39 research outputs found

    Additional file 2: of Frequency and impact of confounding by indication and healthy vaccinee bias in observational studies assessing influenza vaccine effectiveness: a systematic review

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    Search strategy for the systematic review on frequency and impact of selection bias in observational studies on influenza vaccine effectiveness. (DOCX 21 kb

    Numbers of persons who took part in interviews or meetings by country and type of position.

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    a<p>Includes Presidents, General Secretaries and other top officials from national medical, pediatric, infectious disease and public health associations.</p>b<p>All were from local vaccine producers, except in Colombia, where representatives from Sanofi Pasteur were interviewed.</p>c<p>One of the professional society officials in Mexico was counted in another category and thus not included in the total.</p

    Risk of Invasive Meningococcal Disease in Men Who Have Sex with Men: Lessons Learned from an Outbreak in Germany, 2012—2013 - Fig 2

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    IMD cases due to the outbreak finetype C:P1.5–1,10–8:F3-6 according to fHbp and aniA alleles in (A) men and (B) women aged 20–49 years, Germany, 2002–2014 (N = 68).aniA(6A) is associated with expression of a nitrite reductase that facilitates survival of meningococci in microanaerobic environments (see text).</p

    Effectiveness of the 23-Valent Pneumococcal Polysaccharide Vaccine (PPV23) against Pneumococcal Disease in the Elderly: Systematic Review and Meta-Analysis

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    <div><p>Background</p><p>Routine vaccination of elderly people against pneumococcal diseases is recommended in many countries. National guidelines differ, recommending either the 23-valent polysaccharide vaccine (PPV23), the 13-valent conjugate vaccine (PCV13) or both. Considering the ongoing debate on the effectiveness of PPV23, we performed a systematic literature review and meta-analysis of the vaccine efficacy/effectiveness (VE) of PPV23 against invasive pneumococcal disease (IPD) and pneumococcal pneumonia in adults aged ≥60 years living in industrialized countries.</p><p>Methods</p><p>We searched for pertinent clinical trials and observational studies in databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. We assessed the risk of bias of individual studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies. We rated the overall quality of the evidence by GRADE criteria. We performed meta-analyses of studies grouped by outcome and study design using random-effects models. We applied a sensitivity analysis excluding studies with high risk of bias.</p><p>Results</p><p>We identified 17 eligible studies. Pooled VE against IPD (by any serotype) was 73% (95%CI: 10–92%) in four clinical trials, 45% (95%CI: 15–65%) in three cohort studies, and 59% (95%CI: 35–74%) in three case-control studies. After excluding studies with high risk of bias, pooled VE against pneumococcal pneumonia (by any serotype) was 64% (95%CI: 35–80%) in two clinical trials and 48% (95%CI: 25–63%) in two cohort studies. Higher VE estimates in trials (follow-up ~2.5 years) than in observational studies (follow-up ~5 years) may indicate waning protection. Unlike previous meta-analyses, we excluded two trials with high risk of bias regarding the outcome pneumococcal pneumonia, because diagnosis was based on serologic methods with insufficient specificity.</p><p>Conclusions</p><p>Our meta-analysis revealed significant VE of PPV23 against both IPD and pneumococcal pneumonia <i>by any serotype</i> in the elderly, comparable to the efficacy of PCV13 against <i>vaccine-serotype</i> disease in a recent clinical trial in elderly people. Due to its broader serotype coverage and the decrease of PCV13 serotypes among adults resulting from routine infant immunization with PCV13, PPV23 continues to play an important role for protecting adults against IPD and pneumococcal pneumonia.</p></div
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