Evidence map›Paper›PMID 42322679›Full record

ReviewVaccine2026

Half a century of pneumococcal vaccination in sickle cell disease: Are we winning the battle or losing immunity?

Sumit Jamwal, Britney Omene, Abhishek Giri, Keyner Rojas, Subhasis Mohanty, Cecelia Calhoun, Lakshmanan Krishnamurti, Ruth R Montgomery, Albert C Shaw, Biree Andemariam and 1 more

Abstract readReview
In one paragraph

Review in Vaccine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Sumit JamwalSection of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA. Electronic address: sumit.jamwal@yale.edu.
Britney OmeneSection of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
Abhishek GiriSection of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
Keyner RojasSection of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA; Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Subhasis MohantySection of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Cecelia CalhounSection of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Lakshmanan KrishnamurtiSection of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
Ruth R MontgomerySection of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Albert C ShawSection of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Biree AndemariamNew England Sickle Cell Institute, Division of Hematology Oncology, University of Connecticut School of Medicine, Farmington, CT, USA.
Inci YildirimSection of Infectious Diseases, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA; Yale Center for Infection and Immunity, Yale University, New Haven, CT, USA; Epidemiology of Microbial Diseases, Yale School of Public Health, 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 Albert C Shaw · 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

Despite marked reductions in the rate of invasive pneumococcal disease (IPD) due to widespread use of penicillin prophylaxis and vaccination, individuals with sickle cell disease (SCD) remain at disproportionately high risk of pneumococcal infections. Pneumococcal conjugate vaccines (PCVs) have demonstrated improved immunogenicity over time by inducing T cell-dependent memory responses and have contributed significantly to reducing vaccine-type IPD in this population. However, persistent disease burden from non-vaccine serotypes and suboptimal antibody durability underscores the need for broader serotype coverage and a tailored immunization schedule. Until recently, the 23-valent pneumococcal polysaccharide vaccine (PPSV23) was recommended for individuals with SCD to expand serotype protection. However, numerous studies indicate that PPSV23 has limited effectiveness in immunocompromised populations, including SCD, and may induce hyporesponsiveness when administered repeatedly or when inappropriately sequenced with PCVs. The approval of higher-valency conjugate vaccines (e.g., PCV20 and PCV21) offers promise for expanding serotype coverage while minimizing reliance on PPSV23. Nonetheless, real-world data on immunogenicity, durability, and clinical efficacy in SCD remain sparse. This review examines the intricate immunological interactions between PCVs and PPSV23 in the context of SCD, with a focus on vaccine-induced hyporesponsiveness, serotype replacement, and the evolving epidemiology of pneumococcal disease. It highlights the need for optimized evidence-based vaccination strategies and longitudinal monitoring among patients with SCD. A precision vaccination approach tailored to the unique immunological deficits of individuals with SCD will be essential to ensure sustained and comprehensive protection against pneumococcal disease.

Indexed as

Anemia, Sickle CellPneumococcal InfectionsPneumococcal VaccinesAntibodies, BacterialHumansImmunization ScheduleSerogroupStreptococcus pneumoniaeVaccinationVaccines, Conjugate23-valent pneumococcal capsular polysaccharide vaccineAntibodies, BacterialPneumococcal VaccinesVaccines, ConjugateHyporesponsivenessPCVPneumococcal vaccinesPPSV23Sickle cell disease

Identifiers

PMID42322679
PMCPMC13361791

What OpenQuestion holds

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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.