Comparison 1. RCTs of vaccination versus placebo.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Invasive pneumococcal disease	11		Odds Ratio (M‐H, Random, 95% CI)	Subtotals only
1.1 All studies	11	36489	Odds Ratio (M‐H, Random, 95% CI)	0.26 [0.14, 0.45]
1.2 i) Adults in low‐income countries	1	5373	Odds Ratio (M‐H, Random, 95% CI)	0.14 [0.03, 0.61]
1.3 ii) Adults in high‐income countries with chronic illness	5	3230	Odds Ratio (M‐H, Random, 95% CI)	1.56 [0.35, 6.94]
1.4 iii) Adults in high‐income countries	5	27886	Odds Ratio (M‐H, Random, 95% CI)	0.20 [0.10, 0.39]
2 Pneumonia, all causes	16		Odds Ratio (M‐H, Random, 95% CI)	Subtotals only
2.1 All studies	16	47734	Odds Ratio (M‐H, Random, 95% CI)	0.72 [0.56, 0.93]
2.2 i) Adults in low‐income countries	4	14562	Odds Ratio (M‐H, Random, 95% CI)	0.54 [0.43, 0.67]
2.3 ii) Adults in high‐income countries with chronic illness	6	4010	Odds Ratio (M‐H, Random, 95% CI)	0.93 [0.73, 1.19]
2.4 iii) Adults in high‐income countries	6	29186	Odds Ratio (M‐H, Random, 95% CI)	0.71 [0.45, 1.12]
3 Mortality, all causes	14		Odds Ratio (M‐H, Random, 95% CI)	Subtotals only
3.1 All studies	14	47560	Odds Ratio (M‐H, Random, 95% CI)	0.90 [0.74, 1.09]
3.2 i) Adults in low‐income countries	1	11958	Odds Ratio (M‐H, Random, 95% CI)	0.79 [0.62, 0.99]
3.3 ii) Adults in high‐income countries with chronic illness	6	3603	Odds Ratio (M‐H, Random, 95% CI)	1.13 [0.90, 1.43]
3.4 iii) Older adults in high‐income countries	7	32023	Odds Ratio (M‐H, Random, 95% CI)	0.88 [0.67, 1.17]
4 Invasive pneumococcal disease (vaccine types only)	5	31223	Odds Ratio (M‐H, Random, 95% CI)	0.18 [0.10, 0.31]
5 Definitive pneumococcal pneumonia	10	35483	Odds Ratio (M‐H, Random, 95% CI)	0.26 [0.15, 0.46]
5.1 All studies	10	35483	Odds Ratio (M‐H, Random, 95% CI)	0.26 [0.15, 0.46]
6 Definitive pneumococcal pneumonia (vaccine types only)	4	30561	Odds Ratio (M‐H, Random, 95% CI)	0.13 [0.05, 0.38]
7 Presumptive pneumococcal pneumonia	9	20335	Odds Ratio (M‐H, Random, 95% CI)	0.46 [0.25, 0.84]
8 Presumptive pneumococcal pneumonia (vaccine types only)	5	18568	Odds Ratio (M‐H, Random, 95% CI)	0.27 [0.08, 0.87]
9 Mortality due to pneumonia	9	30723	Odds Ratio (M‐H, Random, 95% CI)	0.71 [0.44, 1.16]
10 Mortality due to pneumococcal infection	3	2445	Odds Ratio (M‐H, Random, 95% CI)	2.51 [0.45, 14.13]