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Systematic review and meta-analysis of the non-specific and broader impact of respiratory vaccines on acute lower respiratory infections in young children

Por: Holland · C. · Oakes · D. · Sarna · M. · Chai · K. · Ng · L. · Moore · H. C.
Objectives

Growing evidence suggests that vaccines targeting respiratory pathogens have non-specific and broader effects. We aimed to investigate the non-specific effects of respiratory vaccines on acute lower respiratory infection (ALRI) hospitalisations and associated outcomes in children

Design

Systematic review and meta-analysis.

 Data sources

We searched online databases including Medline, Embase, CINAHL, Scopus and Clinical Trials.gov from inception to 24 January 2024.

 Eligibility criteria

We included human studies involving non-specific/off-target effects of respiratory vaccines (including maternal, infant and childhood vaccines) and excluded studies investigating the Bacille Calmette-Guérin vaccine and non-pathogen-confirmed outcomes following pneumococcal conjugate vaccination (PCV).

 Data extraction and synthesis

We used Research Screener, a machine learning tool, to semi-automate the abstract screening process and Covidence, a management and streamlining software for full-text reviews and data extraction. A meta-analysis was conducted if four or more studies reported on the same outcome and the same exposure vaccine.

 Results

After removing duplicates, 9727 articles were identified. After screening and full-text reviews, 20 articles were eligible. Of those, four met the requirements for a meta-analysis which showed a 21% vaccine effectiveness (VE) (95% CI 8.0% to 32.0%) of maternal influenza vaccine against all-cause ALRI hospitalisations in infants

Conclusions

Our review demonstrated both protective and neutral non-specific effects of respiratory vaccines against ALRI-hospitalisations and related outcomes in young children. Such effects should be considered as part of the full value of a vaccine and how vaccine investments are prioritised. Further research on the impact of respiratory vaccines on antibiotic prescribing rates is essential as consistent reductions may help contribute to reducing the global burden of antimicrobial resistance.

 PROSPERO registration number

CRD 42023476038.

Cross-sectional survey to assess public awareness of childhood cancer symptoms

Por: Noakes · A. · Lipshaw · M.

Commentary on: Liu JF, Shanmugavadivel D, Ball-Gamble A, Stewart A, Walker D. Public awareness of childhood, teenager and young adult cancer signs and symptoms in Great Britain: a cross-sectional survey. BMJ 2023; 108: 987–93.

Implications for practice and research

  • Clinical staff should have good awareness of childhood cancer symptoms to assist in raising public awareness.

  • Further research is required with adolescents to assess their awareness and knowledge-seeking behaviour.

    • Context

    Childhood cancer is the leading cause of death in children over 1 year and a major cause of acquired disability.1 The wide range of clinical symptoms connected with childhood cancers can mean several differential diagnoses to consider. In child health, practitioners ordinarily adopt an approach of waiting for symptom progression, aiming to avoid investigatory procedures that could impact their ongoing health.2

    Ordinarily, clinicians will piece together ‘red flag’ symptoms within...

    Qualitative descriptive study to explore paediatric oncology patients readiness and preferences towards using a mobile health application for supportive pain management

    Por: Noakes · A.

    Commentary on: Madi D, Abi Abdallah Doumit M, Hallal M, Moubarak MM. Outlooks on using a mobile health intervention for supportive pain management for children and adolescents with cancer: a qualitative study. BMC Nurs. 2023 Sep 4;221,:301. doi: 10.1186/s12912-023-01461-z.

    Implications for practice and research

  • Mobile health (mHealth) applications could provide a vehicle for helping children and young people to establish social support networks and a sense of connectedness.

  • Further research is required to consider whether and how mobile health applications could be implemented within the UK health system to support children and young people’s pain management.

    •  Context

    Pain can impact cancer patients’ recovery and quality of life by compromising their physiological and psychological state.1 It is recognised that paediatric pain undertreatment remains an ongoing concern.2 Social support can act as a method of pain management, promote treatment adherence and well-being.
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