Impact of pneumococcal conjugate vaccine on pneumonia hospitalization and mortality in children and elderly in Ecuador: Time series analyses

Jimbo, Ruth; Toscano, Cristiana M.; Choez, Xavier Sánchez; Vilema, Jose M.; Condo, Jackson Rivas; Ghisays, Gladys; Haneuse, Sebastien; McGee, Glen; Oliveira, Lúcia Helena de

doi:10.1016/j.vaccine.2020.09.032

Cited by 12 publications

(10 citation statements)

References 26 publications

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“…When we applied LASSO regression to the real-world data, we found that PCV statistically significantly reduced all-cause pneumonia hospitalization in the youngest children age groups in Chile and Ecuador, which is consistent with existing literature on PCV impact in Chile 46,47 and Ecuador 37,48 , but we did not observe similar results in the youngest age groups in Mexico and in the US. This is in contrast to the established PCV impact estimated among children in Mexico 48 and the US 29 .…”

Section: Discussionsupporting

confidence: 86%

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Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines

Wong

Krämer

Piccininni

et al. 2022

Preprint

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The pneumococcal conjugate vaccines (PCVs) protect against diseases caused by Streptococcus pneumoniae, such as meningitis, bacteremia, and pneumonia. It is challenging to estimate their population-level impact due to the lack of a perfect control population and the subtleness of signals when the endpoint – like all-cause pneumonia – is non-specific. Here we present a new approach to estimate PCVs’ impact – using LASSO regression to predict the counterfactual outcome for vaccine impact inference. We first used a simulation study to test the performance of LASSO regression and established methods including the synthetic control (SC) approach. We found that LASSO achieved accurate and precise estimation, even in complex simulation scenarios where the association between outcome and all control variables was non-causal. We then applied LASSO to real-world data and found that it yielded estimates of vaccine impact similar to SC. The LASSO method is accurate, easily implementable, and can be applied to study the impact of PCVs and of other vaccines.

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Section: Discussionsupporting

confidence: 86%

“…37,48 , but we did not observe similar results in the youngest age groups in Mexico and in the US. This is in contrast to the established PCV impact estimated among children in Mexico48 and the US29 .…”

contrasting

confidence: 99%

Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines

Wong

Krämer

Piccininni

et al. 2022

Preprint

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“…In a time series analysis (2005–2015 national data) of PCV impact on pneumonia mortality and hospitalization in Ecuador [ 28 ], in the post-vaccination period, there was a clear and significant reduction in pneumonia hospitalizations (27% and 33% for children < 1 and < 5 years, respectively); however, the reduction in pneumonia mortality was lower (14% and 10% for children < 1 and < 5 years, respectively) and with uncertainty, i.e., wide credible intervals. The authors reported that other studies assessing vaccine impact on pneumonia mortality also showed a decline but with similar difficulties related to uncertainty [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Countries in Latin America were among the first developing countries to introduce universal PCV programs, with 34 countries offering routine PCV by 2015 [ 20 , 27 ]. Ecuador first introduced PCV vaccination in 2008 for high-risk groups and then recommended the universal infant PCV (PHiD-CV) vaccination in 2010 (implemented in the NIP in 2011 [ 13 ]), achieving coverage of > 90% from 2012 to 2015 [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Mortality Trends of Acute Gastroenteritis and Pneumococcal Disease in Children Following Universal Rotavirus and Pneumococcal Conjugate Vaccination in Ecuador

Juliao¹,

Guzmán-Holst²,

Gupta³

et al. 2021

Infect Dis Ther

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Introduction: Ecuador introduced routine infant rotavirus (RV) vaccination in 2008 and pneumococcal conjugate vaccination (PCV) in 2011 to manage disease and mortality in children caused by gastroenteritis (GE) and by pneumonia (PNE) and invasive pneumococcal disease (IPD), respectively. Methods: This retrospective ecological database study described vaccination coverage as well as the trends in incidence and mortality in the preversus post-vaccination periods and used timetrend analysis models to assess the impact of vaccination. Results: RV vaccination coverage of the second dose was between 79-97% from 2008 to 2016. GE incidence and mortality showed a declining

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“…The year in which higher-valent PCV was introduced into the national vaccination program in each country was considered as a transition year. In Argentina 8 and Colombia 9 this transition year was 2012, in Brazil it was 2010, 10 and in Chile, 11 Ecuador 12 and Mexico 13 it was 2011. The latest year for which locally-published SIREVA data were available was 2019 for Argentina, Brazil and Mexico.…”

Section: Methods: Isolates Reported In Sireva Surveillance Datamentioning

confidence: 99%

Laboratory-based surveillance in Latin America: attributes and limitations in evaluation of pneumococcal vaccine impact

Guevara¹,

Guzmán-Holst²

2021

Human Vaccines & Immunotherapeutics

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Disease surveillance data are needed to monitor trends in disease activity, inform decision-making in public health and evaluate disease prevention/control measures. The Sistema Regional de Vacunas (SIREVA) supports laboratory-based surveillance of invasive pneumococcal disease (IPD) in Latin American countries, providing information on identification, distribution, and anti-microbial susceptibility of pneumococcal strains. We estimated the proportion of pneumococcal meningitis and sepsis/bacteremia cases captured by SIREVA, by comparing the number of SIREVA-reported isolates in Argentina, Brazil, Chile, Colombia, Ecuador and Mexico with the estimated expected number of cases based on regional estimates of disease incidence. In all six countries, the number of isolates reported by SIREVA was consistently lower than the number of cases expected, across all years with data available. The proportion of SIREVA-reported isolates was highest in Chile (43-83%) and lowest in Mexico (1.4-3.5%). Passive surveillance systems such as SIREVA are important tools for monitoring circulating strains that could be related to pneumococcal disease, but our results show that SIREVA is likely to underestimate pneumococcal disease incidence. This under-reporting will limit the precision of surveillance data in monitoring changes in the incidence of IPD after vaccine introduction, and this should be considered when assessing the impact of vaccination programs.

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Impact of pneumococcal conjugate vaccine on pneumonia hospitalization and mortality in children and elderly in Ecuador: Time series analyses

Cited by 12 publications

References 26 publications

Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines

Using LASSO regression to estimate the population-level impact of pneumococcal conjugate vaccines

Incidence and Mortality Trends of Acute Gastroenteritis and Pneumococcal Disease in Children Following Universal Rotavirus and Pneumococcal Conjugate Vaccination in Ecuador

Laboratory-based surveillance in Latin America: attributes and limitations in evaluation of pneumococcal vaccine impact

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