Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children

Black, Steven; Shinefield, Henry R.; Fireman, Bruce; Lewis, Edwin; Ray, Paula; Hansen, John; Elvin, Laura; Ensor, Kathy M.; Hackell, Jill G.; Siber, George R.; Malinoski, Frank; Madore, Dace V.; Chang, Ih; Kohberger, Robert; Watson, Wendy; Austrian, Robert; Edwards, K M

doi:10.1097/00006454-200003000-00003

Cited by 2,078 publications

(1,241 citation statements)

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“…Efficacy was assumed being absent before the age of 5 months. Based on the results of Black et al [13], efficacy was assumed to be 85.7% at the ages of 5-11 months and 93.9% at the ages of 12 months to 9 years. Vaccine effectiveness was assumed to decline 3% per year starting 5 years after the last dosage [11].…”

Section: Updating the Modelmentioning

confidence: 99%

“…In Western Europe, it is estimated that every child experiences one or more episodes of otitis media before the age of 2 years [7,8]. A number of studies have assessed the potential economical impact of mass infant vaccination with PCV7 (Prevnar; Wyeth) [9][10][11][12], since the first published clinical trial showed the high efficacy of this vaccine in the prevention of IPD [13] (see also McIntosh [14] for a recent review). Additionally, ongoing research has provided important new data.…”

Section: Introductionmentioning

confidence: 99%

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Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

Hubben

Bos

Glynn³

et al. 2007

Vaccine

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Enhanced decision support for policy makers using a web interface to health-economic models -Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands Hubben, G.A.A.; Bos, J.M.; Glynn, D.M.; op 't Ende, Anna; van Alphen, L.; Postma, Maarten Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. AbstractWe have developed a web-based user-interface (web interface) to enhance the usefulness of health-economic evaluations to support decision making (http://pcv.healtheconomics.nl). It allows the user to interact with a health-economic model to evaluate predefined and customized scenarios and perform sensitivity analysis. To explore its usefulness, it was applied to an evaluation of cost-effectiveness of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine (PCV7), that was used to support a policy decision on the inclusion of PCV7 in the national vaccination program (NVP) of the Netherlands. We used a decision-tree analytic model to project the impact of infant vaccination with four doses of PCV7 on an annual cohort of infants born in the Netherlands. The base-case analysis includes the beneficial effects on unvaccinated individuals (herd protection). Additional scenarios varying the number of doses, discount rate for effects and the number of serotypes in the vaccine were evaluated and can be analysed on the web. Our model projects a base-case incremental cost-effectiveness ratio (iCER) of D 14,000 (95% uncertainty interval (UI): 9,800-20,200) per quality adjusted life year (QALY) or D 15,600 (95% UI: 11,100-23,900) per life year gained (LYG).

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Section: Updating the Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

Hubben

Bos

Glynn³

et al. 2007

Vaccine

View full text Add to dashboard Cite

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“…In clinical trials, PCV has proved to be protective for invasive pneumococcal disease caused by vaccine serotypes [12] as well as reducing their carriage [3], and hence a possible herd immunity effect. The observed reduction in vaccine serotypes has also been associated with an increase in carriage of non-vaccine serotypes in vaccinated children in carriage studies [13] and in vaccine trials for PCV against otitis media [14].…”

Section: Introductionmentioning

confidence: 99%

A longitudinal household study of Streptococcus pneumoniae nasopharyngeal carriage in a UK setting

Hussain¹,

Melegaro

Pebody³

et al. 2005

Epidemiol. Infect.

170

163

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SUMMARYA 10-month longitudinal household study of pre-school children and their families was undertaken with monthly visits collecting epidemiological data and nasopharyngeal swabs in Hertfordshire, England from 2001 to 2002. Pneumococcal culture was with standard methods. In total, 121 families (489 individuals) took part. Mean prevalence of carriage ranged from 52 % for age groups 0-2 years, 45 % for 3-4 years, 21 % for 5-17 years and 8 % for o18 years. Carriage occurred more than once in 86 % of children aged 0-2 years compared to 36 % of those aged o18 years. The most prevalent serotypes in the 0-2 years age group were 6B followed by 19F, 23F, 6A and 14. Young children were responsible for the majority of introductions of new serotypes into a household. Erythromycin resistance (alone or in combination) occurred in 10% of samples and penicillin non-susceptibility in 3 . 7%. Overall the recently licensed 7-valent conjugate vaccine (PCV) would protect against 64 % of serotypes with no intra-serogroup cross protection and 82% with such protection. Nasopharyngeal carriage of S. pneumoniae is common in a UK setting in the pre-conjugate vaccine era. PCV would protect against a large proportion of carriage isolates. However, the impact of vaccination on non-vaccine serotypes will need to be monitored.

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“…However, conjugation of PS to protein carriers allows T cell help through recruitment of carrier-specific T cells [10][11][12][13][14] and makes the PPS immunogenic in early infancy (reviewed in [15]). Protective immunity against both invasive disease [16,17] and otitis media [18] has been demonstrated after vaccination of infants with pneumococcal conjugate vaccines. In addition, pneumococcal conjugate vaccines induce PS-specific memory B cells [19][20][21], similar to what has been observed after immunization with protein antigens.…”

Section: Introductionmentioning

confidence: 99%

Early life T cell responses to pneumococcal conjugates increase with age and determine the polysaccharide‐specific antibody response and protective efficacy

et al. 2006

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Immunization with a tetanus-protein (TT) pneumococcal polysaccharide (PPS) conjugate vaccine (Pnc1-TT) induces protective immunity against lethal pneumococcal infections in neonatal and infant mice, but anti-PPS IgG response and protective efficacy is lower than in adult mice. Here, we show that reduced antibody (Ab) response and protection against infections is directly related to impaired T cell response to the carrier. Whereas spleen cells from adult mice immunized with Pnc1-TT responded with proliferation and IFN-gamma secretion to in vitro stimulation with TT, spleen cells from neonatal and infant mice did not. However, significant, but age dependent, Th2-cytokine responses were observed in mice immunized with Pnc1-TT. Impaired IFN-gamma production upon TT-stimulation in vitro was also reflected in reduced IFN-gamma/IL-5 ratio. The IL--5 response correlated with IgG anti-PPS titers, and the lack of PPS Ab in the majority of neonatal mice was clearly associated with absence of carrier-specific IL-5 production. These results show that immunization with Pnc1-TT induces carrier-specific T cell responses that increase with age and determine the levels of PPS-specific Ab elicited. Whereas a weak and Th2-biased response was observed in neonatal mice, infant mice showed a mixed Th1-Th2 response as observed in adults

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Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children

Abstract: This heptavalent pneumococcal conjugate appears to be highly effective in preventing invasive disease in young children and to have a significant impact on otitis media.

Cited by 2,078 publications

References 11 publications

Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

Enhanced decision support for policy makers using a web interface to health-economic models—Illustrated with a cost-effectiveness analysis of nation-wide infant vaccination with the 7-valent pneumococcal conjugate vaccine in the Netherlands

A longitudinal household study of Streptococcus pneumoniae nasopharyngeal carriage in a UK setting

Early life T cell responses to pneumococcal conjugates increase with age and determine the polysaccharide‐specific antibody response and protective efficacy

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