Nutritional Advice El Mondo
Objectives:
A lower conversion vaccination rate and a more rapid decline in antibody titers over time in dialysis patients raise concerns about the effectiveness of pneumococcal vaccination (PV) in this population, which has not been systematically reviewed. Therefore, this review article has been conducted.
Does pneumococcal vaccine alone or in combination with influenza vaccine reduce all-cause mortality risk in dialysis patients?
Study design:
This review article included 5 cohort studies and 1 quasi-randomized controlled trial enrolling 394,299 dialysis patients.
Results and conclusions:
The investigators found compared with unvaccinated individuals, those receiving pneumococcal vaccination had a 27%-lower risk of all-cause mortality [adjusted relative risk = 0.73, 95% CI = 0.67 to 0.79, I2 = 31.1%, grade low certainty] and a 20%-lower risk of cardiovascular events [adjusted relative risk = 0.80, 95% CI = 0.69 to 0.93, I2 = 47.2%, grade low certainty] without serious adverse effect reported.
The investigators found compared with no vaccination, lower all-cause mortality was observed in those receiving pneumococcal vaccination combined with influenza vaccination [adjusted relative risk = 0.71, 95% CI = 0.67 to 0.75, I2 = 63.3%], pneumococcal vaccination alone [adjusted relative risk = 0.86, 95% CI = 0.78 to 0.94, I2 = 0%] and influenza vaccination alone [adjusted relative risk = 0.76, 95% CI = 0.73 to 0.79, I2 = 0%].
The investigators found there were no difference between pneumococcal vaccinated patients vs non-vaccinated patients with respect to pneumonia.
The investigators found immune response to pneumococcal conjugate vaccine-13 was weaker in polysaccharide pneumococcal vaccine-23-pre-vaccinated compared with vaccine-naive patients.
The investigators concluded the use of pneumococcal vaccine especially combined with influenza vaccination is associated with lower risks of all-cause mortality in dialysis patients but may be affected by residual confounding/healthy vaccinee bias.
Original title:
Effectiveness and safety of pneumococcal vaccines used alone or combined with influenza vaccination in dialysis patients: A systematic review and meta-analysis by Mo Y, Zeng J, […], Su G.
Link:
https://www.sciencedirect.com/science/article/pii/S0264410X20312627?via%3Dihub
Additional information of El Mondo:
Find more information/studies on vaccination and kidney disease right here.