ArticleThorax2019
Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination.
Article in Thorax, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 5 of them syntheses that pooled 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.
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.
Who cites it
77 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Systematic review on serotypes distribution of pneumococcal pneumonia in adults and the elderly.BMC public health · 2025Pooled it
- Serotype distribution of invasive and non-invasive pneumococcal disease in adults ≥65 years of age following the introduction of 10- and 13-valent pneumococcal conjugate vaccines in infant national immunization programs: a systematic literature review.Frontiers in public health · 2025Pooled it
- Recommendations and Health Technology Assessment (HTA) landscape evaluation for pediatric pneumococcal conjugate vaccines (PCV) in Europe: A systematic literature review.Human vaccines & immunotherapeutics · 2022Pooled it
- Burden of pneumococcal disease among adults in Southern Europe (Spain, Portugal, Italy, and Greece): a systematic review and meta-analysis.Human vaccines & immunotherapeutics · 2021Pooled it
- Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Invasive Disease Caused by Serotype 3 in Children: A Systematic Review and Meta-analysis of Observational Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Pooled it
- Trial
- Pre-existing influenza-specific nasal IgA or nasal viral infection does not affect live attenuated influenza vaccine immunogenicity in children.Clinical and experimental immunology · 2021Trial
- Overview of adult immunization in Finland: Successes, lessons learned and the way forward.Human vaccines & immunotherapeutics · 2026Review
- Burden of Invasive Pneumococcal Disease and Community-Acquired Pneumonia in Adults: Significant Adverse Outcomes and Costs beyond Direct Treatment.Infectious diseases and therapy · 2026Article
- Community-acquired bacterial meningitis in Southern Sweden 2013-2023: a population-based study of incidence, aetiology and diagnostic yield.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Global distribution and characteristics of pneumococcal serotypes in adults.Human vaccines & immunotherapeutics · 2025Review
- Pneumococcal vaccination offer and schedules in adults in EU countries: An update.Human vaccines & immunotherapeutics · 2025Review
- Molecular Epidemiology, Antimicrobial Resistance, and Clinical Characteristics ofAntibiotics (Basel, Switzerland) · 2025Article
- Rationale and design of the Pneumococcal Pneumonia Epidemiology, Urine Serotyping and Mental Outcomes (PNEUMO) study Europe.ERJ open research · 2025Article
- Trends of serotypes and resistance among Streptococcus pneumoniae in the UK and Ireland (1999-2019).The Journal of antimicrobial chemotherapy · 2025Article
- Real world effectiveness of antipneumococcal vaccination against pneumonia in adults: a population-based cohort study, Catalonia, 2019.BMC infectious diseases · 2025Article
- Recommendations on PCV20 vaccine in adults and at-risk populations.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Global impact of ten-valent and 13-valent pneumococcal conjugate vaccines on invasive pneumococcal disease in all ages (the PSERENADE project): a global surveillance analysis.The Lancet. Infectious diseases · 2025Article
- Update on the evolving landscape of pneumococcal capsule types: new discoveries and way forward.Clinical microbiology reviews · 2025Review
- Investigating two decades ofMicrobial genomics · 2025Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
31 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies.
methodsFor each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100.
resultsAfter five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively.
conclusionOverall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.
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