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Michels SY, Daley MF, Newcomer SR. Completion of multidose vaccine series in early childhood: current challenges and opportunities. Curr Opin Infect Dis 2024; 37:176-184. [PMID: 38427536 PMCID: PMC11210715 DOI: 10.1097/qco.0000000000001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
PURPOSE OF REVIEW Completion of all doses in multidose vaccine series provides optimal protection against preventable infectious diseases. In this review, we describe clinical and public health implications of multidose vaccine series noncompletion, including current challenges to ensuring children receive all recommended vaccinations. We then highlight actionable steps toward achieving early childhood immunization goals. RECENT FINDINGS Although coverage levels are high for most early childhood vaccinations, rates of completion are lower for vaccinations that require multiple doses. Recent research has shown that lower family socioeconomic status, a lack of health insurance coverage, having multiple children in the household, and moving across state lines are associated with children failing to complete multidose vaccine series. These findings provide contextual evidence to support that practical challenges to accessing immunization services are impediments to completion of multidose series. Strategies, including reminder/recall, use of centralized immunization information systems, and clinician prompts, have been shown to increase immunization rates. Re-investing in these effective interventions and modernizing the public health infrastructure can facilitate multidose vaccine series completion. SUMMARY Completion of multidose vaccine series is a challenge for immunization service delivery. Increased efforts are needed to address remaining barriers and improve vaccination coverage in the United States.
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Affiliation(s)
- Sarah Y. Michels
- Center for Population Health Research, University of Montana, Missoula, Montana
| | - Matthew F. Daley
- Institute for Health Research, Kaiser Permanente Aurora, Colorado
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Sophia R. Newcomer
- Center for Population Health Research, University of Montana, Missoula, Montana
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, USA
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2
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Ryman J, Sachs JR, Yee KL, Banniettis N, Weaver J, Weiss T. Predicted serotype-specific effectiveness of pneumococcal conjugate vaccines V114 and PCV20 against invasive pneumococcal disease in children. Expert Rev Vaccines 2024; 23:60-68. [PMID: 38073483 DOI: 10.1080/14760584.2023.2292773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Next-generation, higher-valency pneumococcal conjugate vaccines (PCVs), 15-valent PCV V114 and 20-valent PCV (PCV20), have been assessed by comparing their immune responses across serotypes shared with the 13-valent PCV (PCV13). Without efficacy or real-world vaccine effectiveness (VE) it becomes important to relate IgG titers to VE to aid in the interpretation of the immune response elicited by V114 and PCV20. METHODS We estimated the protective antibody concentrations for each serotype in 7-valent PCV (PCV7) and PCV13 which were then used to predict the serotype-specific VE for each PCV7 and PCV13 non PCV7 serotype present in V114 and PCV20. RESULTS The predicted effectiveness of V114 was comparable to PCV7 and PCV13 for 11 of the 13 shared serotypes (1, 4, 5, 6B, 7F, 9 V, 14, 18C, 19A, 19F, and 23F), with improved effectiveness against serotype 3 and decreased effectiveness against serotype 6A. PCV20 had predicted effectiveness comparable to PCV7 and PCV13 for 7 of the 13 shared serotypes (5, 6A, 7F, 9 V, 18C, 19F, and 23F), with decreased effectiveness against the remaining serotypes (1, 3, 4, 6B, 14, and 19A). CONCLUSIONS Prediction of serotype-specific VE values suggests that V114 retains greater effectiveness than PCV20 toward most serotypes present in PCV7 and PCV13.
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Affiliation(s)
- Josiah Ryman
- Quantitative Pharmacology and Pharmacometrics, Rahway, NJ, USA
| | - Jeffrey R Sachs
- Quantitative Pharmacology and Pharmacometrics, Rahway, NJ, USA
| | - Ka Lai Yee
- Quantitative Pharmacology and Pharmacometrics, Rahway, NJ, USA
| | | | - Jessica Weaver
- Center for Observational and Real-World Evidence,Merck & Co, Inc, Rahway, NJ, USA
| | - Thomas Weiss
- Center for Observational and Real-World Evidence,Merck & Co, Inc, Rahway, NJ, USA
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Feemster K, Weaver J, Buchwald U, Banniettis N, Cox KS, McIntosh ED, Spoulou V. Pneumococcal Vaccine Breakthrough and Failure in Infants and Children: A Narrative Review. Vaccines (Basel) 2023; 11:1750. [PMID: 38140155 PMCID: PMC10747311 DOI: 10.3390/vaccines11121750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Globally, Streptococcus pneumoniae is a leading cause of vaccine-preventable morbidity and mortality in infants and children. In recent decades, large-scale pediatric immunization programs have substantially reduced the incidence of invasive pneumococcal disease. Despite this, residual vaccine-type pneumococcal disease remains in the form of vaccine breakthrough and vaccine failure. This targeted literature review aims to discuss aspects of vaccine breakthrough and failure in infants and children, including disease epidemiology, clinical presentation, risk factors, vaccination schedules, vaccine serotypes, correlates of protection, comorbidities, disease surveillance, and potential implications for future vaccine development.
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Affiliation(s)
- Kristen Feemster
- Merck & Co., Inc., Rahway, NJ 07065, USA; (J.W.); (U.B.); (N.B.); (K.S.C.)
| | - Jessica Weaver
- Merck & Co., Inc., Rahway, NJ 07065, USA; (J.W.); (U.B.); (N.B.); (K.S.C.)
| | - Ulrike Buchwald
- Merck & Co., Inc., Rahway, NJ 07065, USA; (J.W.); (U.B.); (N.B.); (K.S.C.)
| | - Natalie Banniettis
- Merck & Co., Inc., Rahway, NJ 07065, USA; (J.W.); (U.B.); (N.B.); (K.S.C.)
| | - Kara S. Cox
- Merck & Co., Inc., Rahway, NJ 07065, USA; (J.W.); (U.B.); (N.B.); (K.S.C.)
| | | | - Vana Spoulou
- Immunobiology and Vaccinology Research Laboratory, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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Gonzales BE, Mercado EH, Castillo-Tokumori F, Montero AE, Luna-Muschi A, Marcelo-Ragas M, Campos F, Chaparro E, Del Águila O, Castillo ME, Saenz A, Reyes I, Hernandez R, Ochoa TJ. Pneumococcal serotypes and antibiotic resistance in healthy carriage children after introduction of PCV13 in Lima, Peru. Vaccine 2023:S0264-410X(23)00592-3. [PMID: 37270366 DOI: 10.1016/j.vaccine.2023.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/23/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To determinate the frequency of Streptococcus pneumoniae nasopharyngeal carriers, serotypes and antimicrobial resistance in healthy children in Lima, Peru, post-PCV13 introduction and to compare the results with a similar study conducted between 2006 and 2008 before PCV7 introduction (pre-PCV7). METHODS A cross-sectional multicenter study was conducted between January 2018 and August 2019 in 1000 healthy children under two years of age. We use standard microbiological methods to determinate S. pneumoniae from nasopharyngeal swab, Kirby Bauer and minimum inhibitory concentration methods to determinate antimicrobial susceptibility and whole genomic sequencing to determinate pneumococcal serotypes. RESULTS The pneumococcal carriage rate was 20.8 % vs. 31.1 % in pre-PCV7 (p < 0.001). The most frequent serotypes were 15C, 19A and 6C (12.4 %, 10.9 % and 10.9 % respectively). The carriage of PCV13 serotypes after PCV13 introduction decreased from 59.1 % (before PCV7 introduction) to 18.7 % (p < 0.001). Penicillin resistance was 75.5 %, TMP/SMX 75.5 % and azithromycin 50.0 %, using disk diffusion. Penicillin resistance rates using MIC breakpoint for meningitis (MIC ≥ 0.12) increased from 60.4 % to 74.5 % (p = 0.001). CONCLUSION The introduction of PCV13 in the immunization program in Peru has decreased the pneumococcal nasopharyngeal carriage and the frequency of PCV13 serotypes; however, there has been an increase in non-PCV13 serotypes and antimicrobial resistance.
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Affiliation(s)
- Brayan E Gonzales
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru
| | - Erik H Mercado
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru
| | - Franco Castillo-Tokumori
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru
| | - Andrea E Montero
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alessandra Luna-Muschi
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru
| | - Madhelli Marcelo-Ragas
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru
| | - Francisco Campos
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Departamento de Pediatría, Hospital Nacional Docente Madre-Niño San Bartolomé, Lima, Peru
| | - Eduardo Chaparro
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Pediatría, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Olguita Del Águila
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Servicio de Pediatría de Especialidades Clínicas, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - María E Castillo
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Oficina de Epidemiología, Instituto Nacional de Salud del Niño, Lima, Peru
| | - Andrés Saenz
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Departamento de Pediatría, Hospital Nacional Daniel Alcides Carrión, Lima, Peru
| | - Isabel Reyes
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Servicio de Hospitalización, Hospital de Emergencias Pediátricas, Lima, Peru
| | - Roger Hernandez
- Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Pediatría, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Theresa J Ochoa
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Grupo Peruano de Investigación en Neumococo (GPIN), Lima, Peru; Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Kawade A, Dayma G, Apte A, Telang N, Satpute M, Pearce E, Roalfe L, Patil R, Wang Y, Noori N, Gondhali A, Juvekar S, Oron AP, Sanghavi S, Goldblatt D, Dagan R, Bavdekar A. Effect of reduced two-dose (1+1) schedule of 10 and 13-valent pneumococcal conjugate vaccines (Synflorix TM and Prevenar13 TM)) on nasopharyngeal carriage and serotype-specific immune response in the first two years of life: Results from an open-labelled randomized controlled trial in Indian children. Vaccine 2023; 41:3066-3079. [PMID: 37045679 DOI: 10.1016/j.vaccine.2023.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION This study aimed to assess the effect of a reduced dose regime (1 + 1) of PCV10 and PCV13 along with 3-dose regimes on pneumococcal vaccine-type (VT) carriage and immunogenicity in the first two years of life in PCV-naïve Indian children. METHODS A total of 805 healthy infants aged 6-8 weeks were randomised to 7 groups (n = 115). Six groups received SynflorixTM(PCV10) or Prevenar13TM(PCV13) in the following schedules: 3 + 0 (three primary at 6, 10, and 14 weeks); 2 + 1 (two primary 6 and 14 weeks with booster at 9 months; 1 + 1 (one primary at 14 weeks with booster at 9 months). The 7th group was a PCV-naïve control group. Nasopharyngeal swabs were collected at 6, 18 weeks, 9, 10, 15, and 18 months of age. Venous blood samples were collected at 18 weeks, 9, 10, and 18 months of age for assessment of sero-specific IgG antibodies. Additionally, functional activity using a serotype specific opsonophagocytic assay (OPA) was assessed at 10 and 18 months of age in a subset (20%) of participants. RESULTS All schedules of PCV13 showed significant 13VT carriage reduction in the second year of life as compared to control. At 15 months of age, PCV13 (1 + 1) showed 45 % reduction in 13VT-carriage compared to the control [OR = 0.55 (95% CI; 0.31-0.97), p= 0.038]. None of the PCV10 schedules showed significant reduction in 10VT carriage in the second year. Although not powered for these outcomes, at 18 months of age, 1 + 1 and 2 + 1 schedules of both vaccines demonstrated higher sero-responders for all serotypes, higher geometric mean concentrations (GMC) for all serotypes except 23F [with both vaccines], higher percent OPA responders and OPA geometric mean titres (GMT) compared to the 3 + 0 schedules for all serotypes. CONCLUSION The reduced dose schedule (1 + 1) of PCV13 results in significant VT-carriage reduction in the second year of life. Immune protection provided by 1 + 1 schedules of PCV10 and PCV13 in the second year of life is comparable to WHO-recommended 3-dose schedules.
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Affiliation(s)
- Anand Kawade
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
| | - Girish Dayma
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Aditi Apte
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Nilima Telang
- Department of Microbiology, KEM Hospital, Pune, India
| | | | - Emma Pearce
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Lucy Roalfe
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Rakesh Patil
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Yanyun Wang
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Navideh Noori
- Institute for Disease Modeling, Global Health Division, Bill and Melinda Gates Foundation, 500 5th Ave N, Seattle, WA, USA
| | - Arun Gondhali
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Assaf P Oron
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | | | - David Goldblatt
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Ron Dagan
- The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ashish Bavdekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
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6
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Lupinacci R, Rupp R, Wittawatmongkol O, Jones J, Quinones J, Ulukol B, Dagan R, Richmond P, Stek JE, Romero L, Koseoglu S, Tamms G, McFetridge R, Li J, Cheon K, Musey L, Banniettis N, Bickham K. A phase 3, multicenter, randomized, double-blind, active-comparator-controlled study to evaluate the safety, tolerability, and immunogenicity of a 4-dose regimen of V114, a 15-valent pneumococcal conjugate vaccine, in healthy infants (PNEU-PED). Vaccine 2023; 41:1142-1152. [PMID: 36621410 DOI: 10.1016/j.vaccine.2022.12.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Pneumococcal disease (PD) remains a major health concern with considerable morbidity and mortality in children. Currently licensed pneumococcal conjugate vaccines (PCVs) confer protection against PD caused by most vaccine serotypes, but non-vaccine serotypes contribute to residual disease. V114 is a 15-valent PCV containing all 13 serotypes in Prevnar 13™ (PCV13) and additional serotypes 22F and 33F. This pivotal phase 3 study compared safety and immunogenicity of V114 and PCV13. METHODS 1720 healthy infants were randomized 1:1 to receive a 4-dose regimen of V114 or PCV13 concomitantly with other routine pediatric vaccines. Safety was evaluated after each dose as proportion of participants with adverse events (AEs). Serotype-specific anti-pneumococcal immunoglobulin G (IgG) was measured at 1-month post-dose 3 (PD3), pre-dose 4, and 1-month post-dose 4 (PD4). IgG response rates, geometric mean concentrations (GMCs), and opsonophagocytic activity (OPA) were compared between vaccination groups. RESULTS The proportion, maximum intensity, and duration of injection-site, systemic, and serious AEs were generally comparable between V114 and PCV13 groups. In comparison to PCV13, V114 met non-inferiority criteria for all 15 serotypes based on IgG response rates at PD3. V114 met non-inferiority criteria by IgG GMCs for all serotypes at PD3 and PD4, except for serotype 6A at PD3. V114-induced antibodies had bactericidal activity as assessed by OPA. Further, V114 met superiority criteria for shared serotype 3 and unique serotypes 22F and 33F compared to PCV13 by serotype-specific IgG GMCs at both PD3 and PD4. Immunogenicity of concomitantly administered routine pediatric vaccines was comparable in V114 and PCV13 groups. CONCLUSIONS In healthy infants, V114 displays acceptable safety and tolerability profiles and generates comparable immune responses to PCV13. V114 also met superiority criteria for serotypes 3, 22F, and 33F. These results support use of V114 for prevention of PD as part of routine infant vaccination schedules. TRIAL REGISTRATION ClinicalTrials.gov: NCT03893448; EudraCT: 2018-004109-21.
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Affiliation(s)
| | - Richard Rupp
- University of Texas Medical Branch, Galveston, TX, USA
| | | | | | | | | | - Ron Dagan
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences of the Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Peter Richmond
- University of Western Australia School of Medicine, Perth, Australia
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Mohseni Afshar Z, Barary M, Hosseinzadeh R, Alijanpour A, Hosseinzadeh D, Ebrahimpour S, Nazary K, Sio TT, Sullman MJM, Carson-Chahhoud K, Babazadeh A. Breakthrough SARS-CoV-2 infections after vaccination: a critical review. Hum Vaccin Immunother 2022; 18:2051412. [PMID: 35302905 PMCID: PMC9115792 DOI: 10.1080/21645515.2022.2051412] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
At the beginning of the current pandemic, it was believed that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection would induce lifelong immunity and that reinfections would be unlikely. However, after several cases of reinfection were documented in previously infected patients, this was understood to be a false assumption, and this waning humoral immunity has raised significant concerns. Accordingly, long-term and durable vaccine-induced antibody protection against infection have also become a challenge, as several breakthroughs of COVID-19 infection have been identified in individuals who were fully vaccinated. This review discusses the current evidence on breakthrough COVID-19 infections occurring after vaccination.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Barary
- Student Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Rezvan Hosseinzadeh
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | | | | | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Kosar Nazary
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Terence T Sio
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona, USA
| | - Mark J M Sullman
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus.,Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | | | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Silva-Costa C, Gomes-Silva J, Pinho MD, Friães A, Ramirez M, Melo-Cristino J. Continued Vaccine Breakthrough Cases of Serotype 3 Complicated Pneumonia in Vaccinated Children, Portugal (2016-2019). Microbiol Spectr 2022; 10:e0107722. [PMID: 35862941 PMCID: PMC9431508 DOI: 10.1128/spectrum.01077-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/07/2022] [Indexed: 11/20/2022] Open
Abstract
We previously reported that despite the use of pneumococcal conjugate vaccines (PCVs), vaccine serotypes remained important causes of pneumonia with pleural effusion and empyema (pediatric complicated pneumococcal pneumonia [PCPP]). We cultured and performed PCR on 174 pleural fluid samples recovered from pediatric patients in Portugal from 2016 to 2019 to identify and serotype Streptococcus pneumoniae. Most PCPP cases (n = 87/98) were identified by PCR only. Serotypes 3 (67%), 14, and 8 (5% each) were the most frequent. Vaccine breakthrough cases were seen among age-appropriately, 13-valent, PCV vaccinated children (median: 3 years, range: 17 months to 7 years), mostly with serotype 3 (n = 27) but also with serotypes 14 and 19A (n = 2 each). One breakthrough was seen with serotype 14 in an age-appropriately, 10-valent, PCV-vaccinated child and another with serotype 3 in a child to whom the 23-valent polysaccharide vaccine was administered. While the relative risk of serotype 1 PCPP decreased almost 10-fold from the period of 2010 to 2015 to the period of 2016 to 2019 (relative risk [RR] = 0.106), that of serotype 3 PCPP almost doubled (RR = 1.835). Our data highlight the importance of molecular diagnostics in identifying PCPP and document the continued importance of serotype 3 PCPP, even when PCV13 use with almost universal coverage could be expected to reduce exposure to this serotype. IMPORTANCE The use of conjugate vaccines against Streptococcus pneumoniae in children has led to substantial reductions in pneumococcal invasive disease. However, the reductions seen in each of the 13 serotypes currently included in the highest-valency vaccine approved for use in children (PCV13), were not the same. It is becoming clear that most vaccine breakthroughs worldwide involve serotype 3 and are frequently associated with complicated pneumonia cases, often with empyema or pleural effusion. Here, we show that despite almost universal PCV13 use, which would be expected to reduce vaccine serotype circulation and further reinforce vaccine direct protection, pneumococci and serotype 3 remain the major causes of pediatric complicated pneumonia. Molecular methods are essential to identify and serotype pneumococci in these cases, which frequently reflect vaccine breakthroughs. A broader use of molecular diagnostics will be essential to determine the role of this important serotype in the context of PCV13 use in different geographic regions.
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Affiliation(s)
- Catarina Silva-Costa
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Joana Gomes-Silva
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Marcos D. Pinho
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Friães
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Mário Ramirez
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - José Melo-Cristino
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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9
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Ryman J, Weaver J, Yee KL, Sachs JR. Predicting effectiveness of the V114 vaccine against invasive pneumococcal disease in children. Expert Rev Vaccines 2022; 21:1515-1521. [PMID: 35997125 DOI: 10.1080/14760584.2022.2112179] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The potential impact of new pneumococcal conjugate vaccines (PCVs) is assessed by using immune responses to predict their effectiveness against invasive pneumococcal disease (IPD). This analysis predicted the serotype-specific effectiveness against IPD of a new 15-valent PCV (V114) for the serotypes shared with a 13-valent PCV (PCV13), in a US pediatric population given a 3 + 1 dosing regimen. METHODS Beginning with the known serotype-specific antibody concentrations after vaccination with placebo, 7-valent PCV (PCV7) and PCV13, reverse cumulative distribution curves were used, along with published serotype-specific vaccine effectiveness of PCV7 and PCV13, to derive a protective antibody concentration (Cp) for each PCV13 serotype in V114. Serotype-specific effectiveness was predicted using the Cp estimates and the respective serotype-specific antibody concentrations of placebo and V114 recipients in recent pediatric clinical trials. RESULTS Predicted serotype-specific V114 effectiveness values ranged from 86% to 99% for PCV7 serotypes and from 59% to 97% for (non-PCV7) PCV13 serotypes. CONCLUSIONS V114 serotype-specific effectiveness against IPD in a US pediatric population was predicted to be largely comparable to that of PCV7 and PCV13 for shared serotypes, with models suggesting likelihood of high overall benefit gained from increased serotype 3 effectiveness, and additional protection against serotypes 22 F and 33 F.
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Affiliation(s)
- Josiah Ryman
- Quantitative Pharmacology and Pharmacometrics, Merck & Co., Inc, Rahway, NJ, USA
| | - Jessica Weaver
- Center for Observational and Real-World Evidence, Merck & Co., Inc, Rahway, NJ, USA
| | - Ka Lai Yee
- Quantitative Pharmacology and Pharmacometrics, Merck & Co., Inc, Rahway, NJ, USA
| | - Jeffrey R Sachs
- Quantitative Pharmacology and Pharmacometrics, Merck & Co., Inc, Rahway, NJ, USA
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10
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Post-vaccination outcomes in association with four COVID-19 vaccines in the Kingdom of Bahrain. Sci Rep 2022; 12:9236. [PMID: 35654940 PMCID: PMC9161761 DOI: 10.1038/s41598-022-12543-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/22/2022] [Indexed: 11/08/2022] Open
Abstract
With the emergence of new SARS-Cov2 variants, critical questions have arisen about: (1) the effectiveness of the available COVID-19 vaccines developed to protect against the original Wuhan (wild type) variant and (2) the magnitude and clinical consequences of post-vaccination infections in the context of the Delta variant of SARS-Cov2. While some “real world” experiences with various vaccines have been reported, to our knowledge, few have examined comparative outcomes of various vaccines in one country as new SARS-CoV-2 variants have emerged. Here we present an analysis of COVID-19 related outcomes from a national database in Bahrain, a country with a total population of 1.51 million, where four vaccines were deployed (total vaccinated = 1,003,960 adults): AstraZeneca (AZ/Covishield), Pfizer/BioNtech, Sinopharm and Sputnik V. We compare the four vaccines, based on the following post-vaccination outcomes: SARS-CoV-2 infections, hospitalisations, ICU admissions and deaths, compared to unvaccinated individuals. We conclude that the four vaccines used in Bahrain were effective in significantly reducing all four COVID-19 related outcomes compared to unvaccinated individuals, prior to, and during the period when the Delta variant predominated in the country. However, compared to the three other vaccines, individuals vaccinated with Sinopharm vaccine had a higher risk of post-vaccination infections, hospitalisations and ICU admissions (e.g., 6.94%, 2.24%, 1.99% and 1.52% of COVID-19 cases of Sinopharm, Sputnik V, Pfizer and Covishield recipients, respectively, required hospitalisation versus 13.66% of COVID-19 cases among unvaccinated individuals); however, given the confounding factors, this needs to be confirmed by further studies. We find no evidence of biased selection for any vaccine, but note waning protection of the Pfizer/BioNtech vaccine during the January to June 2021 period in the age > 60 y cohort; however, this cannot be distinguished from the overall fall in hospitalisations overall. Our findings support the value of vaccination in preventing COVID-19 related outcomes, provide real world estimates on the outcomes and frequencies of post-vaccination infections for the four vaccines, which may inform vaccine selection in the context of the Delta variant across the globe.
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Ricketson LJ, Bettinger JA, Sadarangani M, Halperin SA, Kellner JD. Vaccine effectiveness of the 7-valent and 13-valent pneumococcal conjugate vaccines in Canada: An IMPACT study. Vaccine 2022; 40:2733-2740. [PMID: 35351324 DOI: 10.1016/j.vaccine.2022.03.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/26/2022]
Abstract
We used an indirect cohort analysis in children under 5 years-old from 2002 to 2018 to examine vaccine effectiveness (VE) of the 7-valent pneumococcal conjugate vaccine (PCV) (3 + 1 doses in most regions) and the 13-valent PCV (2 + 1 doses in all regions) against invasive pneumococcal disease (IPD) caused by vaccine serotypes in children in Canada. Cases were identified from the Canadian Immunization Monitoring Program ACTive (IMPACT), a national active surveillance network of 12 tertiary care pediatric hospitals that represent about 90% of tertiary care hospital beds in Canada. There were 1477 children evaluated for PCV7 VE and 489 for PCV13 VE. PCV7 VE in children with vaccination up to date for their age was 96% (95% CI: 67-99%) after a single dose and 95% (95% CI: 92-97%) after ≥2 doses. The VE was 91% (95% CI: 85-94%) in children who had received doses but were not up to date for their age. PCV13 VE in children with vaccinations up to date for their age was 55% (95% CI: 28-72%) after ≥2 doses. The PCV13-vaccine serotypes causing breakthrough IPD in children up to date for their age with 2+ doses of PCV13 were 3 (13/27, 48.2%),19A (11/27, 40.7%), and 19F (3/27, 11.1%). When serotype 3 and 19A were excluded, the VE of PCV13 against the remaining vaccine serotypes was 89% (95% CI: 64-97%) in children with ≥2 doses. The lower VE of PCV13 may be due to lower effectiveness against serotypes 3 and 19A, which could be influenced by the change in dosing schedule from 4 to 3 total doses with the introduction of PCV13, combined with vaccine uptake of 80%. However, PCV13 still provides the benefit of protection against more serotypes than PCV7, and good VE against all serotypes except 3 and 19A.
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Affiliation(s)
- Leah J Ricketson
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Scott A Halperin
- Canadian Centre for Vaccinology, Halifax, NS, Canada; Dalhousie University and the IWK Health Centre Dalhousie University, Halifax, NS, Canada
| | - James D Kellner
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital, Calgary Zone, Alberta Health Services, Calgary, AB, Canada.
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Nasreen S, Wang J, Kwong JC, Crowcroft NS, Sadarangani M, Wilson SE, McGeer A, Kellner JD, Quach C, Morris SK, Sander B, Kus JV, Naus M, Hoang L, Rudzicz F, Fadel S, Marra F. Population-based incidence of invasive pneumococcal disease in children and adults in Ontario and British Columbia, 2002-2018: A Canadian Immunization Research Network (CIRN) study. Vaccine 2021; 39:7545-7553. [PMID: 34810001 DOI: 10.1016/j.vaccine.2021.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/01/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Invasive pneumococcal disease (IPD) burden, evaluated in Canada using reported confirmed cases in surveillance systems, is likely underestimated due to underreporting. We estimated the burden of IPD in Ontario and British Columbia (BC) by combining surveillance data with health administrative databases. METHODS We established a cohort of 27,525 individuals in Ontario and BC. Laboratory-confirmed IPD cases were identified from Ontario's integrated Public Health Information System and the BC Centre for Disease Control Public Health Laboratory. Possible IPD cases were identified from hospitalization data in both provinces, and from emergency department visit data in Ontario. We estimated the age and sex adjusted annual incidence of IPD and pneumococcal conjugate/polysaccharide vaccine (PCV/PPV) serotype-specific IPD using Poisson regression models. RESULTS In Ontario, 20,205 overall IPD cases, including 15,299 laboratory-confirmed cases, were identified with relatively stable age- and sex-adjusted annual incidence rates ranging from 13.7/100,000 (2005) to 13.6/100,000 (2018). In BC, 7,320 overall IPD cases, including 5,932 laboratory-confirmed cases were identified; annual incidence rates increased from 10.9/100,000 (2002) to 13.2/100,000 (2018). Older adults aged ≥ 85 years had the highest incidence rates. During 2007-2018 the incidence of PCV7 serotypes and additional PCV13 serotypes decreased while the incidence of unique PPV23 and non-vaccine serotypes increased in both provinces. CONCLUSIONS IPD continues to cause a substantial public health burden in Canada despite publicly funded pneumococcal vaccination programs, resulting in part from an increase in unique PPV23 and non-vaccine serotypes.
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Affiliation(s)
- Sharifa Nasreen
- Centre for Vaccine Preventable Diseases, University of Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Jun Wang
- Public Health Ontario, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - Jeffrey C Kwong
- Centre for Vaccine Preventable Diseases, University of Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada
| | - Natasha S Crowcroft
- Centre for Vaccine Preventable Diseases, University of Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Manish Sadarangani
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Sarah E Wilson
- Centre for Vaccine Preventable Diseases, University of Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - Allison McGeer
- Centre for Vaccine Preventable Diseases, University of Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Sinai Health System, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - James D Kellner
- Department of Pediatrics, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada
| | - Caroline Quach
- Departments of Microbiology, Infectious Diseases & Immunology and Pediatrics, University of Montreal, Quebec, Canada
| | - Shaun K Morris
- Division of Infectious Diseases, The Hospital for Sick Children, and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Beate Sander
- Public Health Ontario, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Julianne V Kus
- Public Health Ontario, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Monika Naus
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Linda Hoang
- BC Centre for Disease Control, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Frank Rudzicz
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; Department of Computer Science, Faculty of Arts & Science, University of Toronto, Toronto, Ontario, Canada; Vector Institute for Artificial Intelligence, Toronto, Ontario, Canada
| | - Shaza Fadel
- Centre for Vaccine Preventable Diseases, University of Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Fawziah Marra
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
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Mungall BA, Hoet B, Nieto Guevara J, Soumahoro L. A systematic review of invasive pneumococcal disease vaccine failures and breakthrough with higher-valency pneumococcal conjugate vaccines in children. Expert Rev Vaccines 2021; 21:201-214. [PMID: 34882050 DOI: 10.1080/14760584.2022.2012455] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION : The pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV or PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13) protect against vaccine-serotype invasive pneumococcal disease (VT IPD). However, VT IPD can still occur in fully or partially vaccinated children (vaccine failure or breakthrough). We performed a systematic review of vaccine failures and breakthrough IPD with PCV10 and PCV13 in ≤5-year-olds. AREAS COVERED : We searched Scopus/Medline/EMBASE to retrieve articles/abstracts published between 1/2008-7/2019. We excluded reports from studies only including data from adults or children ≥6 years, exclusively assessing PCV7-vaccinated children or children with underlying comorbidities. Twenty-six reports (20 PCV13, 1 PCV10, 5 both), covering studies with various designs in six continents, using different schedules, were included. Collectively, these studies reported 469 VT IPD cases classified as vaccine failures and 403 as breakthrough. Vaccine failure and breakthrough rates were low: 8.4% and 9.3%, respectively, of all IPD in vaccinated children, consistent with the vaccines' high effectiveness. The main serotypes associated with vaccine failure or breakthrough were 19A, 3 and 19F in PCV13 studies and 14, 6B and vaccine-related 19A and 6A in PCV10 studies. EXPERT OPINION : As we move to vaccines with more serotypes, it is not only important to consider which serotypes are added, but also to monitor and address incomplete protection against specific serotypes.
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Vyse A, Campling J, Czudek C, Ellsbury G, Mendes D, Reinert RR, Slack M. A review of current data to support decision making for introduction of next generation higher valency pneumococcal conjugate vaccination of immunocompetent older adults in the UK. Expert Rev Vaccines 2021; 20:1311-1325. [PMID: 34550850 DOI: 10.1080/14760584.2021.1984888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The burden of pneumococcal disease in older UK adults remains substantial. Higher valency pneumococcal conjugate vaccines (PCVs) are currently in development with adult formulations for two of these anticipated to become available in 2022. This article collates and reviews relevant candidate data now available that may be used to support cost effectiveness assessments of vaccinating immunocompetent UK adults aged ≥65-years with PCVs. AREAS COVERED This article uses published data from surveillance systems, randomized controlled trials and observational studies. It focuses on local data from the UK but where these are either limited or not available relevant global data are considered. EXPERT OPINION The body of relevant data now available suggests the UK is well placed to assess the cost effectiveness of vaccinating immunocompetent ≥65-year olds with new generation higher valency PCVs. Recent contemporary data provide important new and robust insights into the epidemiology of pneumococcal disease in older UK adults and help to address much of the uncertainty and data gaps associated with previous analyses. Using these data to make informed decisions about use of new higher valency PCVs for routine use in older adults will be important for public health in the UK.
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Affiliation(s)
- Andrew Vyse
- Medical Affairs, Pfizer Ltd, Walton Oaks, Tadworth, KT20 7NS, UK
| | - James Campling
- Medical Affairs, Pfizer Ltd, Walton Oaks, Tadworth, KT20 7NS, UK
| | - Carole Czudek
- Medical Affairs, Pfizer Ltd, Walton Oaks, Tadworth, KT20 7NS, UK
| | - Gillian Ellsbury
- Medical Affairs, Pfizer Ltd, Walton Oaks, Tadworth, KT20 7NS, UK
| | - Diana Mendes
- Health & Value, Pfizer Ltd, Walton Oaks, Tadworth, KT20 7NS, UK
| | | | - Mary Slack
- School of Medicine & Dentistry, Griffith University, Gold Coast Campus, Queensland 4222, Australia
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Dion SB, Major M, Gabriela Grajales A, Nepal RM, Cane A, Gessner B, Vojicic J, Suaya JA. Invasive pneumococcal disease in Canada 2010-2017: The role of current and next-generation higher-valent pneumococcal conjugate vaccines. Vaccine 2021; 39:3007-3017. [PMID: 33824041 DOI: 10.1016/j.vaccine.2021.02.069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/09/2021] [Accepted: 02/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND In 2010-2011, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced the 7- or 10-valent vaccine (PCV7 and PCV10, respectively) in pediatric immunization programs across Canada. For adults aged ≥65 years, the 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been publicly funded for several decades; PCV13 funding was not recommended in this population, partly due to expected ongoing vaccine-serotype disease decline stemming from herd effects of the pediatric program. Higher-valent PCVs (ie, 15- and 20-valent PCVs [PCV15 and PCV20, respectively]) currently in development may become available in Canada in the coming years. METHODS Using the National Microbiology Laboratory surveillance reports, annual case counts and serotype distribution of invasive pneumococcal disease (IPD) from 2010 to 2017 in Canada were examined to assess the impact of existing programs on PCV13-serotype IPD and determine the proportion of IPD that can potentially be prevented by current and forthcoming higher-valent PCVs. RESULTS The percentages of PCV13-serotype IPD decreased from 55% [1492/2708] in 2010 to 30% [902/3006] in 2017 in all age groups combined, including a decline from 67% [221/331] to 18% [40/219] in children aged <5 years and from 50% [487/967] to 23% [287/1238] in adults aged ≥65 years. Overall, IPD cases declined mainly before 2014 and have plateaued since then. In 2017, PCV15- and PCV20-serotypes (inclusive of PCV13 serotypes) accounted for 42% and 58% of IPD cases, respectively, in all ages. CONCLUSIONS In Canada, publicly funded pediatric PCV13 use was associated with large declines in IPD due to vaccine serotypes. Substantial residual PCV13-serotype IPD proportions observed among all ages imply limits to indirect protection afforded by the pediatric PCV13 program at the current uptake level and suggest the adult PPSV23 program alone is insufficient. Higher-valent PCVs have the potential to address a substantial proportion of remaining IPD cases among all age groups.
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The proportion of contemporary invasive pneumococcal disease and pneumococcal pneumonia in UK adults reflected by serotypes included in the 13-valent pneumococcal conjugate vaccine and next generation higher valency pneumococcal conjugate vaccines in development. Vaccine 2020; 38:8068-8070. [PMID: 33190949 DOI: 10.1016/j.vaccine.2020.10.090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 11/22/2022]
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Assessing reduced-dose pneumococcal vaccine schedules in South Africa. THE LANCET. INFECTIOUS DISEASES 2020; 20:1355-1357. [PMID: 32857991 DOI: 10.1016/s1473-3099(20)30577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 11/27/2022]
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Kanik-Yuksek S, Gülhan B, Özkaya-Parlakay A, Bedir Demirdağ T. Severe suppurative otitis media due to Streptococcus pneumoniae serotype 19A in a fully vaccinated infant by age. Hum Vaccin Immunother 2020; 16:2779-2780. [PMID: 32401687 DOI: 10.1080/21645515.2020.1747924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The routine use of pneumococcal conjugated vaccines (PCVs) in childhood has significantly reduced the frequency of invasive pneumococcal diseases (IPDs). Serotype replacement has occurred, resulting in an increase in nonvaccine serotypes. Despite this changing profile, both invasive and noninvasive cases continue to be seen with strains within the scope of PCV coverage. Although older children with comorbid disease are described as a risky group for vaccine insufficiency, vaccine failure patterns should be described in detail.
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Affiliation(s)
- Saliha Kanik-Yuksek
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara City Hospital , Ankara, Turkey
| | - Belgin Gülhan
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara City Hospital , Ankara, Turkey
| | - Aslınur Özkaya-Parlakay
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara City Hospital , Ankara, Turkey
| | - Tuğba Bedir Demirdağ
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara City Hospital , Ankara, Turkey
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