Pneumococcal vaccine in the elderly: an evidence based review
DOI:
https://doi.org/10.32385/rpmgf.v29i6.11199Keywords:
Pneumococcal Vaccine, AgedAbstract
Objectives: To determine the effectiveness and safety of pneumococcal vaccine in the elderly. Data Sources: National Guideline Clearing House, Canadian Medical Association, Cochrane Library, TRIP database, Pubmed, Bandolier, Dare and Índex de Revistas Médicas Portuguesas. Review methods: A search for clinical practice guidelines, systematic reviews, meta-analyses and randomized controlled trials published between May 2002 and July 2012 was performed using the MeSH terms “pneumococcal vaccines” and “aged”. The Strength of Recommendation Taxonomy scale of the American Family Physician was applied to evaluate the quality of the studies and the level of evidence. Results: We found 517 articles, but only twelve met the inclusion criteria. These included five clinical practice guidelines, three meta-analyses, three systematic reviews and one randomized controlled trial. Studies were inconsistent regarding the effectiveness of pneumococcal vaccine in the elderly, despite its safety. Observational studies showed that the vaccine has an effectiveness of 55% to 59% in preventing invasive pneumococcal disease, in contrast with the randomized controlled clinical trials included in the meta-analyses and systematic reviews evaluated which did not demonstrate benefit. Conclusions: The available evidence is not strong enough to support the routine use of the pneumococcal vaccine in the elderly (Strength of Recommendation B). Additional high quality randomized controlled trials with a representative sample of the population for whom the vaccine is recommended are necessary to assess the need for the pneumococcal vaccine.Downloads
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