ArticlePloS one2026
Pneumococcal conjugate vaccine effectiveness against hypoxemia in children with suspected pneumonia in Kenya; analysis from a real-world sentinel surveillance platform.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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9 authors.
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Abstract
The 10-valent pneumococcal conjugate vaccine (PCV-10) has reduced the burden of pneumococcal disease in children. Integrated facility-based sentinel surveillance (IFBS) monitors a range of common causes of febrile illnesses in Kenya. We used this system to assess the real-world vaccine effectiveness (VE) of PCV-10 against hypoxemia among children with suspected pneumonia in Kenya. We analysed IFBS data collected from 13 sites across Kenya from 2017 to 2024. We included children aged 6 weeks to 59 months with reported fever or temperature ≥38.0°C, respiratory features consistent with suspected pneumonia, and a copy of their vaccination records (i.e., child health booklet). We excluded children with a positive test result indicating a non-Pneumococcal aetiology (i.e., positive result on a multiplex PCR, malaria microscopy or rapid diagnostic test, or SARS-CoV-2 PCR). We assessed the association of vaccination status with hypoxemia, defined as an oxygen saturation of ≤90%, adjusting for age, sex, and year. VE was calculated as 1 minus the odds ratio of hypoxemia among children with suspected pneumonia calculated using generalized estimating equations to account for clustering by site. Overall, 3,533 children were analysed, with 94% being up to date with PCV-10 vaccination. The median patient age was 11 months (interquartile range: 6-17). Hypoxemia was observed in 37% of fully vaccinated children, 41% in partially vaccinated children, and 52% in unvaccinated children (χ² test, p = 0.03). The adjusted VE for full vaccination against hypoxemia in children with suspected pneumonia was 39% (95% confidence interval: 6-61%). Among children with suspected pneumonia in Kenya, PCV-10 vaccination was associated with reduced hypoxemia. The PCV-10 coverage in this dataset was high, potentially reflecting a robust routine vaccination effort since PCV-10 was introduced in Kenya in 2011. High-quality surveillance data can be used to provide real-world evidence to support routine immunization programs.
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