Update on the Use of Conjugate Pneumococcal Vaccines in Childhood

Desai, Shalini; McGeer, Allison; Quach-Thanh, Caroline; Elliott, D.E.

doi:10.14745/ccdr.v36i00a12

Cited by 25 publications

(7 citation statements)

References 31 publications

(30 reference statements)

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“…The main clinical trials of PCV7 were all conducted using a four-dose schedule, which includes a three-dose series in infancy followed by a fourth booster dose after one year of age. The high cost of PCV7 relative to other vaccines, vaccine shortages in the US and immunogenicity studies comparing two or three doses in infancy have led to evaluations suggesting that three doses (two in infancy followed by a third booster dose in the second year of life) may be as effective as a four-dose schedule (24)(25)(26).…”

Section: Reduced Dose Schedules Of Pcv7mentioning

confidence: 99%

“…Several studies (24,26) have shown that two infant doses, compared with three infant doses, of PCV7 in the first six months of life, produce similar levels of antibodies after the infant series. Whether two or three infant doses are given, a booster dose at 12 months of age or later is needed to produce the best immune response in toddlers.…”

Section: Reduced Dose Schedules Of Pcv7mentioning

confidence: 99%

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Update on the success of the pneumococcal conjugate vaccine

Kellner

2011

Paediatrics &Amp; Child Health

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Several years after the seven-valent pneumococcal conjugate vaccine (PCV7) was introduced in Canada and elsewhere, routine infant vaccination has led to near eradication of invasive pneumococcal disease caused by vaccine serotype strains in both children and adults. There have also been significant declines in pneumococcal-related disease including lobar pneumonia and otitis media. These declines have been offset, to some extent, by increases in nonvaccine serotype disease. Serotype 19A, which is often highly resistant to antibiotics, has become predominant. In most populations, however, the magnitude of replacement disease is much lower than the magnitude of decline in invasive pneumococcal disease with the use of PCV7. There is increasing evidence that three PCV7 doses provide protection that is nearly identical to that of four doses. New 10-valent and 13-valent pneumococcal conjugate vaccines were recently approved in Canada. These vaccines increase pneumococcal serotype coverage including serotype 19A (present in the 13-valent vaccine). Many provinces and territories have incorporated the 13-valent vaccine in their vaccination programs.

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Section: Reduced Dose Schedules Of Pcv7mentioning

confidence: 99%

Section: Reduced Dose Schedules Of Pcv7mentioning

confidence: 99%

Update on the success of the pneumococcal conjugate vaccine

Kellner

2011

Paediatrics &Amp; Child Health

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“…Of the 66 (70%) patients with known pneumococcal vaccination status at the time of IPD, 34 (36%) received age-appropriate pneumococcal conjugate vaccinations as per NACI guidelines for high-risk children (Table 1). 12 Five patients were partially immunized (1–2 doses) based on their age and general pediatric recommendations and 15 (23%) were unvaccinated. Of the unvaccinated children, many had an active malignancy at the time of IPD (n = 7, 47%), or were taking an immunosuppressant medication (n = 5, 33%).…”

Section: Resultsmentioning

confidence: 99%

“…For children with high-risk conditions, the US Advisory Committee on Immunization Practices and Canadian National Advisory Committee on Immunization (NACI) currently recommend 4 doses of PCV13 in infancy (at 2, 4, 6 and 12–15 months of age) and 1 dose of PPSV23 ≥2 years of age (with an additional booster at 5 years of age for children with immunocompromising conditions or asplenia). 11,12 Healthy, non-high-risk children are recommended to receive 3 doses of PCV13 and no PPSV23 vaccination. 9 The primary objective of this study was to describe the IPD case numbers and clinical outcomes in pediatric patients with underlying high-risk conditions.…”

mentioning

confidence: 99%

Invasive Pneumococcal Disease in High-risk Children: A 10-Year Retrospective Study

Warmerdam

Campigotto

Bitnun

et al. 2022

Pediatric Infectious Disease Journal

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Background: Despite the availability of conjugate pneumococcal vaccines, children with high-risk conditions remain vulnerable to invasive pneumococcal disease (IPD). This study sought to describe IPD prevalence, vaccination and outcomes among high-risk children. Methods: We used International Classification of Disease10 discharge and microbiology codes to identify patients hospitalized for IPD at a large pediatric hospital from January 1, 2009, to December 31, 2018. Patients were considered high-risk if they had: primary immunodeficiency, asplenia, transplant, active malignancy, sickle cell disease, cochlear implant, nephrotic syndrome, chronic lung disease, cerebrospinal fluid leak, HIV or used immunosuppressive therapy. Results: In total 94 high-risk patients were hospitalized for IPD. The most common high-risk conditions included malignancy (n = 33, 35%), solid-organ or bone marrow transplant (n = 17, 18%) and sickle cell disease (n = 14, 15%). Bacteremia was the most common presentation (n = 81, 86%) followed by pneumonia (n = 23, 25%) and meningitis (n = 9, 10%). No deaths occurred. Of 66 patients with known pneumococcal vaccination status, 15 (23%) were unvaccinated, and 51 (77%) received at least one dose of a pneumococcal vaccine; 20 received all four recommended pneumococcal conjugate vaccine (PCV) doses. Only three children received PPSV23. Of 20 children with no or partial (<3 doses) immunization, 70% (14) of IPD episodes were due to vaccine-preventable serotypes. Of 66 known IPD serotypes, 17% (n = 11) were covered by PCV13, 39% (n = 26) were covered by PPSV23 and 39% (n = 26) were nonvaccine serotype. Conclusions: Despite the availability of effective pneumococcal vaccines, IPD persists among children with high-risk conditions. Improving PCV13 and PPSV23 vaccination could significantly reduce IPD; most episodes were due to vaccine-preventable serotypes in incompletely immunized patients.

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“…After widespread implementation in 2002 of the 7-valent pneumococcal conjugate vaccine (PCV7, covering serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F) in Canadian children, the incidence of IPD due to PCV7 serotypes decreased significantly in all age groups within the Canadian population (Kellner et al, 2009). In 2010 the new PCV13 vaccine (PCV7 serotypes plus 1, 3, 5, 6A, 7F, and 19A) replaced the PCV7 vaccine for routine immunization of children (Desai et al, 2010). Shortly after implementation of PCV13 in Canada, the number of IPD cases due to vaccine-associated serotypes such as 19A and 7F declined (Deng et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Whole-genome Sequencing for Surveillance of Invasive Pneumococcal Diseases in Ontario, Canada: Rapid Prediction of Genotype, Antibiotic Resistance and Characterization of Emerging Serotype 22F

et al. 2016

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Background: Molecular typing is essential for inferring genetic relatedness between bacterial pathogens. In this study, we applied whole genome sequencing (WGS) for rapid prediction of sequence type and antibiotic resistance for invasive pneumococcal isolates.Methods: 240 isolates from adults (≥50 years old) in Ontario, Canada during 2009 to 2013 were subjected to WGS. Sequence type, antibiotic susceptibility and resistance were predicted directly from short reads. Emerging non-vaccine serotype 22F was further characterized by WGS.Results: Sequence type was successfully determined for 98.3% of isolates. The overall sensitivity and specificity for antibiotic resistance prediction were 95 and 100% respectively, compared to standard susceptibility testing methods. WGS-based phylogeny divided emerging 22F (ST433) strains into two distinct clades: clade A harboring a 23 kb-prophage and anti-phage PhD/Doc system and clade B with virulence-related proteases. Five isolates in clade A developed macrolide resistance via 5.1 kb mega element recombination (encoding mefE and msrD), while one isolate in clade B displayed quinolone resistance via a gyrA mutation.Conclusions: WGS is valuable for routine surveillance of pneumococcal clinical isolates and facilitates prediction of genotype and antibiotic resistance. The emergence of 22F in Ontario in the post-vaccine era and evidence of evolution and divergence of the 22F population warrants heightened pneumococcal molecular surveillance.

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Update on the Use of Conjugate Pneumococcal Vaccines in Childhood

Cited by 25 publications

References 31 publications

Update on the success of the pneumococcal conjugate vaccine

Update on the success of the pneumococcal conjugate vaccine

Invasive Pneumococcal Disease in High-risk Children: A 10-Year Retrospective Study

Whole-genome Sequencing for Surveillance of Invasive Pneumococcal Diseases in Ontario, Canada: Rapid Prediction of Genotype, Antibiotic Resistance and Characterization of Emerging Serotype 22F

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