How nasopharyngeal pneumococcal carriage evolved during and after a PCV13-to-PCV10 vaccination programme switch in Belgium, 2016 to 2018

Wouters, Ine; Desmet, Stefanie; Heirstraeten, Liesbet Van; Herzog, Sereina A.; Beutels, Philippe; Verhaegen, Jan; Goossens, Herman; Damme, Pierre Van; Malhotra-Kumar, Surbhi; Theeten, Heidi

doi:10.2807/1560-7917.es.2020.25.5.1900303

Cited by 22 publications

(39 citation statements)

References 38 publications

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“…The current study was embedded in the nasopharyngeal (NP) carriage study that started in Belgium in 2016 to monitor changes in the proportions of pneumococcal serotypes in children between six and thirty months of age attending DCCs. 17 0.8% positives in the remaining sample). 19 Similarly, in Italy no children younger than 10 were infected in a large-scale survey before and after the start of the lockdown in the municipality where the first COVID-19 death in Italy was reported.…”

Section: Study Population and Samplingmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

“…A questionnaire regarding the child's demographic and clinical characteristics, as well as pneumococcal vaccination status, was filled in by their parents. Signs of the common cold in children were defined as coughing and/or running nose and were registered at the moment of sampling 17 …”

Section: Methodsmentioning

confidence: 99%

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No SARS‐CoV‐2 carriage observed in children attending daycare centers during the intial weeks of the epidemic in Belgium

Desmet

Ekinci

Wouters

et al. 2020

Journal of Medical Virology

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To gain knowledge about the role of young children attending daycare in the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) epidemic, a random sample of children ( n = 84) aged between 6 and 30 months attending daycare in Belgium was studied shortly after the start of the epidemic (February 29th) and before the lockdown (March 18th) by performing in‐house SARS‐CoV‐2 real‐time polymerase chain reaction. No asymptomatic carriage of SARS‐CoV‐2 was detected, whereas common cold symptoms were common (51.2%). Our study shows that in Belgium, there was no sign of early introduction into daycare centers at the moment children being not yet isolated at home, although the virus was clearly circulating. It is clear that more evidence is needed to understand the actual role of young children in the transmission of SARS‐CoV‐2 and their infection risk when attending daycare.

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Section: Study Population and Samplingmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

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No SARS‐CoV‐2 carriage observed in children attending daycare centers during the intial weeks of the epidemic in Belgium

Desmet

Ekinci

Wouters

et al. 2020

Journal of Medical Virology

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“…Belgium has a unique pneumococcal vaccine program history: serotype coverage moved from PCV7 to PCV13 (in 2011) to PCV10 (in 2016), and only very recently (in 2019) the switch back to PCV13 was made. After the PCV13-to-PCV10 switch, the carriage proportion of PCV13-non-PCV10 serotype 19A showed an increasing trend in healthy children in day care centres (DCC) [2]. No recent data were available on the serotype distribution and antibiotic susceptibility of pneumococcal isolates in Belgian children with AOM, and their relationship with clinical symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Acute otitis media (AOM) is one of the most common paediatric infections and has been described as one of the leading causes of antibiotic prescription in children in industrialized countries [1, 2]. It is estimated that 80-90% of children have an episode of acute otitis media (AOM) before the age of three, with a peak incidence between six and fifteen months [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Streptococcus pneumoniaeserotypes carried by young children and their association with Acute Otitis Media during the period 2016 – 2019

Ekinci

Desmet

Heirstraeten

et al. 2020

Preprint

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BackgroundStreptococcus pneumoniae (Sp) is a major cause of acute otitis media (AOM). Pneumococcal conjugate vaccine (PCV) programs have altered pneumococcal serotype epidemiology in disease and carriage. To establish the clinical picture of AOM in young children exposed to the PCV program in Belgium and the Sp strains they carry, a cross-sectional study started in 2016.Material/methodsIn three collection periods from February 2016 to May 2018, nasopharyngeal swabs and background characteristics were collected from children aged 6-30 months either presenting at their physician with AOM (AOM-group) or healthy and attending day care (DCC-group). Sp was detected, quantified, and characterized using both conventional culture and qPCR. Clinical signs of AOM episodes and treatment were registered by the physicians.ResultsAmong 3264 collected samples, overall pneumococcal carriage and density were similar in AOM (79.2% and 0.50 ×106 copies/μl) and DCC (77.5% and 0.42 ×106 copies/μl). Non-vaccine serotypes were most frequent: 23B (AOM: 12.3%; DCC: 17.4%), 11A (AOM: 7.5%; DCC: 7.4%) and 15B (AOM: 7.5%; DCC: 7.1%). Serotypes 3, 6C, 7B, 9N, 12F, 17F and 29 were more frequent in AOM than in DCC, whereas 23A and 23B frequencies were lower. Antibiotic susceptibility of Sp strains was similar in both groups . No predictors of AOM severity were identified, and 77.3% received an antibiotic prescription.ConclusionYoung children with AOM did not carry Sp more frequently or at higher load than healthy children in day care, but some ST were more frequent in AOM and are not included in the currently used vaccines.

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Validation of a Novel Forecasting Method for Estimating the Impact of Switching Pneumococcal Conjugate Programs: Evidence from Belgium

et al. 2021

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Introduction: Since 2010, 10-valent (PCV10) and 13-valent pneumococcal conjugate vaccines (PCV13) have been available as part of infant national immunization programs. Belgium is as one of the few countries that implemented PCV13 (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015), switched to PCV10 (2015)(2016)(2017)(2018) and then switched back to PCV13 (2018-present) after observing increases in disease. We assessed the impacts of both historical and prospective PCV choice in the context of the Belgian health care system and used this experience to validate previously developed economic models. Methods: Using historical incidence (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018) of pneumococcal disease for Belgian children aged \ 16 years, observed invasive pneumococcal disease (IPD) trends from surveillance data were used to estimate future disease in a given PCV13-or PCV10-based program. We compared observed incidence data with two modeled scenarios: (1) the 2015 switch to PCV10 and (2) a hypothetical continuation of PCV13 in 2015. Finally, we explored the potential impact of PCV choice from 2019 to 2023 by comparing three scenarios: (3) continued use of PCV10; (4) a switch back to PCV13;(5) a hypothetical scenario in which Belgium never switched from PCV13. Results: Model predictions underestimated observed data from 2015 to 2018 by 100 IPD cases among ages \ 16 years. Comparing observed data with scenario 2 suggests that PCV13 would have prevented 105 IPD cases from 2015 to 2018 compared with PCV10. Switching to PCV13 in 2019 would avert 625 IPD cases through 2023 compared with continuing PCV10. Scenario never switching from PCV13 would have resulted in a reduction of 204 cases from 2016 to 2023 compared with switching to PCV10 and switching back to PCV13. Conclusion:The findings from this study suggest that previously published modeling results of PCV13 versus PCV10 in other countries may have underestimated the benefit of PCV13. These results highlight the importance of continually protecting against vaccine-preventable pneumococcal serotypes.

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How nasopharyngeal pneumococcal carriage evolved during and after a PCV13-to-PCV10 vaccination programme switch in Belgium, 2016 to 2018

Cited by 22 publications

References 38 publications

No SARS‐CoV‐2 carriage observed in children attending daycare centers during the intial weeks of the epidemic in Belgium

No SARS‐CoV‐2 carriage observed in children attending daycare centers during the intial weeks of the epidemic in Belgium

Streptococcus pneumoniaeserotypes carried by young children and their association with Acute Otitis Media during the period 2016 – 2019

Validation of a Novel Forecasting Method for Estimating the Impact of Switching Pneumococcal Conjugate Programs: Evidence from Belgium

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