ArticlePublic health2025
Public health effects of adult pneumococcal vaccination choice amid increased serotype 4 rates in US subpopulations.
Article in Public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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
2 citing papers in PubMed.
- Economic Evaluation of PCV21 Use in Populations with Increasing Serotype 4 Invasive Pneumococcal Disease in the US: An Attributable Fraction Threshold Analysis.Infectious diseases and therapy · 2026Article
- What is driving the resurgence and persistence of vaccine-targeted pneumococcal serotypes?-Serotype 19F as the paradigm.PLoS pathogens · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectivesPneumococcal serotype 4 illness surged among some US Native American and homeless populations. The impact of potential serotype 4 rate increases on US adult pneumococcal conjugate vaccine (PCV) options is unclear. STUDY
designDecision analysis.
methodsA Markov model estimated differences in public health effects in US 50- and 65-year-old cohorts between 21-valent PCV (PCV21), which does not contain serotype 4, and 20-valent PCV (PCV20), which does contain it, tracking outcome differences resulting from serotype 4 illness rate increases from 0 to 6 per 100,000 over baseline annual rates. CDC data informed vaccine serotype-specific pneumococcal disease risks. Model parameters were varied in deterministic and probabilistic sensitivity analyses.
resultsAt a baseline serotype 4 disease risk of <1 per 100,000, PCV21 resulted in fewer lifetime pneumococcal disease cases in 50- and 65-year-olds compared to PCV20 and gained lifetime quality-adjusted life years. In 50-year-olds, absolute increases in serotype 4 illness rates of ≥3 per 100,000 and in 65-year-olds increases >5 per 100,000 (i.e., to levels not observed in US national or regional data) were necessary for PCV21 to become unfavorable. Results were robust in sensitivity analyses.
conclusionsPCV21 was favored in US 50- and 65-year-olds unless potentially implausible general population increases in serotype 4 illness occur.
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Registered trials
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.