scholarly journals Early Impact of 13-Valent Pneumococcal Conjugate Vaccine Use on Invasive Pneumococcal Disease Among Adults With and Without Underlying Medical Conditions—United States

2019 ◽  
Vol 70 (12) ◽  
pp. 2484-2492 ◽  
Author(s):  
Sana S Ahmed ◽  
Tracy Pondo ◽  
Wei Xing ◽  
Lesley McGee ◽  
Monica Farley ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
National Health ◽  
Indirect Effects ◽  
Pneumococcal Disease ◽  
National Health Survey ◽  
Medical Conditions ◽  
In Series ◽  
Interview Survey ◽  
Us Children ◽  
Immunocompetent Adults

Abstract Background The 13-valent pneumococcal vaccine (PCV13) was introduced for US children in 2010 and for immunocompromised adults ≥19 years old in series with the 23-valent polysaccharide vaccine (PPSV23) in 2012. We evaluated PCV13 indirect effects on invasive pneumococcal disease (IPD) among adults with and without PCV13 indications. Methods Using Active Bacterial Core surveillance and the National Health Survey, using Active Bacterial Core surveillance and the National Health Interview Survey, we estimated and compared IPD incidence in 2013–2014 and 2007–2008, by age and serotype group (PCV13, PPSV23-unique, or nonvaccine types [NVTs]), among adults with and without PCV13 indications. Results IPD incidence declined among all adults. Among adults 19–64 years, PCV13-type IPD declined 57% (95% confidence interval [CI], −68% to −43%) in adults with immunocompromising conditions (indication for PCV13 use), 57% (95% CI, −62% to –52%) in immunocompetent adults with chronic medical conditions (CMCs, indications for PPSV23 use alone), and 74% (95% CI, −78% to −70%) in adults with neither vaccine indication. Among adults aged ≥65 years, PCV13-type IPD decreased 68% (95% CI, −76% to −60%) in those with immunocompromising conditions, 68% (95% CI, −72% to −63%) in those with CMCs, and 71% (95% CI, −77% to −64%) in healthy adults. PPSV23-unique types increased in adults 19‒64 years with CMCs, and NVTs did not change among adults with or without PCV13 indications. From 2013 to 2014, non-PCV13 serotypes accounted for 80% of IPD. Conclusions IPD incidence among US adults declined after PCV13 introduction in children. Similar reductions in PCV13-type IPD in those with and without PCV13 indications suggest that observed benefits are largely due to indirect effects from pediatric PCV13 use rather than direct use among adults.

scholarly journals Direct and Indirect Impact of 13-valent Pneumococcal Conjugate Vaccine (PCV13) on Invasive Pneumococcal Disease (IPD) Among Children and Adults in the U.S.

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S66-S67 ◽  
Author(s):  
Tamara Pilishvili ◽  
Ryan Gierke ◽  
Monica Farley ◽  
William Schaffner ◽  
Ann Thomas ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Indirect Effects ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
Polysaccharide Vaccine ◽  
Direct And Indirect Effects ◽  
Vaccine Type ◽  
Indirect Impact ◽  
In Series ◽  
The U.S

Abstract Background In February 2010, PCV13 was introduced for routine use among children aged < 5 years. In June 2012, PCV13 was recommended for use in series with 23-valent polysaccharide vaccine (PPSV23) for adults ≥19 years with select medical conditions, and in August 2014, for all adults ≥65 years. We evaluated the direct and indirect effects of PCV13 6 years post-introduction on invasive pneumococcal disease (IPD). Methods IPD cases (isolation of pneumococcus from sterile sites) were identified among residents of Active Bacterial Core surveillance (ABCs) sites during July 2007–June 2016. Isolates were serotyped by Quellung, PCR, or whole genome sequencing and classified as PCV13 or non-vaccine type (NVT). Incidence changes were estimated as percent changes (one minus rate ratio) and 95% confidence intervals (95% CI) between pre-PCV13 (2007–2009) and two post-PCV13 periods (July 2014–June 2015 and July 2015–June 2016). Results ABCs identified 31,190 IPD cases between 2007 and 2015, with 2,750 cases among children <5 years and 10,930 among those ≥65 years. During the two post-PCV13 periods, overall IPD rates were 33%-62% lower relative to 2007–2009 among all age groups, including <5 years and ≥65 years (Figure). Significant reductions in PCV13-type IPD incidence were observed for all age groups during both post-PCV13 periods, with incidence 84% (q95% CI 78, 88%) and 68% (95% CI 63, 73%) lower in 2015–2016 among children < 5 years and adults ≥65 years, respectively. PCV13-type IPD reductions were driven by serotypes 19A and 7F. IPD due to non-vaccine types also declined significantly among children < 5 years (−27%, 95% CI –42, –9%) and adults ≥65 years (-24%, 95% CI –34, –14%). PCV13-type IPD incidence did not differ significantly between the two post-PCV13 periods. Conclusion IPD incidence declined among children and adults in the U.S. following PCV13 introduction among children. The lack of difference in PCV13 rates between 2014–2015 and 2015–2016 suggests no measurable early impact of PCV13 introduction among adults ≥65 years. To date, we found no evidence of significant replacement disease with non-PCV13 types. Further work is needed to explain reductions in non-vaccine type disease observed in the post-PCV13 era. Disclosures W. Schaffner, Pfizer: Scientific Advisor, Consulting fee; Merck: Scientific Advisor, Consulting fee; Novavax: Consultant, Consulting fee; Dynavax: Consultant, Consulting fee; Sanofi-pasteur: Consultant, Consulting fee; GSK: Consultant, Consulting fee; Seqirus: Consultant, Consulting fee; L. Harrison, GSK: Scientific Advisor, Consulting fee

scholarly journals Excess Risks And Costs Of Invasive Pneumococcal Disease And Pneumonia Among Us Persons With Underlying Medical Conditions

2013 ◽  
Vol 16 (3) ◽  
pp. A232
Author(s):  
D. Weycker ◽  
R. Farkouh ◽  
D.R. Strutton ◽  
J. Edelsberg ◽  
K. Shea ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Medical Conditions

scholarly journals Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults

2019 ◽  
Vol 86 ◽  
pp. 122-130 ◽  
Author(s):  
Pilar Ciruela ◽  
Sonia Broner ◽  
Conchita Izquierdo ◽  
Roman Pallarés ◽  
Carmen Muñoz-Almagro ◽  
...  
Keyword(s):  
Older Adults ◽  
Invasive Pneumococcal Disease ◽  
Indirect Effects ◽  
Pneumococcal Disease ◽  
Conjugate Vaccines

scholarly journals Comparison of different anthropometric measures in the adult population in Serbia as indicators of obesity: data from the National Health Survey 2013

2016 ◽  
Vol 19 (12) ◽  
pp. 2246-2255 ◽  
Author(s):  
Miloš Ž Maksimović ◽  
Jelena M Gudelj Rakić ◽  
Hristina D Vlajinac ◽  
Nadja D Vasiljević ◽  
Marina I Nikić ◽  
...  
Keyword(s):  
National Health ◽  
Health Survey ◽  
Adult Population ◽  
National Health Survey ◽  
Anthropometric Measures ◽  
Health Interview Survey ◽  
Health Interview ◽  
Interview Survey ◽  
European Health ◽  
European Health Interview Survey

AbstractObjectiveThe present study aimed to compare different indicators of obesity in the Serbian adult population.DesignCross-sectional study. A stratified, two-stage, national-representative random sampling approach was used for the selection of the survey sample. Data sources were questionnaires created according to the European Health Interview Survey questionnaire. Measurements of weight, height and waist circumference (WC) were performed using standard procedures. Anthropometric measures included BMI, WC and waist-to-height ratio (WHtR).SettingData for the study were obtained from the 2013 National Health Survey, performed in line with the EUROSTAT recommendations for performance of the European Health Interview Survey.SubjectsAdults aged ≥20 years.ResultsAccording to BMI, out of the whole studied population (12 460 adults of both sexes) 2·4 % were underweight, 36·4 % overweight and 22·4 % obese. Using WC and WHtR as measures of adiposity showed that 22·5 % and 42·8 % of participants were overweight and 39·8 % and 25·3 % were obese, respectively. Men and women differed significantly in all variables observed. Overweight was more frequent in men and obesity in women regardless of adiposity measure used.ConclusionsIn spite of strong correlations between BMI, WC and WHtR, substantial discrepancies between these three measures in the assessment of overweight and obesity were found, especially in some age groups. Which of these anthropometric measures should be used, or whether two or all three of them should be applied, depends on their associations with cardiovascular or some other disease of interest.

Nationwide Trends of Invasive Pneumococcal Disease in Spain From 2009 Through 2019 in Children and Adults During the Pneumococcal Conjugate Vaccine Era

2020 ◽  
Author(s):  
Sara de Miguel ◽  
Mirian Domenech ◽  
Fernando González-Camacho ◽  
Julio Sempere ◽  
Dolores Vicioso ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
National Laboratory ◽  
Laboratory Data ◽  
Pneumococcal Polysaccharide Vaccine ◽  
Conjugate Vaccines ◽  
Spanish Regions ◽  
Herd Protection ◽  
Immunocompetent Adults ◽  
The Impact

Abstract Background Introduction of pneumococcal conjugate vaccines (PCVs) has reduced the disease caused by vaccine serotypes in children, providing herd protection to adults. However, the emergence of nonvaccine serotypes is of great concern worldwide. Methods This study includes national laboratory data from invasive pneumococcal disease (IPD) cases that affected pediatric and adult populations during 2009–2019. The impact of implementing different vaccine strategies for immunocompetent adults by comparing Spanish regions that used the 13-valent PCV (PCV13) vs regions that used the 23-valent pneumococcal polysaccharide vaccine (PPV23) was also analyzed for 2017−2019. Results The overall reductions in IPD cases by PCV13 serotypes in children and adults were 88% and 59%, respectively, during 2009–2019, with a constant increase in serotype 8 in adults since 2015. IPD cases by additional serotypes covered by PPV23 increased from 20% in 2009 to 52% in 2019. In children, serotype 24F was the most frequent in 2019, whereas serotypes 3 and 8 accounted for 36% of IPD cases in adults. Introduction of PCV13 or PPV23 in the adult calendar of certain Spanish regions reduced the IPD cases by PCV13 serotypes by up to 25% and 11%, respectively, showing a decrease of serotype 3 when PCV13 was used. Conclusions Use of PCV13 in children has affected the epidemiology, reducing the burden of IPD in children but also in adults by herd protection; however, the increase in serotype 8 in adults is worrisome. Vaccination with PCV13 in adults seems to control IPD cases by PCV13 serotypes including serotype 3.

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