Surveillance of the impact of pneumococcal conjugate vaccines in developing countries

Rodgers, Gail L.; Klugman, Keith P.

doi:10.1080/21645515.2015.1057671

Cited by 34 publications

(37 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our predictions are in line with the experience of PCV7 in Europe and North America [37-44], as well with post-PCV trends observed in the few studies from low-income settings [36]. In the region of Kilifi in Kenya, where a catch-up campaign was conducted at PCV introduction, impact studies have shown a two third reduction in VT carriage prevalence across all age groups within two years of PCV10 introduction with a catch-up campaign among children <5 years [43].…”

Section: Discussionsupporting

confidence: 89%

“…Moreover, we were not able to assess the impact of PCV on pneumococcal pneumonia, the burden of which is much higher than that of IPD [34], given the lack of robust data and the challenges in the aetiological assessment of clinical pneumonia. Results from ongoing studies in Gavi-eligible countries [35, 36] might help modelling work on the impact of PCV on pneumonia in the future.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predicting the impact of pneumococcal conjugate vaccine programme options in Vietnam: a dynamic transmission model

Edmunds

Takahashi

et al. 2017

Preprint

View full text Add to dashboard Cite

BackgroundCatch-up campaigns (CCs) at the introduction of the pneumococcal conjugate vaccines (PCVs) may accelerate the impact of PCVs. However, limited vaccine supplies may delay vaccine introduction if additional doses are needed for such campaigns. We studied the relative impact of introducing PCV13 with and without catch-up campaign, and the implications of potential introduction delays.MethodsWe used a dynamic transmission model applied to the population of Nha Trang in Sout central Vietnam. Four strategies were considered: routine vaccination (RV) only, and RV alongside catch-up campaigns among <1y olds (CC1), <2y olds (CC2) and <5y olds (CC5). The model was parameterised with local data on human social contact rates, and was fitted to local carriage data. Post-PCV predictions were based on best estimates of parameters governing post-PCV dynamics, including serotype competition, vaccine efficacy and duration of protection.ResultsOur model predicts elimination of vaccine-type (VT) carriage across all age groups within 10 years of introduction in all scenarios with near-complete replacement by non-VT. Most of the benefit of CCs is predicted to occur within the first 3 years after introduction, with the highest impact in the first year, when IPD incidence is predicted to be 11% (95%CrI 9 – 14%) lower than RV with CC1, 25% (21 – 30 %) lower with CC2 and 38% (32 – 46%) lower with CC5.However, CCs would only prevent more cases of IPD insofar such campaigns do not delay introduction by more than 31 (95%CrI 30 – 32) weeks with CC1, 58 (53 – 63) weeks with CC2 and 89 (78 – 101) weeks for CC5.ConclusionCCs are predicted to offer a substantial additional reduction in pneumococcal disease burden over RV alone, if their implementation does not result in much introduction delay. Those findings are important to help guide vaccine introduction in countries that have not yet introduced PCV, particularly in Asia.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Predicting the impact of pneumococcal conjugate vaccine programme options in Vietnam: a dynamic transmission model

Edmunds

Takahashi

et al. 2017

Preprint

View full text Add to dashboard Cite

show abstract

“…The incidence of CAP due to serotypes included in the PCV7 declined by 88% (IRR 0.12, 95% CI 0.08–0.20; p < 0.001), and CAP due to the additional 6 serotypes in PCV13 declined by 30% (IRR 0.70, 95% CI 0.51–0.96; p = 0.024). This study and other previous studies described the finding of so-called herd immunity, reducing the incidence of pneumococcal pneumonia in children and adults, after the introduction of PCV7 and PCV13 into the infant immunization programs [ 29 , 30 ]. Other authors found that although PCV13 protects against key serotypes that increased after routine immunization with the PCV7, its potential for herd immunity and serotype replacement is uncertain [ 31 – 37 ].…”

Section: Discussionsupporting

confidence: 53%

Decreased relative risk of pneumococcal pneumonia during the last decade, a nested case-control study

et al. 2018

View full text Add to dashboard Cite

BackgroundStreptococcus pneumoniae (SP) is one of the most common pathogens of Community-Acquired Pneumonia (CAP), but recent reports suggest that its incidence may be declining in relation to the use of the conjugate 13-valent pneumococcal vaccine in children. We compared the result of the immunochromatographic SP urinary antigen test (SPUAT) and clinical outcomes in patients with CAP admitted in two periods of time: 2001–2002(CAP1) and 2015–2016(CAP2).MethodsThis was a matched nested case-control study of two prospectively recorded cohorts of patients admitted with CAP, with SPUAT and blood culture performed in all patients. CAP2 cases and CAP1 controls were matched for age ± 4 years, sex, and Pneumonia Severity Index (PSI) score ± 10 points. Odds ratios (OR) for having SPUAT positive was estimated by conditional logistic regression. A multivariate model assessed the contribution of individual variables.ResultsFour hundred ninety-eight patients were recruited; 307 during the CAP1 and 191 during the CAP2 periods. Comparing both periods we observed differences, in age, PSI score, and the percentage of smokers, outpatients, previously immunized with pneumococcal vaccine, and positive SPUAT. On the other hand, mortality, admission from nursing homes, pneumococcal bacteremia and hospital admission were not different. After matching, pneumonia due to SP per the SPUAT was observed in 34(23.4%) of CAP1 and in 12(8.3%) of CAP2 patients (p < 0.001), and 6/145 CAP1 vs 33/145 CAP2 patients had received pneumococcal immunization before their admission (p < 0.001). A multivariate analysis confirmed that, independent of falling into PSI class 5, having not received the pneumococcal vaccine and having not survived the episode of pneumonia, there were two factors that increased the probability of having SPUAT positive: developing pneumonia during the CAP1 period (OR = 1.23) and having pneumococcal bacteremia (OR = 2.66).ConclusionWe observed a reduction of the role of SP as pathogen, along with an increase in the number of patients who received pneumococcal immunization before admission, in 2015-2016 compared to 2001-2002. In addition, the use of conjugate 13-valent vaccine, starting in 2012 for childhood immunization, could be an additional factor contributing to these changes, as a result of early herd immunity in adults pneumonia.

show abstract

“…15 Pneumococcal conjugate vaccines have been effective in reducing pneumococcal disease both directly, by protecting individual children, and indirectly, by preventing transmission of disease-causing serotypes to susceptible unimmunised people. 2,17 Vaccines have targeted the most high-burden pathogens but some causes of pneumonia are not preventable by use of vaccines. Pathogens not preventable by vaccines include non-vaccine-type S pneumoniae, Staphylococcus aureus, Salmonella, Klebsiella pneumoniae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Mycobacterium tuberculosis, and viruses other than influenza, such as respiratory syncytial virus, parainfluenza viruses 1-3, human metapneumovirus, adenovirus, coronavirus, and bocavirus.…”

Section: Aetiology and Vaccine Coveragementioning

confidence: 99%

Challenges in the diagnosis of paediatric pneumonia in intervention field trials: recommendations from a pneumonia field trial working group

Goodman¹,

Pervaiz²,

McCollum³

et al. 2019

The Lancet Respiratory Medicine

View full text Add to dashboard Cite

Pneumonia is a leading killer of children younger than 5 years despite high vaccination coverage, improved nutrition, and widespread implementation of the Integrated Management of Childhood Illnesses algorithm. Assessing the effect of interventions on childhood pneumonia is challenging because the choice of case definition and surveillance approach can affect the identification of pneumonia substantially. In anticipation of an intervention trial aimed to reduce childhood pneumonia by lowering household air pollution, we created a working group to provide recommendations regarding study design and implementation. We suggest to, first, select a standard case definition that combines acute (≤14 days) respiratory symptoms and signs and general danger signs with ancillary tests (such as chest imaging and pulse oximetry) to improve pneumonia identification; second, to prioritise active hospital-based pneumonia surveillance over passive case finding or home-based surveillance to reduce the risk of non-differential misclassification of pneumonia and, as a result, a reduced effect size in a randomised trial; and, lastly, to consider longitudinal follow-up of children younger than 1 year, as this age group has the highest incidence of severe pneumonia.

show abstract

Surveillance of the impact of pneumococcal conjugate vaccines in developing countries

Cited by 34 publications

References 10 publications

Predicting the impact of pneumococcal conjugate vaccine programme options in Vietnam: a dynamic transmission model

Predicting the impact of pneumococcal conjugate vaccine programme options in Vietnam: a dynamic transmission model

Decreased relative risk of pneumococcal pneumonia during the last decade, a nested case-control study

Challenges in the diagnosis of paediatric pneumonia in intervention field trials: recommendations from a pneumonia field trial working group

Contact Info

Product

Resources

About