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Grant LR, Hanquet G, Sepúlveda-Pachón IT, Theilacker C, Baay M, Slack MPE, Jodar L, Gessner BD. Effects of PCV10 and PCV13 on pneumococcal serotype 6C disease, carriage, and antimicrobial resistance. Vaccine 2024; 42:2983-2993. [PMID: 38553292 DOI: 10.1016/j.vaccine.2024.03.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/26/2024] [Accepted: 03/24/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND The cross-protection of pneumococcal conjugate vaccines (PCV) against serotype 6C is not clearly documented, although 6C represents a substantial burden of pneumococcal disease in recent years. A systematic review by the World Health Organization that covered studies through 2016 concluded that available data were insufficient to determine if either PCV10 (which contains serotype 6B but not 6A) or PCV13 (containing serotype 6A and 6B) conferred protection against 6C. METHODS We performed a systematic review of randomized controlled trials and observational studies published between January 2010 - August 2022 (Medline/Embase), covering the direct, indirect, and overall effect of PCV10 and PCV13 against 6C invasive pneumococcal disease (IPD), non-IPD, nasopharyngeal carriage (NPC), and antimicrobial resistance (AMR). RESULTS Of 2548 publications identified, 112 were included. Direct vaccine effectiveness against 6C IPD in children ranged between 70 and 85 % for ≥ 1 dose PCV13 (n = 3 studies), was 94 % in fully PCV13 vaccinated children (n = 2), and -14 % for ≥ 1 dose of PCV10 (n = 1). Compared to PCV7, PCV13 efficacy against 6C NPC in children was 66 % (n = 1). Serotype 6C IPD rates or NPC prevalence declined post-PCV13 in most studies in children (n = 5/6) and almost half of studies in adults (n = 5/11), while it increased post-PCV10 for IPD and non-IPD in all studies (n = 6/6). Changes in AMR prevalence were inconsistent. CONCLUSIONS In contrast to PCV10, PCV13 vaccination consistently protected against 6C IPD and NPC in children, and provided some level of indirect protection to adults, supporting that serotype 6A but not 6B provides cross-protection to 6C. Vaccine policy makers and regulators should consider the effects of serotype 6A-containing PCVs against serotype 6C disease in their decisions.
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Affiliation(s)
- Lindsay R Grant
- Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA.
| | - Germaine Hanquet
- P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium.
| | | | - Christian Theilacker
- Medical Development and Scientific Clinical Affairs, Pfizer Pharma GmbH, Berlin, Germany.
| | - Marc Baay
- P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium.
| | - Mary P E Slack
- School of Medicine & Dentistry, Griffith University Gold Coast Campus, Parklands Drive, Southport, Queensland, QLD 4222, Australia.
| | - Luis Jodar
- Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA.
| | - Bradford D Gessner
- Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA.
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Hanquet G, Theilacker C, Vietri J, Sepúlveda-Pachón I, Menon S, Gessner B, Begier E. Best Practices for Identifying Hospitalized Lower Respiratory Tract Infections Using Administrative Data: A Systematic Literature Review of Validation Studies. Infect Dis Ther 2024; 13:921-940. [PMID: 38498108 PMCID: PMC11058181 DOI: 10.1007/s40121-024-00949-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/22/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Estimating the burden of lower respiratory tract infections (LRTIs) increasingly relies on administrative databases using International Classification of Diseases (ICD) codes, but no standard methodology exists. We defined best practices for ICD-based algorithms that estimate LRTI incidence in adults. METHODS We conducted a systematic review of validation studies assessing the use of ICD code-based algorithms to identify hospitalized LRTIs in adults, published in Medline, EMBASE, and LILACS between January 1996 and January 2022, according to PRISMA guidelines. We assessed sensitivity, specificity, and other accuracy measures of different algorithms. RESULTS We included 26 publications that used a variety of ICD code-based algorithms and gold standard criteria, and 18 reported sensitivity and/or specificity. Sensitivity was below 80% in 72% (38/53) of algorithms and specificity exceeded 90% in 77% (37/48). Algorithms for all-cause LRTI (n = 18) that included only pneumonia codes in primary position (n = 3) had specificity greater than 90% but low sensitivity (55-72%). Sensitivity increased by 5-15%, with minimal loss in specificity, with the addition of primary codes for severe pneumonia (e.g. sepsis) while pneumonia codes were in secondary position, and by 13% with codes from LRTI-related infections (e.g. viral) or other respiratory diseases (e.g. empyema). Sensitivity increased by 8% when pneumonia codes were in any position, but specificity was not reported. In hospital-acquired pneumonia and pneumococcal-specific pneumonia, algorithms containing only nosocomial- or pathogen-specific ICD codes had poor sensitivity, which improved when broader pneumonia codes were added, in particular codes for unspecified organisms. CONCLUSION Our systematic review highlights that most ICD code-based algorithms are relatively specific, but miss a substantial number of hospitalized LRTI adult cases. Best practices to estimate LRTI incidence in this population include the use of all pneumonia ICD codes for any LRTI outcome and, to a lesser extent, those for other LRTI-related infections or respiratory diseases.
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Affiliation(s)
- Germaine Hanquet
- P95 Epidemiology and Pharmacovigilance, Koning Leopold III Laan 1, 3001, Louvain, Belgium
| | | | - Jeffrey Vietri
- Pfizer Inc., 500 Arcola Rd, Collegeville, PA, 19426, USA
| | | | - Sonia Menon
- P95 Epidemiology and Pharmacovigilance, Koning Leopold III Laan 1, 3001, Louvain, Belgium
| | | | - Elizabeth Begier
- Scientific Affairs, Older Adult RSV Vaccine Program, Global Medical Development Scientific and Clinical Affairs, Pfizer Vaccines, Pfizer Inc., 9 Riverwalk, Citywest Business Campus, Dublin 24, Dublin, Ireland.
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Sepúlveda-Pachón IT, Dunne EM, Hanquet G, Baay M, Menon S, Jodar L, Gessner BD, Theilacker C. Effect of pneumococcal conjugate vaccines on viral respiratory infections: a systematic literature review. J Infect Dis 2024:jiae125. [PMID: 38462672 DOI: 10.1093/infdis/jiae125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/21/2024] [Accepted: 03/06/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND In addition to preventing pneumococcal disease, emerging evidence indicates that pneumococcal conjugate vaccines (PCVs) might indirectly reduce viral respiratory tract infections (RTI) by affecting pneumococcal-viral interactions. METHODS We performed a systematic review of interventional and observational studies published during 2000-2022 on vaccine efficacy/adjusted effectiveness (VE) and overall effect of PCV7, PCV9, PCV10, or PCV13 against viral RTI. RESULTS Sixteen of 1671 records identified were included. Thirteen publications described effects of PCVs against viral RTIs in children. VE against influenza ranged between 41-86% (n=4), except for the 2010-2011 influenza season. In a randomized controlled trial, PCV9 displayed efficacy against any viral RTI, human seasonal coronavirus, parainfluenza, and human metapneumovirus. Data in adults were limited (n=3). PCV13 VE ranged between 4-25% against viral lower RTI, 32-35% against COVID-19 outcomes, 24-51% against human seasonal coronavirus, and 13-36% against influenza A lower RTI, with some 95%CI spanning zero. No protection was found against adenovirus or rhinovirus in children or adults. CONCLUSIONS PCVs were associated with protection against some viral RTI, with the strongest evidence for influenza in children. Limited evidence for adults was generally consistent with pediatric data. Restricting public health evaluations to confirmed pneumococcal outcomes may underestimate the full impact of PCVs.
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Affiliation(s)
| | | | | | - Marc Baay
- P95 Epidemiology & Pharmacovigilance, Leuven, Belgium
| | - Sonia Menon
- P95 Epidemiology & Pharmacovigilance, Leuven, Belgium
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Méroc E, Fletcher MA, Hanquet G, Slack MPE, Baay M, Hayford K, Gessner BD, Grant LR. Systematic Literature Review of the Epidemiological Characteristics of Pneumococcal Disease Caused by the Additional Serotypes Covered by the 20-Valent Pneumococcal Conjugate Vaccine. Microorganisms 2023; 11:1816. [PMID: 37512988 PMCID: PMC10383425 DOI: 10.3390/microorganisms11071816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Higher valency pneumococcal conjugate vaccines (PCV15 and PCV20) have been developed to address the disease burden of current non-vaccine serotypes. This review describes the epidemiological characteristics of serotypes beyond PCV13 (serotypes 8, 10A, 11A, 12F, 15B/C, 22F, and 33F; PCV20nonPCV13 serotypes). Peer-reviewed studies published between 1 January 2010 (the year PCV13 became available) and 18 August 2020 were systematically reviewed (PROSPERO number: CRD42021212875). Data describing serotype-specific outcomes on disease proportions, incidence, severity, and antimicrobial non-susceptibility were summarized for individual and aggregate PCV20nonPCV13 serotypes by age group and by type and duration of pediatric PCV immunization program. Of 1168 studies, 127 (11%) were included in the analysis. PCV20nonPCV13 serotypes accounted for 28% of invasive pneumococcal disease (IPD), although the most frequent serotypes differed between children (10A, 15B/C) and adults (8, 12F, 22F). In children, serotype 15B/C tended to be more frequently associated with pneumococcal meningitis and acute otitis media; in adults, serotype 8 was more frequently associated with pneumonia and serotype 12F with meningitis. Serotypes 10A and 15B/C in children and 11A and 15B/C in adults were often associated with severe IPD. Serotype 15B/C was also among the most frequently identified penicillin/macrolide non-susceptible PCV20nonPCV13 serotypes. These results could inform decision making about higher valency PCV choice and use.
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Affiliation(s)
- Estelle Méroc
- P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium
| | - Mark A Fletcher
- Emerging Markets Medical Affairs, Vaccines, Pfizer, 23-25 Av. du Dr Lannelongue, 75014 Paris, France
| | - Germaine Hanquet
- P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium
| | - Mary P E Slack
- School of Medicine & Dentistry, Griffith University Gold Coast Campus, Parklands Drive, Southport, QLD 4222, Australia
| | - Marc Baay
- P95 Epidemiology & Pharmacovigilance, Koning Leopold III-laan 1, 3001 Leuven, Belgium
| | - Kyla Hayford
- Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA
| | - Bradford D Gessner
- Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA
| | - Lindsay R Grant
- Medical Development and Scientific Clinical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA
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Savulescu C, Krizova P, Valentiner-Branth P, Ladhani S, Rinta-Kokko H, Levy C, Mereckiene J, Knol M, Winje BA, Ciruela P, de Miguel S, Guevara M, MacDonald L, Kozakova J, Slotved HC, Fry NK, Pekka Nuorti J, Danis K, Corcoran M, van der Ende A, Vestrheim DF, Munoz-Almagro C, Sanz JC, Castilla J, Smith A, Colzani E, Pastore Celentano L, Hanquet G. Effectiveness of 10 and 13-valent pneumococcal conjugate vaccines against invasive pneumococcal disease in European children: SpIDnet observational multicentre study. Vaccine 2022; 40:3963-3974. [PMID: 35637067 DOI: 10.1016/j.vaccine.2022.05.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/19/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pneumococcal conjugate vaccines covering 10 (PCV10) and 13 (PCV13) serotypes have been introduced in the infant immunization schedule of most European countries in 2010-11. To provide additional real-life data, we measured the effectiveness of PCV10 and PCV13 against invasive pneumococcal disease (IPD) in children of 12 European sites (SpIDnet). METHODS We compared the vaccination status of PCV10 and PCV13 serotype IPD (cases) to that of nonPCV13 serotype IPD (controls) reported in 2012-2018. We calculated pooled effectiveness as (1-vaccination odds ratio)*100, and measured effectiveness over time since booster dose. RESULTS The PCV13 and PCV10 studies included 2522 IPD cases from ten sites and 486 cases from four sites, respectively. The effectiveness of ≥ 1 PCV13 dose was 84.2% (95 %CI: 79.0-88.1) against PCV13 serotypes (n = 2353) and decreased from 93.1% (87.8-96.1) < 12 months to 85.1% (72.0-92.1) ≥ 24 months after booster dose. PCV13 effectiveness of ≥ 1 dose was 84.7% (55.7-94.7) against fatal PCV13 IPD, 64.5% (43.7-77.6), 83.2% (73.7-89.3) and 85.1% (67.6-93.1) against top serotypes 3, 19A and 1, respectively, and 85.4% (62.3-94.4) against 6C. Serotype 3 and 19A effectiveness declined more rapidly. PCV10 effectiveness of ≥ 1 dose was 84.8% (69.4-92.5) against PCV10 serotypes (n = 370), 27.2% (-187.6 to 81.6) and 85.3% (35.2-96.7) against top serotypes 1 and 7F, 32.5% (-28.3 to 64.5) and -14.4% (-526.5 to 79.1) against vaccine-related serotypes 19A and 6C, respectively. CONCLUSIONS PCV10 and PCV13 provide similar protection against IPD due to the respective vaccine serotype groups but serotype-specific effectiveness varies by serotype and vaccine. PCV13 provided individual protection against serotype 3 and vaccine-related serotype 6C IPD. PCV10 effectiveness was not significant against vaccine-related serotypes 19A and 6C. PCV13 effectiveness declined with time after booster vaccination. This multinational study enabled measuring serotype-specific vaccine effectiveness with a precision rarely possible at the national level. Such large networks are crucial for the post-licensure evaluation of vaccines.
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Affiliation(s)
| | - Pavla Krizova
- National Institute of Public Health, Prague, Czech Republic
| | | | | | | | | | | | - Mirjam Knol
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Pilar Ciruela
- Health Agency of Catalunya, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | | | - Marcela Guevara
- Public Health Institute of Navarra - IdiSNA, Pamplona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | | | - Jana Kozakova
- National Institute of Public Health, Prague, Czech Republic
| | | | | | - J Pekka Nuorti
- National Institute for Health and Welfare, Helsinki, Finland; Tampere University, Tampere, Finland
| | - Kostas Danis
- Santé publique France, the National Public Health Institute, Saint-Maurice, France
| | - Mary Corcoran
- Temple Street Children's University Hospital, Irish Pneumococcal Reference Laboratory, Dublin, Ireland
| | - Arie van der Ende
- Academic Medical Centre, National Reference Laboratory for Bacterial Meningitis, Amsterdam, the Netherlands
| | | | - Carmen Munoz-Almagro
- Hospital Sant Joan de Déu, and International University of Catalunya, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | | | - Jesus Castilla
- Public Health Institute of Navarra - IdiSNA, Pamplona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Andrew Smith
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratory, Glasgow Royal Infirmary & MVLS, University of Glasgow, Glasgow, Scotland, UK
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Germaine Hanquet
- Epiconcept, Paris, France; Antwerp university, Antwerp, Belgium.
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Hanquet G, Krizova P, Dalby T, Ladhani SN, Nuorti JP, Danis K, Mereckiene J, Knol MJ, Winje BA, Ciruela P, de Miguel S, Portillo ME, MacDonald L, Morfeldt E, Kozakova J, Valentiner-Branth P, Fry NK, Rinta-Kokko H, Varon E, Corcoran M, van der Ende A, Vestrheim DF, Munoz-Almagro C, Sanz JC, Castilla J, Smith A, Henriques-Normark B, Colzani E, Pastore-Celentano L, Savulescu C. Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe. Emerg Infect Dis 2022; 28:137-138. [PMID: 34932457 PMCID: PMC8714201 DOI: 10.3201/eid2801.210734] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We evaluated invasive pneumococcal disease (IPD) during 8 years of infant pneumococcal conjugate vaccine (PCV) programs using 10-valent (PCV10) and 13-valent (PCV13) vaccines in 10 countries in Europe. IPD incidence declined during 2011-2014 but increased during 2015-2018 in all age groups. From the 7-valent PCV period to 2018, IPD incidence declined by 42% in children <5 years of age, 32% in persons 5-64 years of age, and 7% in persons >65 years of age; non-PCV13 serotype incidence increased by 111%, 63%, and 84%, respectively, for these groups. Trends were similar in countries using PCV13 or PCV10, despite different serotype distribution. In 2018, serotypes in the 15-valent and 20-valent PCVs represented one third of cases in children <5 years of age and two thirds of cases in persons >65 years of age. Non-PCV13 serotype increases reduced the overall effect of childhood PCV10/PCV13 programs on IPD. New vaccines providing broader serotype protection are needed.
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Bollaerts K, Fletcher MA, Suaya JA, Hanquet G, Baay M, Gessner BD. Vaccine-Preventable Disease Incidence Based on Clinically, Radiologically and Etiologically Confirmed Outcomes: Systematic Literature Review and Re-analysis of Pneumococcal Conjugate Vaccine Efficacy Trials. Clin Infect Dis 2021; 74:1362-1371. [PMID: 34313721 PMCID: PMC9049266 DOI: 10.1093/cid/ciab649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Indexed: 11/14/2022] Open
Abstract
Background Vaccine regulatory decision making is based on vaccine efficacy against etiologically confirmed outcomes, which may underestimate the preventable disease burden. To quantify this underestimation, we compared vaccine-preventable disease incidence (VPDI) of clinically defined outcomes with radiologically/etiologically confirmed outcomes. Methods We performed a systematic review of efficacy trials for several vaccines (1997–2019) and report results for pneumococcal conjugate vaccines. Data were extracted for outcomes within a clinical syndrome, organized from most sensitive to most specific. VPDI was determined for each outcome, and VPDI ratios were calculated, with a clinically defined outcome (numerator) and a radiologically/etiologically confirmed outcome (denominator). Results Among 9 studies, we calculated 27 VPDI ratios; 24 had a value >1. Among children, VPDI ratios for clinically defined versus vaccine serotype otitis media were 0.6 (95% CI not calculable), 2.1 (1.5–3.0), and 3.7 (1.0–10.2); the VPDI ratios comparing clinically defined with radiologically confirmed pneumonia ranged from not calculable to 2.7 (1.2–10.4); the VPDI ratio comparing clinically suspected invasive pneumococcal disease (IPD) with laboratory-confirmed IPD was 3.8 (95% CI not calculable). Among adults, the ratio comparing clinically defined with radiologically confirmed pneumonia was 1.9 (−6.0 to 9.1) and with vaccine serotype–confirmed pneumonia was 2.9 (.5–7.8). Conclusions While there is substantial uncertainty around individual point estimates, there is a consistent trend in VPDI ratios, most commonly showing under-ascertainment of 1.5- to 4-fold, indicating that use of clinically defined outcomes is likely to provide a more accurate estimate of a pneumococcal conjugate vaccine’s public health value.
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Affiliation(s)
| | - Mark A Fletcher
- Pfizer Inc., Emerging Markets Medical Affairs, Paris, France
| | - Jose A Suaya
- Pfizer Inc., Vaccines Medical Development & Scientific/Clinical Affairs, New York, NY, United States of America
| | | | - Marc Baay
- P95 Epidemiology and Pharmacovigilance, Leuven, Belgium
| | - Bradford D Gessner
- Pfizer Inc., Scientific Affairs, Collegeville, PA, United States of America
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Edwards K, Hanquet G, Black S, Mignot E, Jankosky C, Shimabukuro T, Miller E, Nohynek H, Neels P. Meeting report narcolepsy and pandemic influenza vaccination: What we know and what we need to know before the next pandemic? A report from the 2nd IABS meeting. Biologicals 2019; 60:1-7. [PMID: 31130313 DOI: 10.1016/j.biologicals.2019.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 05/14/2019] [Indexed: 12/20/2022] Open
Abstract
A group of scientific and public health experts and key stakeholders convened to discuss the state of knowledge on the relationship between adjuvanted monovalent inactivated 2009 influenza A H1N1 vaccines used during the 2009 influenza pandemic and narcolepsy. There was consensus that an increased risk of narcolepsy was consistently observed after Pandemrix (AS03-adjuvanted) vaccine, but similar associations following Arepanrix (AS03-adjuvanted) or Focetria (MF59-adjuvanted) vaccines were not observed. Whether the differences are due to vaccine composition or other factors such as the timing of large-scale vaccination programs relative to H1N1pdm09 wild-type virus circulation in different geographic regions is not clear. The limitations of retrospective observational methodologies could also be contributing to some of the differences across studies. More basic and epidemiologic research is needed to further elucidate the association between adjuvanted influenza vaccine and narcolepsy and its mechanism and to inform planning and preparation for vaccination programs in advance of the next influenza pandemic.
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Affiliation(s)
- Kathryn Edwards
- Medical Center North, Vanderbilt University School of Medicine, Nashville, TN, D7227, USA.
| | - Germaine Hanquet
- Brussels, and Antwerp University, Universiteitsplein 1, 2610, Antwerp, Belgium.
| | - Steve Black
- Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Emmanuel Mignot
- Stanford Center for Sleep Sciences and Medicine, Stanford University, Palo Alto, CA, USA
| | - Christopher Jankosky
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Tom Shimabukuro
- Immunization Safety Office, Centers for Disease Control and Prevention (CDC), 1600, Clifton Road, Atlanta, GA, USA.
| | | | - Hanna Nohynek
- National Institute for Health and Welfare THL Department of Health Security, Infectious Disease Control and Vaccinations Unit Helsinki, Finland
| | - Pieter Neels
- IABS, Rue de la Vallée 3, 1204, Genève, Switzerland.
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9
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Hanquet G, Krizova P, Valentiner-Branth P, Ladhani SN, Nuorti JP, Lepoutre A, Mereckiene J, Knol M, Winje BA, Ciruela P, Ordobas M, Guevara M, McDonald E, Morfeldt E, Kozakova J, Slotved HC, Fry NK, Rinta-Kokko H, Varon E, Corcoran M, van der Ende A, Vestrheim DF, Munoz-Almagro C, Latasa P, Castilla J, Smith A, Henriques-Normark B, Whittaker R, Pastore Celentano L, Savulescu C. Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination. Thorax 2018; 74:473-482. [PMID: 30355641 PMCID: PMC6484683 DOI: 10.1136/thoraxjnl-2018-211767] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/31/2018] [Accepted: 08/20/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies. METHODS For each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100. RESULTS After five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively. CONCLUSION Overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.
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Affiliation(s)
| | - Pavla Krizova
- National Institute of Public Health, Prague, Czech Republic
| | | | | | - J Pekka Nuorti
- National Institute for Health and Welfare, Helsinki, Finland.,University of Tampere, Tampere, Finland
| | | | | | - Mirjam Knol
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Pilar Ciruela
- Public Health Agency of Catalunya, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Madrid, Spain
| | | | - Marcela Guevara
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Eisin McDonald
- Health Protection Scotland, National Services Scotland, Glasgow, UK
| | | | - Jana Kozakova
- National Institute of Public Health, Prague, Czech Republic
| | | | | | | | - Emmanuelle Varon
- National Centre for Pneumococci, European Hospital George Pompidou, Paris, France
| | - Mary Corcoran
- Irish Pneumococcal Reference Laboratory, Temple Street Children's University Hospital, Dublin, Ireland
| | - Arie van der Ende
- Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Centre, Amsterdam, The Netherlands
| | | | - Carmen Munoz-Almagro
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Instituto de Recerca Pediátrica, Hospital Sant Joan de Deu, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Pello Latasa
- General Directorate of Public Health, Madrid, Spain
| | - Jesus Castilla
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Andrew Smith
- Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Glasgow, UK
| | - Birgitta Henriques-Normark
- Public Health Agency of Sweden, Solna, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Robert Whittaker
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Willem L, Blommaert A, Hanquet G, Thiry N, Bilcke J, Theeten H, Verhaegen J, Goossens H, Beutels P. Economic evaluation of pneumococcal vaccines for adults aged over 50 years in Belgium. Hum Vaccin Immunother 2018; 14:1218-1229. [PMID: 29420161 PMCID: PMC5989887 DOI: 10.1080/21645515.2018.1428507] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/12/2017] [Accepted: 01/12/2018] [Indexed: 11/23/2022] Open
Abstract
Streptococcus pneumoniae causes a high disease burden including pneumonia, meningitis and septicemia. Both a polysaccharide vaccine targeting 23 serotypes (PPV23) and a 13-valent conjugate vaccine (PCV13) are indicated for persons aged over 50 years. We developed and parameterized a static multi-cohort model to estimate the incremental cost-effectiveness and budget-impact of these vaccines at different uptake levels. Using three different vaccine efficacy scenarios regarding non-invasive pneumococcal pneumonia and extensive uni- and multivariate sensitivity analyses, we found a strong preference for PPV23 over PCV13 in all age groups at willingness to pay levels below €300 000 per quality adjusted life year (QALY). PPV23 vaccination would cost on average about €83 000, €60 000 and €52 000 per QALY gained in 50-64, 65-74 and 75-84 year olds, whereas for PCV13 this is about €171 000, €201 000 and €338 000, respectively. Strategies combining PPV23 and PCV13 vaccines were most effective but generally less cost-effective. When assuming a combination of increased duration of PCV13 protection, increased disease burden preventable by PCV13 and a 75% reduction of the PCV13 price, PCV13 could become more attractive in <75 year olds, but would remain less attractive than PPV23 from age 75 years onwards. These observations are independent of the assumption that PPV23 has 0% efficacy against non-invasive pneumococcal pneumonia. Pneumococcal vaccination would be most cost-effective in Belgium, when achieving high uptake with PPV23 in 75-84 year olds, as well as by negotiating a lower market-conform PPV23 price to improve uptake and cost-effectiveness.
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Affiliation(s)
- Lander Willem
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Adriaan Blommaert
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | | | - Nancy Thiry
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - Joke Bilcke
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Heidi Theeten
- Center for the Evaluation of Vaccination (CEV), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Jan Verhaegen
- Department of Clinical Microbiology, Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology (LMM), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research & Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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11
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Bochicchio A, Schiavo L, Chiummiento L, Lupattelli P, Funicello M, Hanquet G, Choppin S, Colobert F. Convergent total synthesis of (±) myricanol, a cyclic natural diarylheptanoid. Org Biomol Chem 2018; 16:8859-8869. [DOI: 10.1039/c8ob02052c] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Third total synthesis of the meta, meta-bridged diarylheptanoid: myricanol with remarkable anti-tau properties.
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Affiliation(s)
- A. Bochicchio
- Department of Science
- University of Basilicata
- 85100 Potenza
- Italy
- Laboratoire d'Innovation Moléculaire et Applications (UMR CNRS 7042)
| | - L. Schiavo
- Laboratoire d'Innovation Moléculaire et Applications (UMR CNRS 7042)
- Université de Strasbourg/Université de haute Alsace
- ECPM
- Strasbourg
- France
| | - L. Chiummiento
- Department of Science
- University of Basilicata
- 85100 Potenza
- Italy
| | - P. Lupattelli
- Department of Science
- University of Basilicata
- 85100 Potenza
- Italy
| | - M. Funicello
- Department of Science
- University of Basilicata
- 85100 Potenza
- Italy
| | - G. Hanquet
- Laboratoire d'Innovation Moléculaire et Applications (UMR CNRS 7042)
- Université de Strasbourg/Université de haute Alsace
- ECPM
- Strasbourg
- France
| | - S. Choppin
- Laboratoire d'Innovation Moléculaire et Applications (UMR CNRS 7042)
- Université de Strasbourg/Université de haute Alsace
- ECPM
- Strasbourg
- France
| | - F. Colobert
- Laboratoire d'Innovation Moléculaire et Applications (UMR CNRS 7042)
- Université de Strasbourg/Université de haute Alsace
- ECPM
- Strasbourg
- France
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12
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Vygen S, Hellenbrand W, Stefanoff P, Hanquet G, Heuberger S, Stuart J. European public health policies for managing contacts of invasive meningococcal disease cases better harmonised in 2013 than in 2007. ACTA ACUST UNITED AC 2016; 21:23-31. [PMID: 26875517 DOI: 10.2807/1560-7917.es.2016.21.5.30125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 05/07/2015] [Indexed: 11/20/2022]
Abstract
In 2007, a European survey identified variation in country policies on public health management of invasive meningococcal disease (IMD). In 2009-10, the European Centre for Disease Prevention and Control (ECDC) published evidence-based guidance on IMD. We therefore surveyed again European countries to describe policies for managing IMD cases and contacts in 2013. We asked national IMD public health experts from 32 European countries to complete a questionnaire focusing on post-exposure prophylaxis (PEP) for IMD contacts and meningococcal vaccination. Proportions in 2007 and 2013 were compared using the chi-squared test. All 32 countries responded, with responses from two regions for Belgium and Italy; half stated having used ECDC guidance to update national recommendations. PEP was recommended to close contacts in 33 of 34 countries/regions, mainly ciprofloxacin for adults (29/32 countries) and rifampicin for children (29/32 countries). ECDC guidance for managing IMD contacts in airplanes was strictly followed by five countries/regions. Twenty-three countries/regions participated in both surveys. Compared with 2007, in 2013, more countries/regions recommended i) ceftriaxone for children (15/23 vs 6/20; p = 0.03), ii) PEP for all children in the same preschool group (8/23 vs 17/23; p = 0.02). More countries/regions recommended evidence-based measures for IMD public health management in 2013 than 2007. However, some discrepancies remain and they call for further harmonisation.
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Affiliation(s)
- Sabine Vygen
- French Institute of Public Health Surveillance, Department of Coordination of Alerts and Regions, Regional office in Aquitaine, Bordeaux, France
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13
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Ultsch B, Damm O, Beutels P, Bilcke J, Brüggenjürgen B, Gerber-Grote A, Greiner W, Hanquet G, Hutubessy R, Jit M, Knol M, von Kries R, Kuhlmann A, Levy-Bruhl D, Perleth M, Postma M, Salo H, Siebert U, Wasem J, Wichmann O. Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks: A Consensus Framework from a European Vaccine Economics Community. Pharmacoeconomics 2016; 34:227-44. [PMID: 26477039 PMCID: PMC4766233 DOI: 10.1007/s40273-015-0335-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
BACKGROUND Incremental cost-effectiveness and cost-utility analyses [health economic evaluations (HEEs)] of vaccines are routinely considered in decision making on immunization in various industrialized countries. While guidelines advocating more standardization of such HEEs (mainly for curative drugs) exist, several immunization-specific aspects (e.g. indirect effects or discounting approach) are still a subject of debate within the scientific community. OBJECTIVE The objective of this study was to develop a consensus framework for HEEs of vaccines to support the development of national guidelines in Europe. METHODS A systematic literature review was conducted to identify prevailing issues related to HEEs of vaccines. Furthermore, European experts in the field of health economics and immunization decision making were nominated and asked to select relevant aspects for discussion. Based on this, a workshop was held with these experts. Aspects on 'mathematical modelling', 'health economics' and 'decision making' were debated in group-work sessions (GWS) to formulate recommendations and/or--if applicable--to state 'pros' and 'contras'. RESULTS A total of 13 different aspects were identified for modelling and HEE: model selection, time horizon of models, natural disease history, measures of vaccine-induced protection, duration of vaccine-induced protection, indirect effects apart from herd protection, target population, model calibration and validation, handling uncertainty, discounting, health-related quality of life, cost components, and perspectives. For decision making, there were four aspects regarding the purpose and the integration of HEEs of vaccines in decision making as well as the variation of parameters within uncertainty analyses and the reporting of results from HEEs. For each aspect, background information and an expert consensus were formulated. CONCLUSIONS There was consensus that when HEEs are used to prioritize healthcare funding, this should be done in a consistent way across all interventions, including vaccines. However, proper evaluation of vaccines implies using tools that are not commonly used for therapeutic drugs. Due to the complexity of and uncertainties around vaccination, transparency in the documentation of HEEs and during subsequent decision making is essential.
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Affiliation(s)
- Bernhard Ultsch
- Department for Infectious Disease Epidemiology, Immunisation Unit, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany.
| | | | | | | | | | | | | | | | | | - Mark Jit
- London School of Hygiene and Tropical Medicine (LSHTM), London, UK
- Public Health England (PHE), London, UK
| | - Mirjam Knol
- Centre for Infectious Disease Control (RIVM), Bilthoven, The Netherlands
| | | | | | | | | | | | - Heini Salo
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Uwe Siebert
- University for Health Sciences, Medical Informatics and Technology (UMIT), Hall in Tirol, Austria
- ONCOTYROL, Center for Personalized Cancer Medicine, Innsbruck, Austria
| | | | - Ole Wichmann
- Department for Infectious Disease Epidemiology, Immunisation Unit, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany
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Mattheus W, Hanquet G, Collard JM, Vanhoof R, Bertrand S. Changes in Meningococcal Strains in the Era of a Serogroup C Vaccination Campaign: Trends and Evolution in Belgium during the Period 1997-2012. PLoS One 2015; 10:e0139615. [PMID: 26425857 PMCID: PMC4591272 DOI: 10.1371/journal.pone.0139615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/14/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Invasive meningococcal disease (IMD) is a major cause of bacterial meningitides and septicaemia. This study shows the results of the laboratory-based surveillance of IMD in Belgium over the period 1997-2012. METHODS The results are based on microbiological and molecular laboratory surveillance of 2997 clinical isolates of N. meningitides received by the Belgian Meningococcal Reference Centre (BMRC) over the period 1997-2012. RESULTS Serogroup B has always been a major cause of meningococcal disease in Belgium, with P3.4 as most frequent serotype till 2008, while an increase in non-serotypable strains has been observed in the last few years. Clonal complexes cc-41/44 and cc-269 are most frequently observed in serogroup B strains. In the late nineties, the incidence of serogroup C disease increased considerably and peaked in 2001, mainly associated with phenotypes C:2a:P1.5,2, C:2a:P1.5 and C:2a:P1.2 (ST-11/ET-37 clonal complex). The introduction of the meningococcal C conjugate vaccine has been followed by an 88% significant decrease in serogroup C disease from 2001 to 2004 nationally, yet sharper in Flanders (92%) compared to Wallonia (77%). Since 2008 a difference in incidence of serogroup C was observed in Flanders (0-0.1/100,000) versus Wallonia (0.1-0.3/100,000). CONCLUSION This study showed the change in epidemiology and strain population over a 16 years period spanning an exhaustive vaccination campaign and highlights the influence of regional vaccination policies with different cohorts sizes on short and long-term IMD incidences.
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Affiliation(s)
- Wesley Mattheus
- Sections of Bacterial Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - Germaine Hanquet
- Medical Epidemiologist, Health Care Knowledge Centre, Brussels, Belgium
| | - Jean-Marc Collard
- Sections of Bacterial Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - Raymond Vanhoof
- Sections of Bacterial Diseases, Scientific Institute of Public Health, Brussels, Belgium
| | - Sophie Bertrand
- Sections of Bacterial Diseases, Scientific Institute of Public Health, Brussels, Belgium
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15
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Goeyvaerts N, Willem L, Van Kerckhove K, Vandendijck Y, Hanquet G, Beutels P, Hens N. Estimating dynamic transmission model parameters for seasonal influenza by fitting to age and season-specific influenza-like illness incidence. Epidemics 2015; 13:1-9. [PMID: 26616037 DOI: 10.1016/j.epidem.2015.04.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 04/10/2015] [Accepted: 04/24/2015] [Indexed: 12/20/2022] Open
Abstract
Dynamic transmission models are essential to design and evaluate control strategies for airborne infections. Our objective was to develop a dynamic transmission model for seasonal influenza allowing to evaluate the impact of vaccinating specific age groups on the incidence of infection, disease and mortality. Projections based on such models heavily rely on assumed 'input' parameter values. In previous seasonal influenza models, these parameter values were commonly chosen ad hoc, ignoring between-season variability and without formal model validation or sensitivity analyses. We propose to directly estimate the parameters by fitting the model to age-specific influenza-like illness (ILI) incidence data over multiple influenza seasons. We used a weighted least squares (WLS) criterion to assess model fit and applied our method to Belgian ILI data over six influenza seasons. After exploring parameter importance using symbolic regression, we evaluated a set of candidate models of differing complexity according to the number of season-specific parameters. The transmission parameters (average R0, seasonal amplitude and timing of the seasonal peak), waning rates and the scale factor used for WLS optimization, influenced the fit to the observed ILI incidence the most. Our results demonstrate the importance of between-season variability in influenza transmission and our estimates are in line with the classification of influenza seasons according to intensity and vaccine matching.
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Affiliation(s)
- Nele Goeyvaerts
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Agoralaan Gebouw D, B3590 Diepenbeek, Belgium; Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, B2610 Wilrijk, Belgium.
| | - Lander Willem
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Agoralaan Gebouw D, B3590 Diepenbeek, Belgium; Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, B2610 Wilrijk, Belgium; Department of Mathematics and Computer Science, University of Antwerp, Middelheimlaan 1, B2020 Antwerp, Belgium
| | - Kim Van Kerckhove
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Agoralaan Gebouw D, B3590 Diepenbeek, Belgium; Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, B2610 Wilrijk, Belgium
| | - Yannick Vandendijck
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Agoralaan Gebouw D, B3590 Diepenbeek, Belgium
| | - Germaine Hanquet
- KCE - Belgian Health Care Knowledge Centre, Boulevard du Jardin Botanique 55, B1000 Brussels, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, B2610 Wilrijk, Belgium
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Agoralaan Gebouw D, B3590 Diepenbeek, Belgium; Centre for Health Economics Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, B2610 Wilrijk, Belgium
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16
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Ultsch B, Damm O, Beutels P, Bilcke J, Brüggenjürgen B, Gerber-Grote AU, Greiner W, Hanquet G, Harder T, Hutubessy R, Jit M, Knol M, Kuhlmann A, von Kries R, Levy-Bruhl D, Perleth M, Postma MJ, Salo H, Siebert U, Wasem J, Weidemann F, Wichmann O. Methods for Health Economic Evaluations of Vaccines - Results from an International Expert-Workshop. Value Health 2014; 17:A552. [PMID: 27201800 DOI: 10.1016/j.jval.2014.08.1803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- B Ultsch
- Robert Koch Institute / Charité University Medical Center, Berlin, Germany
| | - O Damm
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - P Beutels
- University of Antwerp, Antwerp, Belgium
| | - J Bilcke
- University of Antwerp, Antwerp, Belgium
| | | | - A U Gerber-Grote
- Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany
| | - W Greiner
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - G Hanquet
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - T Harder
- Robert Koch Institute, Berlin, Germany
| | - R Hutubessy
- World Health Organization, Geneva, Switzerland
| | - M Jit
- London School of Hygiene and Tropical Medicine / Public Health England (PHE), London, UK
| | - M Knol
- RIVM - Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - A Kuhlmann
- Leibniz Universität Hannover, Hannover, Germany
| | - R von Kries
- Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - D Levy-Bruhl
- Institut de Veille Sanitaire, Saint-Maurice Cedex, France
| | - M Perleth
- Gemeinsamer Bundesausschuss (G-BA), Berlin, Germany
| | - M J Postma
- University of Groningen, Groningen, The Netherlands
| | - H Salo
- National Institute for Health and Welfare, Helsinki, Finland
| | - U Siebert
- Medical Informatics and Technology, and Director of the Division for Health Technology Assessment and Bioinformatics, ONCOTYROL, Hall i. T, Austria
| | - J Wasem
- University of Duisburg-Essen, Essen, Germany
| | - F Weidemann
- Robert Koch Institute / Charité Berlin, Berlin, Germany
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Blommaert A, Bilcke J, Vandendijck Y, Hanquet G, Hens N, Beutels P. Cost-effectiveness of seasonal influenza vaccination in pregnant women, health care workers and persons with underlying illnesses in Belgium. Vaccine 2014; 32:6075-83. [PMID: 25239481 DOI: 10.1016/j.vaccine.2014.08.085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 08/14/2014] [Accepted: 08/31/2014] [Indexed: 10/24/2022]
Abstract
Risk groups with increased vulnerability for influenza complications such as pregnant women, persons with underlying illnesses as well as persons who come into contact with them, such as health care workers, are currently given priority (along with other classic target groups) to receive seasonal influenza vaccination in Belgium. We aimed to evaluate this policy from a health care payer perspective by cost-effectiveness analysis in the three specific target groups above, while accounting for effects beyond the target group. Increasing the coverage of influenza vaccination is likely to be cost-effective for pregnant women (median €6589 per quality-adjusted life-year (QALY) gained [€4073-€10,249]) and health care workers (median €24,096/QALY gained [€16,442-€36,342]), if this can be achieved without incurring additional administration costs. Assuming an additional physician's consult is charged to administer each additional vaccine dose, the cost-effectiveness of vaccinating pregnant women depends strongly on the extent of its impact on the neonate's health. For health care workers, the assumed number of preventable secondary infections has a strong influence on the cost-effectiveness. Vaccinating people with underlying illnesses is likely highly cost-effective above 50 years of age and borderline cost-effective for younger persons, depending on relative life expectancy and vaccine efficacy in this risk group compared to the general population. The case-fatality ratios of the target group, of the secondary affected groups and vaccine efficacy are key sources of uncertainty.
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Affiliation(s)
- Adriaan Blommaert
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Belgium.
| | - Joke Bilcke
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Yannick Vandendijck
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Belgium
| | | | - Niel Hens
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
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18
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Hanquet G, Ducoffre G, Vergison A, Neels P, Sabbe M, Van Damme P, Van Herck K. Impact of rotavirus vaccination on laboratory confirmed cases in Belgium. Vaccine 2011; 29:4698-703. [DOI: 10.1016/j.vaccine.2011.04.098] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 04/25/2011] [Accepted: 04/26/2011] [Indexed: 10/18/2022]
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Hanquet G, Lernout T, Vergison A, Verhaegen J, Kissling E, Tuerlinckx D, Malfroot A, Swennen B, Sabbe M. Impact of conjugate 7-valent vaccination in Belgium: addressing methodological challenges. Vaccine 2011; 29:2856-64. [PMID: 21342667 DOI: 10.1016/j.vaccine.2011.02.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 12/30/2010] [Accepted: 02/07/2011] [Indexed: 01/13/2023]
Abstract
In Belgium, the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the national schedule in 2007. The early impact of PCV7 vaccination on paediatric invasive disease was estimated by comparing pre- and post-vaccination incidence from national surveillance. In children <2 year-olds, vaccine-serotype incidence declined by 96% but non-vaccine-types increased 2-3-fold. Overall invasive disease decreased by 23-46%, depending on adjustment for under-reporting and pre-vaccine trends. Non-vaccine-types 1 and 19A had increased before PCV7 use, suggesting the contribution of other factors. Estimation of PCV7 impact comparing pre- and post-vaccination data should adjust for pre-vaccine trends, and serotype dynamics need further exploration.
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20
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Hanquet G, Van Damme P, Brasseur D, De Cuyper X, Gregor S, Holmberg M, Martin R, Molnár Z, Pompa MG, Snacken R, van der Sande M, Van Ranst M, Wirtz A, Neels P. Lessons learnt from pandemic A(H1N1) 2009 influenza vaccination. Highlights of a European workshop in Brussels (22 March 2010). Vaccine 2011; 29:370-7. [DOI: 10.1016/j.vaccine.2010.10.079] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 10/24/2010] [Accepted: 10/29/2010] [Indexed: 11/28/2022]
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21
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Hanquet G, Kissling E, Fenoll A, George R, Lepoutre A, Lernout T, Tarragó D, Varon E, Verhaegen J. Pneumococcal serotypes in children in 4 European countries. Emerg Infect Dis 2010; 16:1428-39. [PMID: 20735928 PMCID: PMC3294971 DOI: 10.3201/eid1609.100102] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
After heptavalent pneumococcal conjugate vaccine (PCV7) was marketed in France, Spain, Belgium, and England and Wales (United Kingdom), invasive disease from non-PCV7 serotypes (NVT) increased. Adjusted serotype-specific incidences among children <15 years of age were compared between 1999-2002 (prevaccine) and 2005-2006 (postmarketing). Vaccine coverage increased to approximately 32%-48% in France, Spain, and Belgium but remained <1% in England and Wales. Serotype 1 incidence rose in all age groups and countries (incidence rate ratio [IRR] 1.3-4.2; p<0.004), independently of PCV7 use, but incidence of serotypes 7F and 19A increased most in France, Spain, and Belgium (IRR 1.9-16.9 in children <5 years; p<0.001), where PCV7 coverage was greater. Vaccine-induced replacement of PCV7 serotypes possibly contributed to NVT increases, as did secular trends. New vaccines targeting these serotypes are available, but serotype dynamics needs further exploration that accounts for underreporting and prevaccine trends.
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Hanquet G, Perrocheau A, Kissling E, Bruhl DL, Tarragó D, Stuart J, Stefanoff P, Heuberger S, Kriz P, Vergison A, de Greeff SC, Amato-Gauci A, Celentano LP. Surveillance of invasive pneumococcal disease in 30 EU countries: Towards a European system? Vaccine 2010; 28:3920-8. [PMID: 20394721 DOI: 10.1016/j.vaccine.2010.03.069] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Revised: 03/21/2010] [Accepted: 03/26/2010] [Indexed: 11/25/2022]
Abstract
In this era of new pneumococcal conjugate vaccines (PCV), we described and compared surveillance of invasive pneumococcal disease (IPD) and PCV policies in 30 European countries to provide guidance for Europe-wide surveillance. We confirmed the heterogeneity of surveillance systems and case definitions across countries but identified elements common to all countries, such as the availability of serotyping and the surveillance of pneumococcal meningitis. PCV impact was monitored in 11/15 countries using it. We propose steps for the monitoring of incidence rates and serotype distribution at EU level, to assess the need to introduce PCV and monitor its impact once introduced.
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Wattiau P, Govaerts M, Frangoulidis D, Fretin D, Kissling E, Van Hessche M, China B, Poncin M, Pirenne Y, Hanquet G. Immunologic response of unvaccinated workers exposed to anthrax, Belgium. Emerg Infect Dis 2010; 15:1637-40. [PMID: 19861061 PMCID: PMC2866386 DOI: 10.3201/eid1510.081717] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
To determine immunologic reactivity to Bacillus anthrax antigens, we conducted serologic testing of workers in a factory that performed scouring of wool and goat hair. Of 66 workers, ≈10% had circulating antibodies or T lymphocytes that reacted with anthrax protective antigen. Individual immunity varied from undetectable to high.
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Affiliation(s)
- Pierre Wattiau
- Veterinary and Agro-chemical Research Centre, Department of Bacterial Diseases, Brussels, Belgium.
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Hoek M, Hanquet G, Heuberger S, Stefanoff P, Zucs P, Ramsay M, Stuart J. A European survey on public health policies for managing cases of meningococcal disease and their contacts. ACTA ACUST UNITED AC 2008; 13. [PMID: 18445439 DOI: 10.2807/ese.13.10.08060-en] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In 2007, a European survey was conducted to compare national policies on public health management of cases of meningococcal disease and their contacts. The results revealed differences in definitions of close contacts and prophylactic regimens between countries. These differences can be attributed to a lack of evidence on optimal prevention and treatment strategies. The development of guidance for best practice in priority areas, based on evidence or consensus, is therefore recommended.
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Affiliation(s)
- M Hoek
- European Programme for Intervention Epidemiology Training, London, United Kingdom
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Quoilin S, Thomas I, Gérard C, Maes S, Haucotte G, Gerard M, Van Laethem Y, Snacken R, Hanquet G, Brochier B, Robesyn E. Management of potential human cases of influenza A/H5N1: lessons from Belgium. ACTA ACUST UNITED AC 2006; 11:E060126.1. [PMID: 16801712 DOI: 10.2807/esw.11.04.02885-en] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Since the first human cases of influenza A/H5N1 were widely reported from Turkey in early January, many European patients with suspected influenza
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Affiliation(s)
- S Quoilin
- Scientific Institute of Public Health, Brussels, Belgium.
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26
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Snacken R, Hanquet G, Maes S, Brochier B. [Avian flu: what kind of danger for public health?]. Rev Med Brux 2005; 26:481-3. [PMID: 16454151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Van Borm S, Thomas I, Hanquet G, Lambrecht B, Boschmans M, Dupont G, Decaestecker M, Snacken R, van den Berg T. Highly pathogenic H5N1 influenza virus in smuggled Thai eagles, Belgium. Emerg Infect Dis 2005; 11:702-5. [PMID: 15890123 PMCID: PMC3320388 DOI: 10.3201/eid1105.050211] [Citation(s) in RCA: 151] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report the isolation and characterization of a highly pathogenic avian influenza A/H5N1 virus from Crested Hawk-Eagles smuggled into Europe by air travel. A screening performed in human and avian contacts indicated no dissemination occurred. Illegal movements of birds are a major threat for the introduction of highly pathogenic avian influenza.
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Affiliation(s)
- Steven Van Borm
- Avian Virology and Immunology Unit, Veterinary and Agrochemical Research Centre, Brussels, Belgium.
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Chiaroni A, Hanquet G, Lusinchi M, Riche C. First X-ray Determination of an Oxaziridinium Salt: (1S,2R,3R,4S)-2,3-Dimethyl-4-phenyl-1,2,3,4-tetrahydro-1,2-epoxyisoquinolinium Tetrafluoroborate and (1S,2R,3R,4S)-3-Methyl-4-phenyl-1,2,3,4-tetrahydro-2,3-epoxyisoquinoline. Acta Crystallogr C 1995. [DOI: 10.1107/s0108270195004604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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