title: Pneumococcal vaccines for cystic fibrosis.
abstract: BACKGROUND
  Invasive pneumococcal disease is associated with significant mortality and many countries have introduced routine pneumococcal vaccination into their childhood immunisation programmes. Whilst pneumococcal disease in cystic fibrosis is uncommon, pneumococcal immunisation may offer some protection against pulmonary exacerbations caused by this pathogen. In the USA and UK pneumococcal vaccination is currently recommended for all children and adults with cystic fibrosis. This is an update of a previously published review.
  
  
  OBJECTIVE
  To assess the efficacy of pneumococcal vaccines in reducing morbidity in people with cystic fibrosis.
  
  
  METHODS
  We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Cystic Fibrosis Trials Register, which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. In addition, the pharmaceutical manufacturers of the polysaccharide and conjugate pneumococcal vaccines were approached.Date of the most recent search: 27 June 2016.
  
  
  METHODS
  Randomised and quasi-randomised controlled trials comparing pneumococcal vaccination (with either a polysaccharide or conjugate pneumococcal vaccine) with non-vaccination or placebo in children or adults with cystic fibrosis were eligible for inclusion.
  
  
  METHODS
  No relevant trials were identified.
  
  
  RESULTS
  There are no trials included in this review.
  
  
  CONCLUSIONS
  As no trials were identified we cannot draw conclusions on the efficacy of routine pneumococcal immunisation in people with cystic fibrosis in reducing their morbidity or mortality. As many countries now include pneumococcal immunisation in their routine childhood vaccination schedule it is unlikely that future randomised controlled trials will be initiated. Rigorously conducted epidemiological studies may offer the opportunity to evaluate the efficacy of pneumococcal vaccination in reducing morbidity and mortality in people with cystic fibrosis.
authors.affiliation: Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, UK, L12 2AP.
authors.forename: Laura
authors.initials: L
authors.lastname: Burgess
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Southern