Abstract:Three years after a 7-valent pneumococcal conjugate vaccine was replaced by a 10-valent pneumococcal conjugate vaccine in the Netherlands, we observed a decrease in incidence of invasive pneumococcal disease caused by Streptococcus pneumoniae serotypes 1, 5, and 7F. Our data do not support or exclude cross-protection against serotype 19A.
“…30 In 2000, 7 years after the introduction of PCV7, ∼211,000 cases of IPD caused by the 7 serotypes covered by PCV7 (including antibiotic-resistant strains) were prevented not only in children but in individuals of all ages 29 , 30 Second generation pneumococcal conjugate vaccines with extended serotype coverage such as PCV10 (10-valent) and PCV13 (13-valent) have increased direct protection and herd immunity to the pneumococcal serotypes covered by these vaccines with similar efficacy. 31 , 32 Very importantly, just as observed after introduction of PCV7, PCV13 also reduced antibiotic use and in parallel the prevalence of antibiotic non-susceptible strains also decreased (Figure 2). 28 , 29 , 31
10.1080/21645515.2018.1476814-F0002Figure 2.Rates of antibiotic non-susceptible invasive pneumococcal disease (<5 years) 2005–2013.…”
Section: Vaccines As Powerful Tools To Fight Amrmentioning
The problem of antimicrobial resistance (AMR) and the associated morbidity and mortality due to antibiotic resistant bacterial pathogens is not new. However, AMR has been increasing at an alarming rate with appearances of diseases caused by bacteria exhibiting resistance to not just one but multiple classes of antibiotics. The World Health Organization (WHO) supported by governments, health ministries and health agencies has formulated global action plans to combat the rise in AMR, supporting a number of proven initiatives such as antimicrobial stewardship, investments in development of new classes of antibiotics, and educational programs designed to eliminate inappropriate antibiotic use. Vaccines as tools to reduce AMR have historically been under-recognized, yet the positive effect in reducing AMR has been well established. For example Haemophilus influenzae type B (Hib) as well as Streptococcus pneumoniae (pneumococcal) conjugate vaccines have impressive track records in not only preventing life threatening diseases caused by these bacteria, but also reducing antibiotic use and AMR. This paper will describe the drivers of antibiotic use and subsequent development of AMR; it will make the case how existing vaccines are already participating in combatting AMR, describe future prospects for the role of new vaccines in development to reduce AMR, and highlight challenges associated with future vaccine development to combat AMR.
“…30 In 2000, 7 years after the introduction of PCV7, ∼211,000 cases of IPD caused by the 7 serotypes covered by PCV7 (including antibiotic-resistant strains) were prevented not only in children but in individuals of all ages 29 , 30 Second generation pneumococcal conjugate vaccines with extended serotype coverage such as PCV10 (10-valent) and PCV13 (13-valent) have increased direct protection and herd immunity to the pneumococcal serotypes covered by these vaccines with similar efficacy. 31 , 32 Very importantly, just as observed after introduction of PCV7, PCV13 also reduced antibiotic use and in parallel the prevalence of antibiotic non-susceptible strains also decreased (Figure 2). 28 , 29 , 31
10.1080/21645515.2018.1476814-F0002Figure 2.Rates of antibiotic non-susceptible invasive pneumococcal disease (<5 years) 2005–2013.…”
Section: Vaccines As Powerful Tools To Fight Amrmentioning
The problem of antimicrobial resistance (AMR) and the associated morbidity and mortality due to antibiotic resistant bacterial pathogens is not new. However, AMR has been increasing at an alarming rate with appearances of diseases caused by bacteria exhibiting resistance to not just one but multiple classes of antibiotics. The World Health Organization (WHO) supported by governments, health ministries and health agencies has formulated global action plans to combat the rise in AMR, supporting a number of proven initiatives such as antimicrobial stewardship, investments in development of new classes of antibiotics, and educational programs designed to eliminate inappropriate antibiotic use. Vaccines as tools to reduce AMR have historically been under-recognized, yet the positive effect in reducing AMR has been well established. For example Haemophilus influenzae type B (Hib) as well as Streptococcus pneumoniae (pneumococcal) conjugate vaccines have impressive track records in not only preventing life threatening diseases caused by these bacteria, but also reducing antibiotic use and AMR. This paper will describe the drivers of antibiotic use and subsequent development of AMR; it will make the case how existing vaccines are already participating in combatting AMR, describe future prospects for the role of new vaccines in development to reduce AMR, and highlight challenges associated with future vaccine development to combat AMR.
“…16 Furthermore, post-marketing surveillance data suggest decreases in IPD, pneumonia, and AOM incidences after the introduction of PHiD-CV in Brazil, Chile, Colombia, Kenya, Finland, Iceland, the Netherlands, Canada, and New Zealand. [25][26][27][28][29][30][31][32][33][34][35][36][37][38] In POET, vaccine efficacy (58%) was shown for AOM caused by 11 vaccine serotypes combined (10 serotypes in common with PHiD-CV plus serotype 3), with robust results for serotypes 6B, 14, 19F, and 23F. 15 The validity of comparing 11Pn-PD and PHiD-CV could be questioned because of differences in vaccine formulation.…”
This phase III, randomized, open-label, multicenter study (NCT01027845) conducted in Japan assessed the immunogenicity, safety, and reactogenicity of 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, given intramuscularly) co-administered with diphtheria-tetanus-acellular pertussis vaccine (DTPa, given subcutaneously). Infants (N=360 ) were randomized (2:1) to receive either PHiD-CV and DTPa (PHiD-CV group) or DTPa alone (control group) as 3-dose primary vaccination (3–4–5 months of age) and booster vaccination (17–19 months of age). Immune responses were measured before and one month after primary/booster vaccination and adverse events (AEs) were recorded. Post-primary immune responses were non-inferior to those in pivotal/efficacy European or Latin American pneumococcal protein D-conjugate vaccine studies. For each PHiD-CV serotype, at least 92.6% of infants post-primary vaccination and at least 97.7% of children post-booster had pneumococcal antibody concentrations ≥0.2 μg/ml, and at least 95.4% post-primary and at least 98.1% post-booster had opsonophagocytic activity (OPA) titers ≥8 . Geometric mean antibody concentrations and OPA titers (except OPA titer for 6B) were higher post-booster than post-priming for each serotype. All PHiD-CV-vaccinated children had anti-protein D antibody concentrations ≥100 EL.U/ml one month post-primary/booster vaccination and all were seroprotected/seropositive against each DTPa antigen. Redness and irritability were the most common solicited AEs in both groups. Incidences of unsolicited AEs were comparable between groups. Serious AEs were reported for 47 children (28 in PHiD-CV group); none were assessed as vaccine-related. In conclusion, PHiD-CV induced robust immune responses and was well tolerated when co-administered with DTPa in a 3-dose priming plus booster regimen to Japanese children.
“…Apesar do fenómeno de substituição observado, a redução importante dos casos vacinais, ultrapassou largamente o aumento dos não vacinais. [12][13][14][15] Em Portugal, a DIP tornou-se uma doença de declaração obrigatória apenas em 2014. 17 Os dados do estudo prospetivo promovido pelo Grupo de Estudo da Doença Invasiva Pneumocócica da Sociedade de Infeciologia Pediátrica da Sociedade Portuguesa de Pediatria (SPP), mostram que a incidência global da doença variou entre 6,3 e 4,6/100 000 crianças e adolescentes, de 2006 a 2014 (Brito MJ, comunicação pessoal).…”
Introduction: Pneumococcal conjugate vaccine was introduced in the private market in Portugal in 2001, reaching over the years a moderately high coverage. In July 2015, it was included in the National Immunisation Program. The aim of this study was to characterize invasive pneumococcal disease in a pediatric hospital before universal use of the vaccine.Material and Methods: Retrospective analysis of medical records of all children with Streptococcus pneumoniae identified by culture and/or molecular biology (available since 2008), in products obtained from sterile sites, from January 1995 to June 2015. We evaluated demographic, clinical and microbiological data. Serotype results are available since 2004.Results: Over those 20 years, 112 invasive pneumococcal disease cases were identified, with a median age of 15 months (1 month - 15 years). The median number of cases /year was 4, the highest between 2001 - 2002 (8/year) and 2007 - 2012 (7 - 11/year). The identification occurred mostly in blood culture (72), cerebrospinal fluid (24), pleural fluid (11) an others (5). The most frequent diagnoses were pneumonia (38%), occult bacteraemia (34%) and meningitis (21%). Over the period under review, there was an increase of pneumonia and slight increase of OB, with meningitis cases remaining relatively unchanged.Discussion: In the last two decades, there was no reduction in the number of cases of invasive pneumococcal disease. There was an increase in isolates from pneumonia and occult bacteraemia that might be due to the introduction of molecular biological methods for Streptococcus pneumoniae detection. Vaccine serotypes were predominant.Conclusion: This retrospective analysis before universal vaccination will contribute to evaluate the impact of vaccination in the Portuguese pediatric population.
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