SynthesisBMJ open2025
Systematic review and meta-analysis of the non-specific and broader impact of respiratory vaccines on acute lower respiratory infections in young children.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Maternal Influenza Vaccine Reduces the Risk of Respiratory Syncytial Virus and Related Respiratory Hospitalizations in Early Infancy: An Epidemiological Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesGrowing evidence suggests that vaccines targeting respiratory pathogens have non-specific and broader effects. We aimed to investigate the non-specific effects of respiratory vaccines on acute lower respiratory infection (ALRI) hospitalisations and associated outcomes in children <5 years. We also assessed broader effects of respiratory vaccines, including antimicrobial prescribing patterns.
designSystematic review and meta-analysis. DATA SOURCES: We searched online databases including Medline, Embase, CINAHL, Scopus and Clinical Trials.gov from inception to 24 January 2024. ELIGIBILITY CRITERIA: We included human studies involving non-specific/off-target effects of respiratory vaccines (including maternal, infant and childhood vaccines) and excluded studies investigating the Bacille Calmette-Guérin vaccine and non-pathogen-confirmed outcomes following pneumococcal conjugate vaccination (PCV). DATA EXTRACTION AND SYNTHESIS: We used Research Screener, a machine learning tool, to semi-automate the abstract screening process and Covidence, a management and streamlining software for full-text reviews and data extraction. A meta-analysis was conducted if four or more studies reported on the same outcome and the same exposure vaccine.
resultsAfter removing duplicates, 9727 articles were identified. After screening and full-text reviews, 20 articles were eligible. Of those, four met the requirements for a meta-analysis which showed a 21% vaccine effectiveness (VE) (95% CI 8.0% to 32.0%) of maternal influenza vaccine against all-cause ALRI hospitalisations in infants <6 months (heterogeneity: 46.0%, p<0.01). Neutral and beneficial non-specific effects were mostly observed for respiratory vaccines against pathogen-confirmed hospitalisations, with the largest reduction observed in Spanish children fully vaccinated with PCV against influenza-confirmed hospitalisations (adjusted OR, aOR=0.52, 95% CI 0.24 to 0.99). Three articles on antibiotic prescribing rates reported reductions in vaccine recipients with VE up to 14.5% (95%CI 9.6% to 19.2%). Respiratory vaccines had discrepant results with broader outcomes of wheezing, all-cause acute otitis media and all-cause mortality associated with respiratory infection hospitalisation.
conclusionsOur review demonstrated both protective and neutral non-specific effects of respiratory vaccines against ALRI-hospitalisations and related outcomes in young children. Such effects should be considered as part of the full value of a vaccine and how vaccine investments are prioritised. Further research on the impact of respiratory vaccines on antibiotic prescribing rates is essential as consistent reductions may help contribute to reducing the global burden of antimicrobial resistance. PROSPERO REGISTRATION NUMBER: CRD 42023476038.
Indexed as
Identifiers
What OpenQuestion holds
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.