Evidence map›Paper›PMID 40813096›Full record

SynthesisBMJ global health2025

Equity in protection: bridging global data gaps for an EBV vaccine-a systematic review and meta-analysis.

Marisa D Muckian, Ting Shi, Vesa Qarkaxhija, Simran Kapoor, Tomos Morgan, Helen R Stagg

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. 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

6 authors.

Marisa D MuckianDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK marisa.muckian@lshtm.ac.uk.ORCID 0000-0003-0419-3797
Ting ShiPopulation Health Sciences and Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-4101-4535
Vesa QarkaxhijaOld Medical School, The University of Edinburgh, UK, Edinburgh, UK.ORCID 0000-0002-3721-7567
Simran KapoorDivision of Reproductive and Developmental Sciences, The University of Edinburgh, Edinburgh, UK.
Tomos MorganOld Medical School, The University of Edinburgh, UK, Edinburgh, UK.
Helen R StaggDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.ORCID 0000-0003-4022-3447

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEpstein-Barr virus (EBV) is linked to multiple malignancies and autoimmune conditions, with different disease burdens globally. Pharmaceutical companies and researchers are placing substantial investment in the development of EBV vaccines. To ensure optimal vaccine roll-out, particularly in resource-limited settings, it is essential to have data on the age at acquisition of EBV. This study aimed to systematically review and meta-analyse seroprevalence by age and country, WHO region and country income level, identify knowledge gaps, and determine an approach to bridge these gaps.

methodsMEDLINE, Embase and Web of Science were searched on 22 March 2022 for studies that measured EBV seroprevalence by age. An updated search was conducted on 22 October 2022. There were no language restrictions. Papers were assessed for quality using an adapted version of the Downs and Black checklist. Seroprevalence by age was estimated using a fixed-effect (country) or random-effects (WHO region and income) meta-analysis. This review has been registered on PROSPERO (CRD42022349900).

resultsOnly one country (USA) had enough data for a country meta-analysis. WHO regional analyses revealed the Western Pacific region to have a higher seroprevalence in younger age groups than other WHO regions. Country income level better explained seroprevalence trends per age. Middle-income countries displayed a quicker rise to balance seroprevalence than high-income countries, with a 30% absolute increase in 0- to 4-year-olds in middle-income than in high-income countries (59% [95% CI 28 to 91%, I

conclusionThis first meta-analysis producing estimates of EBV seroprevalence by age provides crucial information to guide governments when using a vaccine for EBV. However, data variability and limited consistency of methodologies and EBV seroprevalence measurements hindered comprehensive meta-analyses across all WHO regions and countries. This study provides an interim framework for the extrapolation of seroprevalence using country-specific income levels to aid vaccine roll-out decisions. PROSPERO REGISTRATION NUMBER: CRD42022349900.

Indexed as

Epstein-Barr Virus InfectionsHerpesvirus VaccinesGlobal HealthHerpesvirus 4, HumanHumansSeroepidemiologic StudiesHerpesvirus VaccinesEpidemiologyGlobal HealthImmunisationPublic HealthVaccines

Identifiers

PMID40813096
PMCPMC12352159

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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.