title: Comparison of dual influenza and pneumococcal polysaccharide vaccination with influenza vaccination alone for preventing pneumonia and reducing mortality among the elderly: A meta-analysis.
abstract: The purpose of this study was to perform a meta-analysis comparing the effectiveness of influenza vaccination alone versus influenza plus pneumococcal dual vaccination for the prevention of pneumonia and mortality in adults ≥ 65 years of age. Medline, Cochrane, CENTRAL, EMBASE, and Google Scholar databases were searched. Inclusion criteria were: 1) Randomized controlled trials (RCTs), 2-arm prospective studies, or retrospective cohort studies; 2) Patients were ≥ 65 years of age with or without chronic respiratory disease; 3) Patients received the influenza vaccine alone or dual pneumococcal and influenza vaccination; 4) Results included incidence of recurrent respiratory tract infections, length of hospital stay, and overall mortality rate. The outcomes were pneumonia and all-cause mortality rates. Of 142 studies identified in the database searches, 6 were ultimately included in the systematic review, and 5 were included in meta-analysis. The number of patients that received the influenza vaccination alone ranged from 211 to 29,346 (total = 53,107), and the number that received influenza+pneumococcal vaccination ranged from 246 to 72,107 (total = 102,068). Influenza+pneumococcal vaccination was associated with a significantly lower pneumonia rate than influenza vaccination alone (relative risk [RR] = 0.835, 95% confidence interval [CI]: 0.718-0.971, P = 0.019), and with a significantly lower all-cause mortality rate than influenza vaccination alone (relative risk [RR] = 0.771, 95% confidence interval [CI]: 0.707-0.842, P = 0.001). In conclusion, the results of this study support concomitant pneumococcal and influenza vaccination of the elderly as a dual vaccination strategy is associated with lower pneumonia and all-cause mortality rates.
authors.affiliation: a Henan Center for Disease Control and Prevention , Zhengzhou, Henan , China.
authors.forename: Yan-Yang
authors.initials: YY
authors.lastname: Zhang
authors.affiliation: b Sichuan Center for Disease Control and Prevention , Chengdu, Sichuan , China.|c The Center of Gerontology and Geriatrics , West China Medical School/West China Hospital, Sichuan University , Chengdu, Sichuan , China.
authors.forename: Xue-Feng
authors.initials: XF
authors.lastname: Tang
authors.affiliation: d Chengdu Center for Disease Control and Prevention , Chengdu, Sichuan , China.
authors.forename: Chang-Hui
authors.initials: CH
authors.lastname: Du
authors.affiliation: e Anhui Center for Disease Control and Prevention , Hefei, Anhui , China.
authors.forename: Bin-Bing
authors.initials: BB
authors.lastname: Wang
authors.affiliation: f Institute of Bacterial Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention , Jinan, Shandong , China.
authors.forename: Zhen-Wang
authors.initials: ZW
authors.lastname: Bi
authors.affiliation: c The Center of Gerontology and Geriatrics , West China Medical School/West China Hospital, Sichuan University , Chengdu, Sichuan , China.
authors.forename: Bi-Rong
authors.initials: BR
authors.lastname: Dong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D007251:Influenza, Human / Q000150:complications* / Q000517:prevention & control*; D007902:Length of Stay; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control*; D016019:Survival Analysis; D016896:Treatment Outcome; D014611:Vaccination / Q000379:methods*
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines
keywords: aged; influenza vaccine; meta-analysis; mortality; pneumococcal vaccine; pneumonia