Evaluation of the effectiveness of pneumococcal conjugate vaccine for children in Korea with high vaccine coverage using a propensity score matched national population cohort

IntroductionAfter the introduction of the seven-valent pneumococcal conjugate vaccine (PCV7) in the United States (US) in the year 2000, the incidence of invasive pneumococcal disease (IPD) caused by the seven vaccine serotypes declined by 80 percent in vaccinated children and 30 percent in unvaccinated adults. A transmission dynamic equation model developed in 2009 captured the direct and indirect effects of vaccination in the early years after vaccination. Subsequently, the vaccine program switched to the 13-valent PCV and adult PCV13 vaccination. This work explores the accuracy of the mathematical model to predict long-term IPD due to changes in US immunization practices.MethodsThe model simulates the acquisition of asymptomatic carriage of pneumococci and the development of IPD among individuals aged <2, 2–4, 5–17, 18–49, 50–64, and ≥65 years. Pneumococcal serotypes were stratified into three categories: PCV7-type (4, 6B, 9V, 14, 18C, 19F, and 23F), PCV6-type (1, 3, 5, 6A, 7F, and 19A), and non-PCV-type (all others). Model parameters were calibrated using US IPD surveillance data from 1998–2006. Model results were compared to observed epidemiology.ResultsThe model was previously shown to predict observed IPD well through 2007. After adjusting model parameters for PCV13 efficacy and adult vaccine coverage, modeled IPD closely replicated observed IPD. Observed baseline pre-vaccine incidence for children <2 years of age was 192 cases/100,000 and 13.5 cases in 2016, versus 18.5 cases estimated by the model. Similarly, observed versus modeled cases in the ≥65-year-old age group were 24 and 23.6 cases.ConclusionsThis epidemiologic model accurately simulates the observed US IPD surveillance data 17 years after initial introduction of PCV, highlighting the direct and indirect benefits of vaccination. Well-constructed mathematical models can accurately replicate real-world scenarios. Key input parameters of these models can then be modified to predict the impact of alternate scenarios, providing insights to inform public health policy-making.

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Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries: a protocol for a prospective observational study

BMJ Open ◽

10.1136/bmjopen-2018-021512 ◽

2018 ◽

Vol 8 (5) ◽

pp. e021512 ◽

Cited By ~ 7

Author(s):

Jocelyn Chan ◽

Cattram D Nguyen ◽

Jana Y R Lai ◽

Eileen M Dunne ◽

Ross Andrews ◽

...

Keyword(s):

Observational Study ◽

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Prospective Observational Study ◽

Vaccine Coverage ◽

Middle Income ◽

Middle Income Countries ◽

Pneumococcal Carriage ◽

Vaccine Type ◽

Indirect Protection

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Determining the pneumococcal conjugate vaccine coverage required for indirect protection within Asia and the Pacific: a prospective observational study

The Lancet Global Health ◽

10.1016/s2214-109x(19)30100-7 ◽

2019 ◽

Vol 7 ◽

pp. S15

Author(s):

Jocelyn Chan ◽

Jana Y Lai ◽

Claire von Mollendorf ◽

Christopher Blyth ◽

David A B Dance ◽

...

Keyword(s):

Observational Study ◽

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Prospective Observational Study ◽

Vaccine Coverage ◽

The Pacific ◽

Indirect Protection

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Association of Pneumococcal Conjugate Vaccine Coverage With Pneumococcal Meningitis: An Analysis of French Administrative Areas, 2001–2016

American Journal of Epidemiology ◽

10.1093/aje/kwz071 ◽

2019 ◽

Vol 188 (8) ◽

pp. 1466-1474

Author(s):

Anna Alari ◽

Félix Cheysson ◽

Lénaig Le Fouler ◽

Philippe Lanotte ◽

Emmanuelle Varon ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Pneumococcal Meningitis ◽

Vaccine Coverage ◽

Mixed Effect ◽

Cumulative Impact ◽

Vaccine Serotypes ◽

Vaccine Impact

Abstract Geographic variations of invasive pneumococcal disease incidence and serotype distributions were observed after pneumococcal conjugate vaccine introduction at regional levels and among French administrative areas. The variations could be related to regional vaccine coverage (VC) variations that might have direct consequences for vaccination-policy impact on invasive pneumococcal disease, particularly pneumococcal meningitis (PM) incidence. We assessed vaccine impact from 2001 to 2016 in France by estimating the contribution of regional VC differences to variations of annual local PM incidence. Using a mixed-effect Poisson model, we showed that, despite some variations of VC among administrative areas, vaccine impact on vaccine-serotype PM was homogeneously confirmed among administrative areas. Compared with the prevaccine era, the cumulative VC impact on vaccine serotypes led, in 2016, to PM reductions ranging among regions from 87% (25th percentile) to 91% (75th percentile) for 7-valent pneumococcal conjugate vaccine serotypes and from 58% to 63% for the 6 additional 13-valent pneumococcal conjugate vaccine serotypes. Nonvaccine-serotype PM increases from the prevaccine era ranged among areas from 98% to 127%. By taking into account the cumulative impact of growing VC and VC differences, our analyses confirmed high vaccine impact on vaccine-serotype PM case rates and suggest that VC variations cannot explain PM administrative area differences.

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Efficacy of 13-valent pneumococcal conjugate vaccine in healthcare workers

Terapevticheskii arkhiv ◽

10.26442/terarkh201890114-61 ◽

2018 ◽

Vol 90 (11) ◽

pp. 55-61

Author(s):

L A Shpagina ◽

O S Kotova ◽

I S Shpagin ◽

E M Loktin ◽

A A Rukavitsyna ◽

...

Keyword(s):

Critical Care ◽

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Healthcare Workers ◽

Cox Regression ◽

Respiratory Infections ◽

Vaccine Coverage ◽

Healthcare Personnel ◽

Pneumococcal Infections ◽

Care Department

Aim. To establish the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) for healthcare workers protection from occupational acquired infection and impact of healthcare staff vaccination on the risk of transmission to patients. Materials and methods. Healthcare personnel (n=157 of whom 105 critical care department staff) and 1770 patients of that critical care department observed. Healthcare workers received PCV13. Infections caused by Str. pneumoniae, respiratory infections regardless of etiology, work absenteeism in healthcare workers during 12 month before and after vaccination assessed. In the same time monitoring of hospital-acquired infections in patients of critical care department performed. Statistical analysis was done using SPSS 24, relationships were assessed by rate ratio, Cox regression, logistic regression and Kaplan-Meier estimator. Results. Healthcare workers' vaccine coverage in critical care department was 97.2%. In healthcare personnel the rate of all pneumococcal infections, asymptomatic carriage of Str. pneumoniae and respiratory pneumococcal infections were decreased after vaccination by 2.1, 2.2 and 2.1 times accordingly. The rate of respiratory infections regardless of etiology was decreased by 30%, р

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2711. Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Invasive Pneumococcal Disease in Older Adults

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2388 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S953-S954

Author(s):

Ned Lewis ◽

Amber Hsiao ◽

John Hansen ◽

Arnold Yee ◽

Charlie Chao ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Vaccine Coverage ◽

Conditional Logistic Regression ◽

Population Level ◽

P Value ◽

Kaiser Permanente ◽

Vaccine Type

Abstract Background Routine use of 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for infants since early 2010 and for adults ≥65 years since 2014 when KPNC began routine use of PCV13 in adults. PCV13 vaccine effectiveness (VE) against vaccine-type invasive pneumococcal disease (IPD) has been demonstrated; however, recent surveillance data have been interpreted as showing limited population-level impact of PCV13 on serotype 3 IPD. We estimated PCV13 VE against IPD due to vaccine serotypes at Kaiser Permanente Northern California (KPNC). Methods The study period spanned September 2014 through September 2018. The cohort included KPNC members who were aged ≥65 years with no record of pneumococcal polysaccharide vaccine (PPV23) receipt before age 65 years. We compared IPD cases with KPNC members who were the same age on the date of the positive pneumococcal culture using conditional logistic regression, conditioned on age and date, and controlled for sex, race, KPNC service area and membership history, prior season influenza vaccine receipt, PPV23 receipt after age 65 years, risk factors for IPD, and healthcare utilization. Results From September 2014 to September 2018, PCV13 vaccine coverage among persons ≥65 years old increased from < 1% to 77%. During the same period, there was a total of 245 IPD cases. For a variety of reasons, we did not have serotype results for 57 (23%) IPD cases, which were excluded from the analysis. There were 61 (25%) PCV13-type IPD cases included in the analysis, of which 33 (14%) were serotype 3. PCV13 VE against PCV13-type serotypes was 68.0% (95% CI: 37.7%, 83.6%; P-value < 0.01), and 53.4% (95% CI: −10.0%, 80.3%; P = 0.08) against serotype 3. Conclusion During the first 4 years of PCV13 vaccination implementation in adults ≥65 years of age at KPNC, PCV13 provided significant protection against PCV13-type IPD. Further surveillance will allow for more precise estimation of PCV13 VE on overall and serotype 3 IPD over time. Disclosures All authors: No reported disclosures.

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370Measuring pneumococcal conjugate vaccine impact in a low-resource setting with minimal baseline data

International Journal of Epidemiology ◽

10.1093/ije/dyab168.687 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Claire von Mollendorf ◽

Ruth Lim ◽

Molina Choummanivong ◽

Vanphanom Sychareun ◽

Keoudomphone Vilivong ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Vaccine Coverage ◽

Baseline Data ◽

Vaccine Introduction ◽

Resource Setting ◽

Low Resource Setting ◽

Vaccine Type ◽

Combination Of Methods ◽

The Impact

Abstract Background We aimed to measure 13-valent pneumococcal conjugate vaccine (PCV13) impact on various pneumococcal endpoints with minimal baseline data. Methods PCV13 was introduced in October 2013 in Lao People’s Democratic Republic. We implemented studies to evaluate PCV13 impact: retrospective record review of pneumonia cases for three years pre-PCV13; prospective study of acute respiratory infection (ARI) for 4.5 years post-PCV to demonstrate effectiveness against hypoxic pneumonia; invasive pneumococcal disease (IPD) surveillance (2004-2019); carriage in children hospitalised with ARI (2013-2019); and community carriage surveys pre- and two years post-PCV13. Results Annual incidence of hospitalized pneumonia pre-PCV13 in children 2-59 months was 1,530 (95% confidence interval [CI] 1,477-1,584) per 100,000. Vaccine effectiveness against hypoxic pneumonia was 37% (95% CI 6-57%). In children <5 years, 85% (11/13) of IPD cases were due to PCV13 serotypes pre-PCV13, and 43% (3/7) post-PCV13; and in individuals ≥5 years, 61% (27/44) and 42% (17/40), respectively. In hospitalised children, vaccine type carriage prevalence reduced from 20.0% (95% CI 15.2-24.9%) in 2013 to 12.8% (95% CI 8.5-17.1%) in 2019 with increasing vaccine coverage. Results were consistent with community carriage studies. Conclusions Despite limited baseline data in Laos, we found evidence of PCV13 impact using a variety of methods. Our approach could be used in similar settings to augment existing WHO guidelines. Key messages A combination of methods may be useful to determine the impact of vaccine introduction in countries with limited surveillance.

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