Effectiveness of Pneumococcal Vaccines for Asthma: A Systematic Review
Abstract
Aim: We aimed to assess the effectiveness of pneumococcal vaccines among children and adults with asthma.
Methodology: This is a systematic review of randomized controlled trials and analytical studies.
Results: Of the 59 studies screened, 1 Randomized Controlled Trial (RCT) and 2 cohort studies met the eligibility criteria. Pneumococcal vaccination significantly reduced asthma attacks by up to 30% over two years in children. The incidence of pneumonia (Adjusted Relative Risk [aRR] 0.79, 95% CI: 0.50 to 1.25) and pneumococcal pneumonia (aRR 0.30, 95% CI: 0.04 to 1.99) also showed a decrease. Hospitalization rates for asthma patients dropped from 49.59 to 17.75 per 100 person-years. The vaccination demonstrated a largely safe profile, with mild local arm soreness, localized redness, and low-grade fever being the most common side effects. Vaccinated children exhibited improved rates of complete or partial asthma control (93.2%) compared to unvaccinated peers (80.8%, p=0.08). While the cohort studies were of good quality, the RCT had a high risk of bias. The overall certainty of evidence for most outcomes was limited or very low.
Conclusion: Pneumococcal vaccination shows potential in reducing exacerbations, respiratory infections, and hospitalizations in asthma patients, and improving disease control. Additional rigorous randomized trials, including long-term observational studies, are imperative to inform guidelines and practice, particularly in Low-and-Middle-Income Countries (LMICs).