Effectiveness and impact of 7 and 13-valent pneumococcal conjugate vaccines in Chinese children: A systematic review and meta-analysis

Pneumococcal conjugate vaccines (PCVs) are highly effective against pneumococcal diseases, yet coverage in China remains low. We conducted a systematic review of observational studies published between 2006 and 2024 in mainland China, Hong Kong, and Taiwan to evaluate the effectiveness and impact of PCV7 and PCV13. Twenty-seven studies were identified, of which 17 were included in meta-analyses. PCVs showed strong protection against invasive pneumococcal disease (pooled effectiveness: 88.8%, 95%CI: 80.7–96.8%) and significantly reduced the incidence of community-acquired pneumonia (14.3%, 95%CI: 10.1–18.5%). Vaccine-serotype CAP was reduced by 69.9% (95%CI: 60.0–79.7%), and moderate benefits were observed against severe pneumonia, mortality, and recurrent episodes. Evidence for otitis media remained limited. These findings highlight the substantial health benefits of PCVs in Chinese children and underscore the importance of expanding vaccine utilization to reduce the burden of pneumococcal disease.

肺炎球菌结合疫苗（Pneumococcal Conjugate Vaccines，PCVs）对肺炎球菌相关疾病具有极高的防控效力，但在中国的疫苗接种覆盖率仍处于较低水平。本研究对2006年至2024年间于中国大陆、中国香港及中国台湾地区发表的观察性研究开展系统评价，以评估PCV7与PCV13的保护效力及公共卫生影响。最终共检索到27项相关研究，其中17项被纳入荟萃分析。结果显示，PCVs对侵袭性肺炎球菌疾病具有显著保护作用（合并保护效力：88.8%，95%置信区间：80.7%–96.8%），同时可显著降低社区获得性肺炎的发病率（降幅14.3%，95%置信区间：10.1%–18.5%）；疫苗血清型社区获得性肺炎的发病率可降低69.9%（95%置信区间：60.0%–79.7%），且对重症肺炎、病死率及复发感染均具有中等程度的防护获益。针对中耳炎的相关研究证据仍较为有限。本研究结果凸显了PCVs在中国儿童群体中可带来的显著健康收益，同时强调了扩大疫苗接种覆盖以降低肺炎球菌疾病负担的重要性。