Interchangeability between Pneumococcal Conjugate Vaccines: A Systematic Review and Meta-Analysis

CIAPPONI A,; LEE, A.; BARDACH, ARIEL; GARCIA MARTÍ, SEBASTIAN

ELSEVIER SCIENCE B. V.

ELSEVIER

Año: 2016

Objectives: To assess the efficacy, cost-effectiveness, immunogenicity,and safety related to the interchangeability between pneumococcalconjugate vaccines (PCVs) and vaccination schedules inpediatric population. Methods: Systematic searches were conductedin December 2010 and April 2015 for economic evaluations in MEDLINE,EMBASE, LILACS, and Cochrane Central Register of ControlledTrials. Web sites and databases from medical societies, experts, andassociations related to the topic, proceedings or congressional annals,and doctoral theses were also searched. No language or temporalrestriction was applied. We included randomized controlled trials,economic evaluations, and systematic reviews evaluating antibodyresponse, cost-effectiveness, and effectiveness of PCVs? interchangeability.A Strengthening the Reporting of Observational Studies inEpidemiology?based checklist was used to assess the risk of bias inobservational studies and a Cochrane approach for experimental/quasi-experimental studies. Pairs of reviewers independently selected(through the Web-based Early Reviewer Organizer Software), assessedthe quality, and extracted the data of the studies. Discrepancieswere resolved by consensus. We planned to perform meta-analysiswhenever appropriate. Results: Forty-six of 202 studies wereincluded. There was no direct information available on the interchangeabilitybetween PCVs. The immunogenicity and safety betweenthe 10-valent PCV (PCV10) and the 7-valent PCV were similar whenboth vaccines were coadministered with other routine pediatricvaccines. PCV10 and 13-valent PCV (PCV13) were consistently morecost-effective than 7-valent PCV. Conclusions: There was no directcomparative information available on the interchangeability amongPCVs, but they have pretty similar immunogenicity and safety. PCV10versus PCV13 cost-effectiveness varied according to price, indirecteffects, and indirect costs. PCV10 gains more quality-adjusted lifeyearsbecause of the prevention of more frequent yet less severeevents such as otitis media, and PCV13 prevents less frequent butmore costly events such as invasive diseases.