The Efficacy and Duration of Protection of Pneumococcal Conjugate Vaccines Against Nasopharyngeal Carriage

Waroux, Olivier le Polain de; Flasche, Stefan; Prieto‐Merino, David; Green, David; Edmunds, W. John

doi:10.1097/inf.0000000000000717

Cited by 44 publications

(48 citation statements)

References 46 publications

(71 reference statements)

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“…Nasopharyngeal carriage was recently recognized as an important proxy for PCV impact assessments [4]. The one-fifth reduction in S. pneumoniae nasopharyngeal carriage observed in the current study with PCV7 is likely to reduce substantially the burden of VT pneumococcal disease among Chinese A study limitation is that it was conducted in just one city, so the findings cannot necessarily be extrapolated to the rest of the country, particularly for rural areas where PCV7 immunization uptake is even lower [29].…”

Section: Discussionmentioning

confidence: 66%

“…In China, S. pneumoniae is a primary cause of morbidity and mortality among children younger than 5 years [1]: 136,551 cases of severe community-acquired pneumonia and 14,202 deaths were caused by S. pneumoniae in 2010 and 2011, respectively [3]. Nasopharyngeal (NP) colonization by S. pneumoniae is the prerequisite for mucosal and invasive pneumococcal infections [4]. The prevalence of NP colonization varies by season, age, and other genetic and sociological factors.…”

Section: Introductionmentioning

confidence: 99%

“…Pneumococcal conjugate vaccines (PCV) reduce pneumococcal disease by preventing: 1) NP acquisition and the duration or density of carriage of S. pneumoniae, and 2) the progression of pneumococcal colonization to disease [4] [9]. The impact of PCVs on pneumococcal NP colonization and carriage is an indicator of efficacy against disease, and has become an important factor for consideration as a supplementary or alternative endpoint in vaccine licensure [9] [10].…”

Section: Introductionmentioning

confidence: 99%

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Impact of the Pneumococcal Heptavalent Conjugated Vaccine on <i>Streptococcus pneumoniae</i> Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Lv¹,

Bai²,

Sun³

et al. 2017

WJV

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Streptococcus pneumoniae is a primary cause of illness and death among children younger than 5 years in China. The heptavalent pneumococcal conjugate vaccine (PCV7) was the only conjugated vaccine (PCV) available in China from 2008 to 2013. This randomized, controlled, open-label study conducted at 46 Beijing clinics involved 3281 healthy 2-5-year-old Chinese children, randomized 1:1 to receive one dose of the S. pneumoniae heptavalent conjugated vaccine (PCV7) (n = 1643) or Haemophilus influenzae type b conjugate vaccine (Hib) (n = 1638). The main objective of this study was to investigate the impact of PCV7 against that of Hib vaccination in the nasopharyngeal S. pneumoniae colonization in healthy Chinese children. Nasopharyngeal (NP) samples for culture, serotyping and antimicrobial susceptibility testing were collected before vaccination and at Day 60 and 180 post-vaccination. A total 3281 children were enrolled in the study. Demographic characteristics were similar among both study groups: 1641 children received PCV7. Before immunization, S. pneumoniae was isolated in 338 and 360 children in the PCV7 (144 PCV7 isolates) and Hib groups (145 PCV7 isolates), respectively. At Day 180, PCV7 vaccination was more effective than Hib vaccination in reduction NP carriage (20.2% [P = 0.052]) and new acquisition (19.0% [P = 0.066]). When reductions in NP carriage and new acquisition of PCV7 VT plus 6A was analyzed, reduction in the PCV7 vaccinated group achieved statistical significance (P = 0.034 and P = 0.042 versus Hib, respectively). NP carriage of NVT increased in both groups (P = 0.305 between study groups at Day 180). PCV7 decreased NP carriage of non-susceptible VT to amoxicillin (P = 0.000),

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of the Pneumococcal Heptavalent Conjugated Vaccine on <i>Streptococcus pneumoniae</i> Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Lv¹,

Bai²,

Sun³

et al. 2017

WJV

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“…The notable exception was the vaccine efficacy against carriage in toddlers. While the model was unable to replicate the observed steep decrease in VT prevalence following vaccination using the mean prior estimate of 36% efficacy, the posterior suggests a mean efficacy of 55% which has been observed in other sites [23] and falls well into the range of the prior estimate.…”

Section: Discussionmentioning

confidence: 97%

“…Hence our prior on the average duration of protection against carriage and disease is centred around 6 years [16, 23, 24]. Vaccine protection is modelled as leaky protection [25].…”

Section: Methodsmentioning

confidence: 99%

Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya

Ojal

Waroux

Otiende

et al. 2017

BMC Med

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BackgroundThe World Health Organisation recommends the use of catch-up campaigns as part of the introduction of pneumococcal conjugate vaccines (PCVs) to accelerate herd protection and hence PCV impact. The value of a catch-up campaign is a trade-off between the costs of vaccinating additional age groups and the benefit of additional direct and indirect protection. There is a paucity of observational data, particularly from low- and middle-income countries, to quantify the optimal breadth of such catch-up campaigns.MethodsIn Kilifi, Kenya, PCV10 was introduced in 2011 using the three-dose Expanded Programme on Immunisation infant schedule and a catch-up campaign in children <5 years old. We fitted a transmission dynamic model to detailed local data, including nasopharyngeal carriage and invasive pneumococcal disease (IPD), to infer the marginal impact of the PCV catch-up campaign over hypothetical routine cohort vaccination in that setting and to estimate the likely impact of alternative campaigns and their dose efficiency.ResultsWe estimated that, within 10 years of introduction, the catch-up campaign among children <5 years old prevents an additional 65 (48–84) IPD cases across age groups, compared to PCV cohort introduction alone. Vaccination without any catch-up campaign prevented 155 (121–193) IPD cases and used 1321 (1058–1698) PCV doses per IPD case prevented. In the years after implementation, the PCV programme gradually accrues herd protection, and hence its dose efficiency increases: 10 years after the start of cohort vaccination alone the programme used 910 (732–1184) doses per IPD case averted. We estimated that a two-dose catch-up among children <1 year old uses an additional 910 (732–1184) doses per additional IPD case averted. Furthermore, by extending a single-dose catch-up campaign to children aged 1 to <2 years and subsequently to those aged 2 to <5 years, the campaign uses an additional 412 (296–606) and 543 (403–763) doses per additional IPD case averted. These results were not sensitive to vaccine coverage, serotype competition, the duration of vaccine protection or the relative protection of infants.ConclusionsWe find that catch-up campaigns are a highly dose-efficient way to accelerate population protection against pneumococcal disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0882-9) contains supplementary material, which is available to authorized users.

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A Cost-Effectiveness Analysis of the 10-Valent Pneumococcal Non-Typeable Haemophilus influenzae Protein D Conjugate Vaccine (PHiD-CV) Compared to the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) for Universal Mass Vaccination Implementation in New Zealand

Varghese

Talbot²,

Govender³

et al. 2018

Appl Health Econ Health Policy

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ObjectivesInvasive pneumococcal disease (IPD), pneumonia and acute otitis media (AOM) still represent a significant medical burden in children < 5 years of age in New Zealand (NZ), with marked disparities across socio-economic and ethnic groups. This cost-effectiveness evaluation aims to compare the potential impact of two childhood universal immunisation strategies: vaccination with a 3 + 1 schedule of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix, GSK) and the 13-valent pneumococcal conjugate vaccine (PCV13, Prevenar 13, Pfizer).MethodsA static Markov-process cohort model was used to simulate the epidemiological and economic burden of pneumococcal diseases on a single-birth cohort over its lifetime. Costs and outcomes were discounted annually at 3.5%. Epidemiological and cost inputs were extracted from the most recently available NZ data, or derived from the most relevant reference countries’ sources. The most updated evidence on the efficacies of the corresponding vaccines were used, particularly the significant effectiveness for PHiD-CV against IPD caused by serotype 19A.ResultsThe model estimated that both vaccines have a broadly comparable impact on IPD-related diseases and pneumonia. Due to the additional benefits possible through broader impact on AOM, PHiD-CV is estimated to potentially provide additional discounted cost offsets of approximately NZD 0.8 million over the lifetime of the birth cohort.ConclusionsTo ensure health equity in children, given the substantial burden of pneumonia and AOM, decision-makers should also take into account the impact of PCVs on these diseases for decisions relating to routine infant immunization.GSK study identifierHO-15-16775.Electronic supplementary materialThe online version of this article (10.1007/s40258-018-0387-5) contains supplementary material, which is available to authorized users.

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The Efficacy and Duration of Protection of Pneumococcal Conjugate Vaccines Against Nasopharyngeal Carriage

Abstract: Our results suggest that PCVs confer reasonable protection against acquisition of pneumococcal carriage of the 7 studied serotypes, for several years after vaccination, albeit with differences across serotypes.

Cited by 44 publications

References 46 publications

Impact of the Pneumococcal Heptavalent Conjugated Vaccine on <i>Streptococcus pneumoniae</i> Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Impact of the Pneumococcal Heptavalent Conjugated Vaccine on <i>Streptococcus pneumoniae</i> Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya

A Cost-Effectiveness Analysis of the 10-Valent Pneumococcal Non-Typeable Haemophilus influenzae Protein D Conjugate Vaccine (PHiD-CV) Compared to the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) for Universal Mass Vaccination Implementation in New Zealand

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The Efficacy and Duration of Protection of Pneumococcal Conjugate Vaccines Against Nasopharyngeal Carriage

Abstract: Our results suggest that PCVs confer reasonable protection against acquisition of pneumococcal carriage of the 7 studied serotypes, for several years after vaccination, albeit with differences across serotypes.

Cited by 44 publications

References 46 publications

Impact of the Pneumococcal Heptavalent Conjugated Vaccine on &lt;i&gt;Streptococcus pneumoniae&lt;/i&gt; Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Impact of the Pneumococcal Heptavalent Conjugated Vaccine on &lt;i&gt;Streptococcus pneumoniae&lt;/i&gt; Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya

A Cost-Effectiveness Analysis of the 10-Valent Pneumococcal Non-Typeable Haemophilus influenzae Protein D Conjugate Vaccine (PHiD-CV) Compared to the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) for Universal Mass Vaccination Implementation in New Zealand

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Impact of the Pneumococcal Heptavalent Conjugated Vaccine on <i>Streptococcus pneumoniae</i> Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China

Impact of the Pneumococcal Heptavalent Conjugated Vaccine on <i>Streptococcus pneumoniae</i> Nasopharyngeal Carriage and Antimicrobial Susceptibility in Children 2-5-Year-Old in Beijing, China