Pneumococcal Disease and the Effectiveness of the PPV23 Vaccine in Adults: A Two-Stage Bayesian Meta-Analysis of Observational and RCT Reports.

Even after removing Christenson et al .’s study 30 which had the largest variance, the estimated effect size failed to reach statistical significance (RR = 0.967, 95% CI; 0.872–1.073; P = 0.532; Cochran’s Q test P = 0.025, I 2 = 67.907%).

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When the analysis was restricted to high income countries, for all-cause pneumonia and pneumococcal pneumonia, although the RRs altered, the difference failed to reach significance (RR = 0.852, 95% CI; 0.644–1.128 for ACP and RR = 0.540, 95% CI; 0.178–1.641 for PP).

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