Evidence map›Paper›PMID 24760002›Full record

Trial reportPloS one2014

A randomized clinical trial of the immunogenicity of 7-valent pneumococcal conjugate vaccine compared to 23-valent polysaccharide vaccine in frail, hospitalized elderly.

C Raina Macintyre, Iman Ridda, Zhanhai Gao, Aye M Moa, Peter B McIntyre, John S Sullivan, Thomas R Jones, Andrew Hayen, Richard I Lindley

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Journal of preventive medicine and hygiene · 2026
    Article
  4. Observational
  5. Review
  6. Article
  7. Review
  8. Article
  9. Asplenia and spleen hypofunction.Nature reviews. Disease primers · 2022
    Review
  10. Article
  11. Frailty and COVID-19 mRNA Vaccine Antibody Response in the COVID-19 Community Research Partnership.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022
    Observational
  12. Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. A case series evaluating the serological response of adult asthma patients to the 23-valent pneumococcal polysaccharide vaccine.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2017
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

C Raina MacintyreSchool of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia; National Centre for Immunization Research and Surveillance (NCIRS), Westmead, Australia.
Iman RiddaSchool of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia.
Zhanhai GaoSchool of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia.
Aye M MoaSchool of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia.
Peter B McIntyreNational Centre for Immunization Research and Surveillance (NCIRS), Westmead, Australia.
John S SullivanCentral Clinical School, The University of Sydney, Sydney, Australia.
Thomas R JonesPfizer Vaccine Research, Pfizer, Pearl River, New York, United States of America.
Andrew HayenSchool of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia.
Richard I LindleyWestmead Clinical School, Westmead Hospital, and the George Institute for Global Health, The University of Sydney, Sydney, Australia.
UNSW Sydney · AUNational Centre for Immunisation Research & Surveillance · AUThe University of Sydney · AUPfizer (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElderly people do not mount strong immune responses to vaccines. We compared 23-valent capsular polysaccharide (23vPPV) alone versus 7-valent conjugate (PCV7) vaccine followed by 23vPPV 6 months later in hospitalized elderly.

methodsParticipants were randomized to receive 23vPPV or PCV7-23vPPV. Antibodies against serotypes 3, 4, 6A, 6B, 9V, 14, 18C, 19A, 19F, 23F were measured by enzyme-linked immunosorbent (ELISA) and opsonophagocytic (OPA) assays at baseline, 6 months and 12 months.

resultsOf 312 recruited, between 40% and 72% of subjects had undetectable OPA titres at baseline. After one dose, PCV7 recipients had significantly higher responses to serotypes 9V (both assays) and 23F (OPA only), and 23vPPV recipients had significantly higher responses to serotype 3 (ELISA), 19F and 19A (OPA only). In subjects with undetectable OPA titres at baseline, a proportionately greater rise in OPA titre (P<0.01) was seen for all serotypes after both vaccines. The GMT ratio of OPA was significantly higher at 12 months in the PCV7-23vPPV group for serotypes 6A, 9V, 18C and 23F. OPA titre levels for these serotypes increased moderately after 6 months, whereas immunity waned in the 23vPPV only arm.

conclusionWe did not show overwhelming benefit of one vaccine over the other. Low baseline immunity does not preclude a robust immune response, reiterating the importance of vaccinating the frail elderly. A schedule of PCV7-23vPPV prevents waning of antibody, suggesting that both vaccines could be useful in the elderly. Follow up studies are needed to determine persistence of immunity.

trial registrationThe Australian Clinical Trials Registry ACTRN12607000387426.

Indexed as

AgedAged, 80 and overAntibodies, BacterialFemaleFrail ElderlyHumansMalePneumococcal InfectionsPneumococcal VaccinesVaccines, Conjugate23-valent pneumococcal capsular polysaccharide vaccineAntibodies, BacterialPneumococcal VaccinesVaccines, Conjugate

Identifiers

PMID24760002
PMCPMC3997415
OpenAlexW1999337436

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.