Evidence map›Paper›PMID 40318350›Full record

ArticleVaccine2025

Serotype specific pneumococcal vaccine effectiveness in children with sickle cell disease: A two-decade analysis.

Ziyu Zhang, Melike Yildirim, Pinar Keskinocak, Yazdani Basha Shaik Dasthagirisaheb, Sarah Hinderstein, Khang Tran, Molly Crockett, Meagan Burns, Hillary Johnson, Marija Popstefanija and 3 more

Abstract read
In one paragraph

Article in Vaccine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Incidence of Invasive Pneumococcal Disease in US Children by Risk Group, 1998-2023.Journal of the Pediatric Infectious Diseases Society · 2026
    Article
  2. Review
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

13 authors.

Ziyu ZhangH. Milton Stewart School of Industrial and Systems Engineering, Atlanta, GA, USA; Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, GA, USA.
Melike YildirimDepartment of Industrial and Systems Engineering, Wayne State University, Detroit, MI, USA; Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA. Electronic address: melike.y@wayne.edu.
Pinar KeskinocakH. Milton Stewart School of Industrial and Systems Engineering, Atlanta, GA, USA; Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, GA, USA.
Yazdani Basha Shaik DasthagirisahebDepartment of Pediatrics, Section of Infectious Diseases, Boston University, Chobanian and Averdisian School of Medicine, Boston, MA, USA.
Sarah HindersteinDepartment of Pediatrics, Section of Infectious Diseases and Global Health; Yale University School of Medicine, New Haven, CT, USA.
Khang TranLos Angeles County Department of Public Health, Los Angeles, CA, USA.
Molly CrockettMassachusetts Department of Public Health, Boston, MA, USA.
Meagan BurnsMassachusetts Department of Public Health, Boston, MA, USA.
Hillary JohnsonMassachusetts Department of Public Health, Boston, MA, USA.
Marija PopstefanijaMassachusetts Department of Public Health, Boston, MA, USA.
Lawrence C MadoffMassachusetts Department of Public Health, Boston, MA, USA.
Stephen I PeltonDepartment of Pediatrics, Section of Infectious Diseases, Boston University, Chobanian and Averdisian School of Medicine, Boston, MA, USA.
Inci YildirimDepartment of Pediatrics, Section of Infectious Diseases and Global Health; Yale University School of Medicine, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale Center for Infection and Immunity, Yale University, New Haven, CT, USA; Yale Institute for Global Health, Yale University, New Haven, CT, USA. Electronic address: inci.yildirim@yale.edu.

Funding

Systems investigation of vaccine responses in B cell depleted autoimmune patientsU19AI089992 · NIAID · YALE UNIVERSITY · PI David A. Hafler, RUTH R MONTGOMERY · 2010 to 2026
$50.4M
Immune signatures of vaccine responses in children with sickle cell diseaseR01AI181379 · NIAID · YALE UNIVERSITY · PI Albert C Shaw, Inci Burcin Yildirim · 2024 to 2026
$1.8M
NIAID NIH HHS R01 AI181379NIAID NIH HHS U19 AI089992
6 · The paper itself

Abstract

objectivesSickle cell disease (SCD) is the most common genetic hematologic disease globally and children with SCD are at increased risk for pneumococcal disease.

methodsWe utilized data from population-based enhanced surveillance for invasive pneumococcal disease (IPD) in children <18 years of age in Massachusetts from 2002 to 2020. We calculated incidence rates (IR) among children with SCD using bootstrapping resampling and incidence rate ratios (IRR) for pre- and post-PCV13 periods. Vaccine effectiveness (VE) was calculated as 100*(1-IRR), and PCV13 vaccine failure probability was predicted using a random forest model.

resultsChildren with SCD had higher IR during both pre-/post-PCV13 periods compared with otherwise healthy children 240.0/100,000 versus 4.6/100,000 in pre-PCV13 period (2002-2009); 172.7/100,000 versus 1.9/100,000 in post-PCV13 period (2011-2020), respectively. After widespread use of PCV7 for a decade, a modest reduction of 28.1 % (95% CI 25.9-37.2%) in the incidence of overall IPD during the post-PCV13 period was observed in children with SCD, whereas a more substantial 59.5% (96% CI 57.8-61.4%) reduction was observed in otherwise healthy children. There was a 60.8% (95% CI 55.2%-NA) reduction in the incidence of VST13 IPD in children with SCD and an 83.0% (95% CI 80.67-85.63%) reduction in children without underlying health condition. Overall, 61.1% of the remaining IPD among children with SCD were due to non-PCV13 serotypes (8, 10A, 15A,15B, 22F, 23B), many of which are included in expanded valency vaccines.

conclusionChildren with SCD continue to have higher rates of IPD compared with otherwise healthy children despite vaccination. Majority of the remaining disease is due to serotypes not included in vaccine formulations that have been used for the last two decades. Our study highlights the potential value of expanded valency vaccines and importance of risk-based vaccination strategies tailored for this vulnerable population.

Indexed as

Anemia, Sickle CellPneumococcal InfectionsPneumococcal VaccinesStreptococcus pneumoniaeVaccine EfficacyAdolescentChildChild, PreschoolFemaleHeptavalent Pneumococcal Conjugate VaccineHumansIncidenceInfantMaleMassachusettsSerogroup13-valent pneumococcal vaccineHeptavalent Pneumococcal Conjugate VaccinePneumococcal VaccinesIncidence rate (IR)Incidence rate ratio (IRR)Invasive pneumococcal disease (IPD)Risk-based vaccinationSickle cell disease (SCD)Vaccine effectiveness (VE)

Identifiers

PMID40318350
PMCPMC12859699

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Registered trials

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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.