Epidemiology of community-acquired pneumonia in the era of extended serotype-covering multivalent pneumococcal conjugate vaccines

Vaccine ◽  
2020 ◽  
Vol 38 (49) ◽  
pp. 7747-7755
Author(s):  
Jung Yeon Heo ◽  
Yu Bin Seo ◽  
Hye Won Jeong ◽  
Min Joo Choi ◽  
Kyung Hoon Min ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines

scholarly journals Pneumococcal Diseases Caused by Serotype Replacement in Colombia: A Cost-Effectiveness Analysis of Pneumococcal Conjugate Vaccines in Infants and Its Herd Protection in Older Adults

2020 ◽  
Author(s):  
Jaime E. Ordóñez ◽  
Angélica Ordóñez
Keyword(s):  
Older Adults ◽  
Acute Otitis Media ◽  
Pneumococcal Vaccination ◽  
Indirect Costs ◽  
Economic Benefits ◽  
Community Acquired Pneumonia ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Serotype Replacement ◽  
Strategy Versus

Abstract Background. The recent and available evidence on the distribution of pneumococcal serotypes, which affects the effectiveness of pneumococcal conjugate vaccines (PCV), suggest that additional health economic studies will be important for better understanding of potential economic benefits of pneumococcal vaccination. Methods A cohort simulation model was used for new births in Colombia between 2019-2022 and adults over 65 years, from social perspective (direct and indirect costs). The time horizon was a life expectancy and discount rate for costs and benefits of 5%. The outcomes were presented in terms of avoided pneumococcal diseases ─ Invasive Pneumococcal Disease (IPD), Community Acquired Pneumonia (CAP), Acute Otitis Media (AOM), and sequelae─, years of life gained (AVG) and herd effect in older adults.Results. Based on data from National Data of the serotype distribution between 2017-2019, PCV10 covers 5% of serotypes while PCV13 63%. The additional cases that PCV13 would prevent are in children: 1,205 cases of IPD, 60,274 of CAP, 26,619 of AOM, 3,980 deaths, 28 cases of neuromotor disability and 1,251 cochlear implants. In older adults, PCV13 would prevent 818 additional cases of IPD and 29,983 of CAP, generating 149,186 additional LYGs to those of PCV10 with a saving to the health system and patients of US $ 169,261 thousand. The model shows robustness in the sensibility analysis.Conclusion. PCV13 is a cost-saving strategy versus PCV10 to prevent pneumococcal diseases.

scholarly journals Estimating serotype-specific efficacy of pneumococcal conjugate vaccines using hierarchical models

2019 ◽  
Author(s):  
Joshua L Warren ◽  
Daniel M. Weinberger
Keyword(s):  
Vaccine Efficacy ◽  
Controlled Trial ◽  
Community Acquired Pneumonia ◽  
Published Data ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Bayesian Hierarchical ◽  
Hierarchical Statistical Model ◽  
The Individual ◽  
High Degree

AbstractPneumococcal conjugate vaccines (PCVs) target 10 or 13 specific serotypes. To evaluate vaccine efficacy for these products, the vaccine-targeted serotypes are typically aggregated into a single group to estimate an overall effect. However, it is often desirable to evaluate variations in effects for different serotypes. These serotype-specific estimates are often based on small numbers, resulting in a high degree of uncertainty and instability in the individual estimates. A better approach is to use a Bayesian hierarchical statistical model, which estimates an overall effectiveness of the vaccine across all vaccine-targeted serotypes but also allows the effect to vary by serotype. We re-analyzed published data from a large randomized controlled trial on the efficacy of PCV13 against non-bacteremic community-acquired pneumonia caused by vaccine-targeted serotype. This model provides a potential framework for obtaining more credible and stable estimates of serotype-specific vaccine efficacy and effectiveness.

scholarly journals Etiology of Clinical Community-Acquired Pneumonia in Swedish Children Aged 1–59 Months with High Pneumococcal Vaccine Coverage—The TREND Study

Vaccines ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 384
Author(s):  
Annika Eklundh ◽  
Samuel Rhedin ◽  
Malin Ryd-Rinder ◽  
Maria Andersson ◽  
Jesper Gantelius ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Vaccine Coverage ◽  
A Priori ◽  
Community Acquired Pneumonia ◽  
World Health ◽  
Respiratory Pathogens ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Health Organization ◽  
Undetermined Etiology

(1) Immunization with pneumococcal conjugate vaccines has decreased the burden of community-acquired pneumonia (CAP) in children and likely led to a shift in CAP etiology. (2) The Trial of Respiratory infections in children for ENhanced Diagnostics (TREND) enrolled children 1-59 months with clinical CAP according to the World Health Organization (WHO) criteria at Sachs’ Children and Youth Hospital, Stockholm, Sweden. Children with rhonchi and indrawing underwent “bronchodilator challenge”. C-reactive protein and nasopharyngeal PCR detecting 20 respiratory pathogens, were collected from all children. Etiology was defined according to an a priori defined algorithm based on microbiological, biochemical, and radiological findings. (3) Of 327 enrolled children, 107 (32%) required hospitalization; 91 (28%) received antibiotic treatment; 77 (24%) had a chest X-ray performed; and 60 (18%) responded to bronchodilator challenge. 243 (74%) episodes were classified as viral, 11 (3%) as mixed viral-bacterial, five (2%) as bacterial, two (0.6%) as atypical bacterial and 66 (20%) as undetermined etiology. After exclusion of children responding to bronchodilator challenge, the proportion of bacterial and mixed viral-bacterial etiology was 1% and 4%, respectively. (4) The novel TREND etiology algorithm classified the majority of clinical CAP episodes as of viral etiology, whereas bacterial etiology was uncommon. Defining CAP in children <5 years is challenging, and the WHO definition of clinical CAP is not suitable for use in children immunized with pneumococcal conjugate vaccines.

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