Pneumococcal disease and use of pneumococcal vaccines in Taiwan

Abstract

The use of pneumococcal vaccine plays an important role for prevention of invasive pneumococcal disease (IPD). However, introducing the pneumococcal vaccine into the national immunization program (NIP) is complex and costly. The strategy of progressively integrating the pneumococcal conjugate vaccine (PCV) into the NIP in Taiwan provides valuable experience for policy makers. The 7-valent PCV (PCV7) was first available in Taiwan in late 2005. PCV7 was first provided free to children with underlying diseases, those in vulnerable socioeconomic status, and those with inadequate health care resources. The catch-up immunization program with the 13-valent PCV was launched in 2013 and the national pneumococcal immunization program was implemented in 2015. Children aged 2-5 years had the highest incidence of IPD among pediatric population in Taiwan. Although the incidence of IPD caused by PCV7 serotypes has declined, the overall incidence of IPD remained high in the context of PCV7 use in the private sector. A surge of IPD caused by serotype 19A occurred, accounting for 53.6% of IPD cases among children aged ≤ 5 years in 2011-2012. After the implementation of the national pneumococcal immunization program, serogroup 15 has become the leading serogroup for IPD in children. Continued surveillance is necessary to monitor the serotype epidemiology in Taiwan.

Thomsen-Friedenreich antigen activation as a predictor for clinical outcome of pediatric patients with invasive pneumococcal disease

“…In 2013, a national catch-up program was launched to provide PCV13 for all children aged 2e5 years, and it has been included in the national immunization program since 2015. 3 Despite that, IPD still plays a role in severe bacterial infection among the pediatric population. Estimated incidence of IPD during post-PCV era varied in different studies and epidemiological area, which was around 6 to 10 per 100,000 population.…”

Trend and outcome of sepsis in children: A nationwide cohort study

“…In Taiwan, the pneumococcal vaccine was commercially available in 2005, and healthy infants could be vaccinated with co‐payment. However, the vaccine was provided for free for infants with immunocompromised conditions, those in vulnerable socio‐economic status and those with inadequate health‐care resources . From 2008 to 2012, the incidence of invasive pneumococcal diseases decreased by 36.4% for infants under 2 years of age, and this was attributed to the increase in pneumococcal vaccination .…”

“…However, the vaccine was provided for free for infants with immunocompromised conditions, those in vulnerable socioeconomic status and those with inadequate health-care resources. 22 From 2008 to 2012, the incidence of invasive pneumococcal diseases decreased by 36.4% for infants under 2 years of age, and this was attributed to the increase in pneumococcal vaccination. 23 Thus, the aforementioned significant decrease in infantile sepsis incidence and mortality over time, especially the discrepancy between respiratory tract infections and urinary tract infections, might be related to childhood vaccination.…”

Pneumococcal vaccination and efficacy in patients with heterotaxy syndrome

“…The introduction of PCV7 has reduced the incidence of invasive pneumococcal disease by 58% in the pediatric population in Taiwan (23). Serotype replacement became a problem after the introduction of PCV7, and PCV13 booster has been recommended to provide broader coverage (9,12,20). Nevertheless, the introduction of pneumococcal vaccine has profoundly changed the epidemiology of pneumococcal disease.…”

“…In patients with heterotaxy, invasive pneumococcal disease and related fulminant sepsis are even more common (5,11). With the introduction of pneumococcal vaccine, mortality caused by pneumococcal infection has decreased significantly (10,12). The National Health Insurance Administration in our country has been reimbursing pneumococcal conjugated vaccine (PCV) prophylaxis in patients with certain congenital heart diseases (e.g., heterotaxy syndrome and CCHD) since July 2009.…”