疫苗接种期间的确诊时间以及疫苗接种时间的长短接种计划开始后的观察期。一项从接种计划开始三年后开始的研究表明，在整个发病率确定期间，接种率> = 80％，报告的发病率降低了98％。关于IRR研究的荟萃分析，该研究涉及IPD减少，<2岁儿童的发病率，表明PCV 7的2 + 1疫苗接种计划非常有效

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