Early impact of PCV7/PCV13 sequential introduction to the national pediatric immunization plan, on adult invasive pneumococcal disease: A nationwide surveillance study

Regev‐Yochay, Gili; Paran, Yael; Bishara, Jihad; Oren, Ilana; Chowers, Michal; Tziba, Yevgenia; Istomin, Valery; Weinberger, Miriam; Miron, Dan; Temper, Violeta; Rahav, Galia; Dagan, Ron

doi:10.1016/j.vaccine.2015.01.030

Cited by 54 publications

(49 citation statements)

References 23 publications

(26 reference statements)

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“…This is similar to other reports in the literature with sequential PCV7/PCV13 introduction. [23][24][25][26] The PCV13 vaccine was licensed based on an aggregate correlate of protection established for PCV7 serotypes of 0.35μg/ mL, as well as an opsonophagocytic antibody (OPA) titre of 1:8. Andrews and colleagues 27 measured serotype-specific correlates of protection in infants who had received 2 doses of conjugate vaccine and found that higher cut-offs for protection were need for serotypes 1, 3, 7F, 19A and 19F, and that an OPA titre of 1:8 was not predictive of protection.…”

Section: Discussionmentioning

confidence: 99%

“…Our data source did not contain information on risk factors, underlying illness including influenza or ethnicity; these additional variables are known to increase the risk of invasive pneumococcal disease. 24 Finally, because there is no vaccination registry, assessment of vaccination status was limited by data provided during case investigation.…”

Section: Limitationsmentioning

confidence: 99%

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The epidemiology of invasive pneumococcal disease in older adults from 2007 to 2014 in Ontario, Canada: a population-based study

et al. 2016

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Background:In Ontario, pneumococcal conjugate vaccines (PCVs) have been sequentially introduced into the publicly funded childhood vaccination program since 2005. A 23-valent polysaccharide pneumococcal vaccine (PPV23) has been routinely recommended for adults aged 65 years and older since 1996. To determine the effect of herd immunity, we examined the epidemiology of invasive pneumococcal disease in adults aged 65 years and older. Methods:Invasive pneumococcal disease is a provincially reportable disease. We were therefore able to conduct a descriptive epidemiologic analysis that included assessing time trends for patients aged 65 years and older using surveillance data from 2007 to 2014. Using serotype information within the surveillance data, cases were grouped into categories according to vaccine type and periods and then compared using Poisson regression.Results: A total of 3825 cases of invasive pneumococcal disease were reported among adults aged 65 years and older, for an overall annualized incidence of 25.4 cases per 100 000 population. There was a decrease in incidence due to serotypes included in 7-valent PCV (3.0 to 0.7 cases per 100 000 population) (p < 0.001). For 13-valent PCV serotypes, there was a decrease in incidence between 2011 and 2014 (9.8 to 5.3 cases per 100 000 population (p < 0.001)). Serotypes unique to PPV23 and those not included in a vaccine increased from 2.3 to 5.8 and from 2.4 to 7.2 cases per 100 000 population, respectively (p < 0.001). Interpretation:In older adults, among serotypes contained in PCVs, we have shown a decrease in incidence of invasive pneumococcal disease. This is likely due to herd immunity from the childhood program. A burden of illness due to unique PPV23 serotypes and those that are not covered by a vaccine exists and has increased over time. Abstract ResearchResearch CMAJ OPEN E546CMAJ OPEN, 4(3)

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

The epidemiology of invasive pneumococcal disease in older adults from 2007 to 2014 in Ontario, Canada: a population-based study

et al. 2016

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“…7 The introduction of the pneumococcal conjugate vaccines (PCVs) to the national immunization plans (NIP) worldwide resulted in substantial rate reductions of various pneumococcal disease end-points, including invasive pneumococcal disease (IPD), 13,14 pneumonia, [15][16][17][18] and otitis media, 3 including unvaccinated age groups and individuals. [17][18][19][20][21] Pneumococcal conjugate vaccines protect against carriage among vaccinated individuals and therefore prevent transmission to unvaccinated children and susceptible adults. This indirect (herd) protection increases PCV impact, both in terms of population health gain and economic value.…”

Section: Introductionmentioning

confidence: 99%

Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

Ben‐Shimol

Givon-Lavi

Greenberg

et al. 2015

Human Vaccines & Immunotherapeutics

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The 7-valent and the 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) were introduced to the Israeli National Immunization plan in July 2009 and November 2010, respectively. Our aim was to assess pneumococcal conjugate vaccines (PCVs) uptake and dynamics in serotype-specific pneumococcal nasopharyngeal (NP) carriage in children <5 years old in southern Israel, during the immediate 5 y following PCV introduction. This was an ongoing, prospective, population-based, active surveillance, from July 2009 through December 2014. PCVs uptake and NP cultures were obtained daily from children seen at the Pediatric Emergency Room for any reason. Overall, 10,702 vaccine status and 7,610 NP swabs were obtained. Both PCV7 and PCV13 uptake were high, reaching~90% by July 2012 and December 2013, respectively. All-pneumococcal carriage rates significantly declined by 10%, from 54.3% in the early-PCV7 period, to 49.1% in the PCV13 impact period. The respective declines for PCV7, 6A and additional PCV13 serotypes carriage rates were 76%, 90% and 66%. In contrast, non-PCV13 serotypes carriage rates increased significantly throughout the study by 71%. All-pneumococcal carriage rates in children <12 months old decreased significantly by 15%, with similar trends observed in other age groups. Initially, all-pneumococcal carriage rates were 45.7%, and 61.9% in Jewish and Bedouin children, respectively (P < 0.001), with a significant 17% reduction throughout the study observed only in Bedouins. While early carriage rates were higher in unvaccinated children compared to vaccinated children, PCV impact on carriage were similar in both groups. In conclusion, a relatively moderate decline in pneumococcal carriage rates, facilitated by a substantial decrease of vaccine-serotypes and increase of non-vaccine serotypes was observed in the immediate period following PCVs introduction in southern Israel.

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“…USA, Nicaragua, Spain, Denmark, France, Ontario, Israel, South Africa, and UK when high vaccine coverage was achieved. [49][50][51][52][53][54][55][56] However, in settings with vastly different environmental risk factors, mixing patterns, family structures, and culture such as Malaysia and Hong Kong, it is uncertain the extent to which similar effects will be observed. In the absence of country-specific estimates of herd effects, it was assumed that herd effects observed in these 2 countries would be very similar to that observed in the US post-PCV7 era.…”

mentioning

confidence: 99%

Cost-effectiveness analysis of infant universal routine pneumococcal vaccination in Malaysia and Hong Kong

Roberts

Lee

et al. 2015

Human Vaccines & Immunotherapeutics

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Keywords: herd effect, incremental cost-effectiveness ratio (ICER), Markov transition-state model, pneumococcal disease, 13-valent pneumococcal conjugate vaccine (PCV13), 10-valent pneumococcal conjugate vaccine (PCV10)Pneumococcal disease causes large morbidity, mortality and health care utilization and medical and non-medical costs, which can all be reduced by effective infant universal routine immunization programs with pneumococcal conjugate vaccines (PCV). We evaluated the clinical and economic benefits of such programs with either 10-or 13-valent PCVs in Malaysia and Hong Kong by using an age-stratified Markov cohort model with many country-specific inputs. The incremental cost per quality-adjusted life year (QALY) was calculated to compare PCV10 or PCV13 against no vaccination and PCV13 against PCV10 over a 10-year birth cohort's vaccination. Both payer and societal perspectives were used. PCV13 had better public health and economic outcomes than a PCV10 program across all scenarios considered. For example, in the base case scenario in Malaysia, PCV13 would reduce more cases of IPD (C2,296), pneumonia (C705,281), and acute otitis media (C376,967) and save more lives (C6,122) than PCV10. Similarly, in Hong Kong, PCV13 would reduce more cases of IPD cases (C529), pneumonia (C172,185), and acute otitis media (C37,727) and save more lives (C2,688) than PCV10. During the same time horizon, PCV13 would gain over 74,000 and 21,600 additional QALYs than PCV10 in Malaysia and Hong Kong, respectively. PCV13 would be cost saving when compared against similar program with PCV10, under both payer and societal perspective in both countries. PCV13 remained a better choice over PCV10 in multiple sensitivity, scenario, and probabilistic analyses. PCV13s broader serotype coverage in its formulation and herd effect compared against PCV10 were important drivers of differences in outcomes.

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Early impact of PCV7/PCV13 sequential introduction to the national pediatric immunization plan, on adult invasive pneumococcal disease: A nationwide surveillance study

Cited by 54 publications

References 23 publications

The epidemiology of invasive pneumococcal disease in older adults from 2007 to 2014 in Ontario, Canada: a population-based study

The epidemiology of invasive pneumococcal disease in older adults from 2007 to 2014 in Ontario, Canada: a population-based study

Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

Cost-effectiveness analysis of infant universal routine pneumococcal vaccination in Malaysia and Hong Kong

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