Serotype Distribution of Remaining Pneumococcal Meningitis in the Mature PCV10/13 Period: Findings from the PSERENADE Project

Abstract

Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining pneumococcal meningitis in countries using PCV10/13 for least 5–7 years with primary series uptake above 70%. The distribution was estimated using a multinomial Dirichlet regression model, stratified by PCV product and age. In PCV10-using sites (N = 8; cases = 1141), PCV10 types caused 5% of cases <5 years of age and 15% among ≥5 years; the top serotypes were 19A, 6C, and 3, together causing 42% of cases <5 years and 37% ≥5 years. In PCV13-using sites (N = 32; cases = 4503), PCV13 types caused 14% in <5 and 26% in ≥5 years; 4% and 13%, respectively, were serotype 3. Among the top serotypes are five (15BC, 8, 12F, 10A, and 22F) included in higher-valency PCVs under evaluation. Other top serotypes (24F, 23B, and 23A) are not in any known investigational product. In countries with mature vaccination programs, the proportion of pneumococcal meningitis caused by vaccine-in-use serotypes is lower (≤26% across all ages) than pre-PCV (≥70% in children). Higher-valency PCVs under evaluation target over half of remaining pneumococcal meningitis cases, but questions remain regarding generalizability to the African meningitis belt where additional data are needed.

Clinical and Bacteriological Analysis of Pediatric Pneumococcal Meningitis after 13-Valent Pneumococcal Conjugate Vaccine Introduction in Japan

“…In countries with a mature vaccination program of PCV, the proportion of pneumococcal meningitis caused by vaccine serotypes is lower than that which was seen in the pre-PCV era ( 10 ). In this study, among the 34 episodes of pneumococcal meningitis after PCV13 introduction, most episodes (30/34) were caused by non-PCV13 serotypes.…”

Pathogen- and type-specific changes in invasive bacterial disease epidemiology during the first year of the COVID-19 pandemic in the Netherlands

“…In contrast to the abovementioned serotypes, serotypes 19A and 6C showed a smaller decrease among IPD cases. This is of interest since these serotypes have become more common in pre-COVID years in several countries that use PCV10 27 , likely as a result of serotype replacement 28 . Whether the relatively limited decrease can be partly explained by an offset caused by serotype replacement after PCV10 introduction is yet unknown 29 .…”

Clinical and Economic Burden of Pneumococcal Disease Due to Serotypes Contained in Current and Investigational Pneumococcal Conjugate Vaccines in Children Under Five Years of Age

“…We did not include a sensitivity analysis where PCV10 provides cross-protection for serotype 19A, despite PCV10 showing some early cross-reactivity between serotypes 19F and 19A [ 56 ]. This hypothesized cross-protection was excluded because countries using PCV10 as part of their NIP have observed a steady rise in cases due to serotype 19A [ 56 , 57 ].…”