Impact of 10-valent pneumococcal conjugate vaccine on pneumococcal meningitis in children up to two years of age in Brazil

Grando, Indianara Maria; Moraes, Camile de; Flannery, Brendan; Ramalho, Walter Massa; Horta, Marco Aurélio Pereira; Pinho, Diana Lúcia Moura; Nascimento, Gilmara Lima

doi:10.1590/0102-311x00169913

Cited by 21 publications

(18 citation statements)

References 31 publications

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“…Before-after was the most common study design, and surveillance the most common data source used in the reported studies (Table 1). A total of 6 studies analyzed mortality: 2 evaluated PCV impact on pneumococcal meningitis deaths [19, 20], 2 evaluated impact on all-cause deaths [21, 22], and 3 analyzed deaths due to pneumonia [22–24]. …”

Section: Resultsmentioning

confidence: 99%

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Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review

et al. 2016

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BackgroundSeveral Latin American and Caribbean (LAC) countries have introduced pneumococcal conjugate vaccine (PCV-10 or PCV-13) in their routine national immunization programs.ObjectivesWe aimed to summarize the evidence of PCV impact and effectiveness in children under 5 years old in the LAC Region.MethodsWe conducted a systematic review of the literature on impact or effectiveness of PCVs on deaths or hospitalizations due to invasive pneumococcal disease (IPD), pneumonia, meningitis and sepsis. We searched Medline, WoS, Lilacs, Scopus, Central and gray literature published in any language from 2009 to January 2016. We included studies addressing the outcomes of interest in children in the target age group, and with the following designs: randomized trials, cohort or case-control, interrupted time series with at least three data points before and after the intervention, and before-after studies. Screening of citations, data extraction, and risk of bias assessment were conducted in duplicate by independent reviewers, according to the study protocol registered on PROSPERO. Descriptive analysis of the effectiveness measurements and sensitivity analysis were conducted. Effectiveness is reported as 1-OR or 1-RR for case control or cohort/clinical trials, and as percent change of disease incidence rates for before-after studies.ResultsWe identified 1,085 citations, 892 from databases and 193 from other sources. Of these, 22 were further analyzed. Studies were from Brazil, Chile, Uruguay, Argentina, Peru and Nicaragua. Effectiveness ranged from 8.8–37.8% for hospitalizations due to X-ray confirmed pneumonia, 7.4–20.6% for clinical pneumonia, and 13.3–87.7% for meningitis hospitalizations, and 56–83.3% for IPD hospitalization, varying by age, outcome definition, type of vaccine and study design.ConclusionsAvailable evidence to date indicates significant impact of both PCV-10 and PCV-13 in the outcomes studied, with no evidence of the superiority of one vaccine over the other on pneumonia, IPD or meningitis hospitalization reduction in children under 5 years old.

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Section: Resultsmentioning

confidence: 99%

“…They comprised four before-after [19, 20, 41, 42], and one case-control study [15]. Hospitalization rates before intervention reported in the before–after studies were higher among younger children, varying from a lower 0.83/100,000 in children aged 2–3 years [20] to 14.85/100,000 in infants <1 year old [19]. (Table 3)…”

Section: Resultsmentioning

confidence: 99%

Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review

et al. 2016

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“…In 2010, Hanquet and colleagues proposed to initially focus on the collection and analysis of meningitis data from all countries as a minimum common data set, as one of the considerations for establishing a uniform European IPD surveillance system 47 . In some countries however, PCV use had variable influence on the rate of pneumococcal meningitis; while a decrease in pneumococcal meningitis morbidity and mortality rates was reported in Brazil after introduction of PHiD-CV, 48 another study reported large confidence intervals, 49 and in several countries, only a slight decrease in pneumococcal meningitis cases after PCV13 implementation was observed 50 . This variability could increase the difficulty to estimate the potential impact of vaccination on pneumococcal disease, when based solely on meningitis data.…”

Section: Resultsmentioning

confidence: 99%

A reflection on invasive pneumococcal disease and pneumococcal conjugate vaccination coverage in children in Southern Europe (2009–2016)

Moreira¹,

Castro²,

Palmieri

et al. 2017

Human Vaccines & Immunotherapeutics

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Higher-valent pneumococcal conjugate vaccines (PCVs) were licensed from 2009 in Europe; similar worldwide clinical effectiveness was observed for PCVs in routine use. Despite a proven medical need, PCV vaccination in Southern Europe remained suboptimal until 2015/16.We searched PubMed for manuscripts published between 2009 and mid-2016. Included manuscripts had to contain data about invasive pneumococcal disease (IPD) incidence, or vaccination coverage with higher-valent PCVs. This review represents the first analysis of vaccination coverage and impact of higher-valent PCVs on overall IPD in Southern European countries (Portugal, Spain, Italy, Greece, Cyprus).Vaccination coverage in the Portuguese private market peaked around 2008 at 75% (children ≤ 2 years) but declined to 63% in 2012. In Madrid, coverage was 95% (2007–2012) but dropped to 67% (2013/14; children ≤ 2 years) after funding termination in May 2012. PCVs were recently introduced in the national immunisation program (NIP) of Portugal (2015) and Spain (2015/16). In Italy, coverage for the complete PCV schedule (children ≤ 2 years) was 88% in 2013, although highly variable between regions (45–99%). In Greece, in 2013, 82.3% had received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months. Overall IPD (net benefit: effect on vaccine types, vaccine-related types, and non-vaccine types) has decreased; in Greece, pneumococcal meningitis incidence remained stable.Continued IPD surveillance or national registers using ICD-10 codes of clinically suspected IPD are necessary, with timely publicly available reports and adequate national vaccination registers to assess trends in vaccination coverage, allowing evaluation of PCVs in NIPs.

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“…12 Similar result was demonstrated against pneumococcal meningitis in children 2 years of age using before-and-after methodology. 13 Both studies were conducted in Brazil between 2007 and 2012.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the impact of PCV-10 on invasive pneumococcal disease in Brazil: A time-series analysis

Andrade

Minamisava

Policena

et al. 2016

Human Vaccines & Immunotherapeutics

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Impact of 10-valent pneumococcal conjugate vaccine on pneumococcal meningitis in children up to two years of age in Brazil

Abstract: The objective of this study was to analyze the

Cited by 21 publications

References 31 publications

Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review

Impact and Effectiveness of 10 and 13-Valent Pneumococcal Conjugate Vaccines on Hospitalization and Mortality in Children Aged Less than 5 Years in Latin American Countries: A Systematic Review

A reflection on invasive pneumococcal disease and pneumococcal conjugate vaccination coverage in children in Southern Europe (2009–2016)

Evaluating the impact of PCV-10 on invasive pneumococcal disease in Brazil: A time-series analysis

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