scholarly journals Effectiveness of pneumococcal conjugate vaccines against community-acquired alveolar pneumonia attributable to vaccine-serotype Streptococcus pneumoniae among children

2020 ◽  
Author(s):  
Joseph A Lewnard ◽  
Noga Givon-Lavi ◽  
Ron Dagan
Keyword(s):  
Streptococcus Pneumoniae ◽  
Pneumococcal Disease ◽  
Population Based ◽  
Prospective Surveillance ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Surveillance Studies ◽  
Pediatric Pneumonia ◽  
Case Status ◽  
Joint Reduction

Abstract Introduction Streptococcus pneumoniae is a leading cause of pneumonia among children. However, owing to diagnostic limitations, the protection conferred by pneumococcal conjugate vaccines (PCVs) against pediatric pneumonia attributable to vaccine-serotype pneumococci remains unknown. Methods We analyzed data on vaccination and nasopharyngeal pneumococcal detection among children <5 years old with community-acquired alveolar pneumonia (CAAP; “cases”) and those without respiratory symptoms (“controls”), who were enrolled in population-based prospective surveillance studies in southern Israel between 2009-18. We measured PCV-conferred protection against carriage of vaccine-serotype pneumococci via the relative risk of detecting these serotypes among vaccinated versus unvaccinated controls. We measured protection against progression of vaccine serotypes from carriage to CAAP via the relative association of vaccine-serotype detection in the nasopharynx with CAAP case status, among vaccinated and unvaccinated children. We measured PCV-conferred protection against CAAP attributable to vaccine-serotype pneumococci via the joint reduction in risks of carriage and disease progression. Results Our analyses included 1,032 CAAP cases and 7,743 controls. At ages 12-35 months, a PCV13 schedule containing two primary doses and one booster dose provided 87.2% (95% confidence interval: 8.1-100.0%) protection against CAAP attributable to PCV13-serotype pneumococci, and 92.3% (–0.9-100.0%) protection against CAAP attributable to PCV7-serotype pneumococci. Protection against PCV13-serotype and PCV7-serotype CAAP was 67.0% (–424.3-100.0%) and 67.7% (–1962.9-100.0%), respectively, at ages 36-59 months. At ages 4-11 months, two PCV13 doses provided 98.9% (–309.8-100.0%) and 91.4% (–191.4-100.0%) against PCV13-serotype and PCV7-serotype CAAP. Conclusions Among children, PCV-conferred protection against CAAP attributable to vaccine-targeted pneumococcal serotypes resembles protection against vaccine-serotype invasive pneumococcal disease.

scholarly journals Evaluating post-vaccine expansion patterns of pneumococcal serotypes

2020 ◽  
Author(s):  
Maile T. Phillips ◽  
Joshua L. Warren ◽  
Noga Givon-Lavi ◽  
Adrienn Tothpal ◽  
Gili Regev-Yochay ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Invasive Pneumococcal Disease ◽  
Jewish Population ◽  
Pneumococcal Disease ◽  
Pneumococcal Serotypes ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Vaccine Serotypes ◽  
Serotype Replacement ◽  
Disease Understanding

ABSTRACTStreptococcus pneumoniae remains a leading cause of morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) are effective but target only a fraction of the more than 90 pneumococcal serotypes. As a result, the introduction of PCVs has been followed by the emergence of non-vaccine serotypes. With higher-valency PCVs currently under development, there is a need to understand and predict patterns of serotype replacement to anticipate future changes. In this study, we evaluated patterns of change in serotype prevalence post-PCV introduction in Israel. We found that the assumption that non-vaccine serotypes increase by the same proportion overestimates changes in serotype prevalence in Jewish and Bedouin children. Furthermore, pre-vaccine prevalence was positively associated with increases in prevalence over the study period. From our analyses, serotypes 12F, 8, 16F, 33F, 9N, 7B, 10A, 22F, 24F, and 17F were estimated to have gained the most cases of invasive pneumococcal disease through serotype replacement in the Jewish population. However, this model also failed to quantify some additional cases gained, suggesting that changes in carriage in children alone may be insufficient to explain serotype replacement in disease. Understanding of serotype replacement is important as higher-valency vaccines are introduced.

Serotype Distribution of Streptococcus pneumoniae causing Invasive Pneumococcal Disease at Bambino Gesù Children's Hospital in Rome: Is It Time for a New Vaccine?

2018 ◽  
Vol 14 (01) ◽  
pp. 013-015
Author(s):  
Elena Bozzola ◽  
Andrzej Krzysztofiak ◽  
Annausa Pantosti ◽  
Laura Lancella ◽  
Paola Bernaschi ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pediatric Age ◽  
Immunization Programs ◽  
Serotype Distribution ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Children's Hospital ◽  
The Impact

AbstractDiseases caused by Streptococcus pneumoniae are mostly preventable infections by current immunization programs. The objective of this study was to evaluate the impact of the introduction of the heptavalent and the 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13) on the burden of pneumococcal disease and on the serotype distribution of S. pneumoniae causing invasive pneumococcal diseases (IPDs) in the pediatric age over a 5-year study (from January 2008 till December 2012). We observed a decrease in IPD rate in children after PCV13 introduction despite increases in nonvaccine serotype (NVS) rates in 2011. Nevertheless, from 2012, an increase in IPD rates due to non-PCV13 serotypes was observed.

scholarly journals Emergence of Meningitis Caused by Nonvaccine Serotypes of Pneumococcus in Rural United States

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Jessie Marks ◽  
Guru V. Bhoojhawon ◽  
Katherine D. Patrick ◽  
Kelly E. Wood
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Vaccine Introduction

Pneumococcal conjugate vaccines have decreased the rates of invasive pneumococcal disease (IPD) in children. Since vaccine introduction, however, rates of infection due to nonvaccine Streptococcus pneumoniae serotypes have increased. We now describe 3 meningitis cases due to the nonvaccine serotypes 35B and 11A from rural United States.

scholarly journals Burden of Streptococcus pneumoniae Sepsis in Children After Introduction of Pneumococcal Conjugate Vaccines: A Prospective Population-based Cohort Study

2019 ◽  
Vol 69 (9) ◽  
pp. 1574-1580 ◽  
Author(s):  
Sandra A Asner ◽  
Philipp K A Agyeman ◽  
Eugénie Gradoux ◽  
Klara M Posfay-Barbe ◽  
Ulrich Heininger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Streptococcus Pneumoniae ◽  
Case Fatality ◽  
Length Of Hospital Stay ◽  
Population Based ◽  
Vaccine Failure ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Pneumococcal Sepsis ◽  
The Impact

AbstractBackgroundPopulation-based studies assessing the impact of pneumococcal conjugate vaccines (PCV) on burden of pneumococcal sepsis in children are lacking. We aimed to assess this burden following introduction of PCV-13 in a nationwide cohort study.MethodsThe Swiss Pediatric Sepsis Study (September 2011 to December 2015) prospectively recruited children <17 years of age with blood culture-proven sepsis due to Streptococcus pneumoniae, meeting criteria for systemic inflammatory response syndrome. Infection with vaccine serotype in children up to date with PCV immunization was defined as vaccine failure. Main outcomes were admission to pediatric intensive care unit (PICU) and length of hospital stay (LOS).ResultsChildren with pneumococcal sepsis (n = 117) accounted for a crude incidence of 2.0 per 100 000 children (95% confidence interval [CI] 1.7–2.4) and 25% of community-acquired sepsis episodes. Case fatality rate was 8%. Forty-two (36%) patients required PICU admission. Children with meningitis (29; 25%) were more often infected by serotypes not included in PCV (69% vs 31%; P < .001). Sixteen (26%) of 62 children up to date with PCV immunization presented with vaccine failure, including 11 infected with serotype 3. In multivariable analyses, children with meningitis (odds ratio [OR] 6.8; 95% CI 2.4–19.3; P < .001) or infected with serotype 3 (OR 2.8; 95% CI 1.1–7.3; P = .04) were more often admitted to PICU. Children infected with serotype 3 had longer LOS (β coefficient 0.2, 95% CI .1–1.1; P = .01).ConclusionsThe incidence of pneumococcal sepsis in children shortly after introduction of PCV-13 remained substantial. Meningitis mostly due to non-vaccine serotypes and disease caused by serotype 3 represented significant predictors of severity.

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