Impact of 13-Valent Pneumococcal Conjugate Vaccine on Pneumococcal Meningitis, Burkina Faso, 2016–2017

Abstract Background In 2013, Burkina Faso introduced 13-valent pneumococcal conjugate vaccine (PCV13) into the routine childhood immunization program, to be administered to children at 8, 12, and 16 weeks of age. We evaluated the impact of PCV13 on pneumococcal meningitis. Methods Using nationwide surveillance, we gathered demographic/clinical information and cerebrospinal fluid (CSF) results for meningitis cases. Pneumococcal cases were confirmed by culture, polymerase chain reaction (PCR), or latex agglutination; strains were serotyped using PCR. We compared annual incidence (cases per 100 000) 4 years after PCV13’s introduction (2017) to average pre-PCV13 incidence (2011–2013). We adjusted incidence for age and proportion of cases with CSF tested at national laboratories. Results In 2017, pneumococcal meningitis incidence was 2.7 overall and 10.5 (<1 year), 3.8 (1–4 years), 3.5 (5–14 years), and 1.4 (≥15 years) by age group. Compared to 2011–2013, PCV13-serotype incidence was significantly lower among all age groups, with the greatest decline among children aged <1 year (77%; 95% confidence interval [CI], 65%–84%). Among all ages, the drop in incidence was larger for PCV13 serotypes excluding serotype 1 (79%; 95% CI, 72%–84%) than for serotype 1 (52%; 95% CI, 44%–59%); incidence of non-PCV13 serotypes also declined (53%; 95% CI, 37%–65%). In 2017, 45% of serotyped cases among all ages were serotype 1 and 12% were other PCV13 serotypes. Conclusions In Burkina Faso, meningitis caused by PCV13 serotypes continues to decrease, especially among young children. However, the concurrent decline in non-PCV13 serotypes and short pre-PCV13 observation period complicate evaluation of PCV13’s impact. Efforts to improve control of serotype 1, such as switching from a 3 + 0 schedule to a 2 + 1 schedule, may improve overall control of pneumococcal meningitis in this setting.

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Can pneumococcal meningitis surveillance be used to assess the impact of pneumococcal conjugate vaccine on total invasive pneumococcal disease? A case-study from South Africa, 2005–2016

Vaccine ◽

10.1016/j.vaccine.2019.04.090 ◽

2019 ◽

Vol 37 (38) ◽

pp. 5724-5730 ◽

Cited By ~ 1

Author(s):

Jackie Kleynhans ◽

Cheryl Cohen ◽

Meredith McMorrow ◽

Stefano Tempia ◽

Penny Crowther-Gibson ◽

...

Keyword(s):

South Africa ◽

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Pneumococcal Meningitis ◽

The Impact

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Immunogenicity and Reactogenicity of 13-Valent Pneumococcal Conjugate Vaccine Among Infants, Toddlers, and Children in Western Burkina Faso: Results From a Clinical Trial of Alternative Immunization Schedules

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piy075 ◽

2018 ◽

Vol 8 (5) ◽

pp. 422-432 ◽

Cited By ~ 1

Author(s):

Jennifer C Moïsi ◽

Seydou Yaro ◽

Sita S Kroman ◽

Clarisse Gouem ◽

Dramane Bayane ◽

...

Keyword(s):

Burkina Faso ◽

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Age Groups ◽

Primary Immune Response ◽

African Countries ◽

Before And After ◽

Bobo Dioulasso ◽

Western Burkina Faso

Abstract Background Many African countries have introduced pneumococcal conjugate vaccine (PCV) into their routine immunization program to reduce the burden of morbidity and death that results from Streptococcus pneumoniae infection, yet immunogenicity and reactogenicity data from the region are limited for the 2 available PCV products. Methods We conducted a randomized trial of 13-valent PCV (PCV13) in Bobo-Dioulasso, Burkina Faso. Infants received 3 doses of PCV at 6, 10, and 14 weeks of age or at 6 weeks, 14 weeks, and 9 months of age; toddlers received 2 doses 2 months apart or 1 dose beginning at 12 to 15 months of age; and children received 1 dose between 2 and 4 years of age. We measured each participant’s serotype-specific serum immunoglobulin G concentration and opsonophagocytic activity before and after vaccination. For each age group, we compared immune responses between study arms and between the standard schedule in our study and the PCV13-licensing trials. Results In total, 280 infants, 302 toddlers, and 81 children were assigned randomly and underwent vaccination; 268, 235, and 77 of them completed follow-up, respectively. PCV13 resulted in low reactogenicity in all the study arms. The vaccine elicited a strong primary immune response in infants after 2 or more doses and in children aged 1 to 4 years after 1 dose. Infants who received a booster dose exhibited a robust memory response. Immunogenicity was higher than or comparable to that observed in the PCV13-licensing trials for a majority of serotypes in all 3 age groups. Conclusions PCV13 has a satisfactory immunogenicity and reactogenicity profile in this population. Our findings will help support decision making by countries regarding their infant and catch-up vaccination schedules.

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2717. The Impact of Pneumococcal Conjugate Vaccine in Nonbacteremic Pneumococcal Pneumonia Among Cancer Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2394 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S956-S956

Author(s):

Yeon Joo Lee ◽

Rocco Richards ◽

Yiqi Su ◽

Anna Kaltsas ◽

Genovefa Papanicolaou

Keyword(s):

Cancer Patients ◽

Conjugate Vaccine ◽

Indirect Effect ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Pneumonia ◽

Hematologic Malignancies ◽

Childhood Immunization ◽

Radiographic Findings ◽

Sputum Production ◽

The Impact

Abstract Background Invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NB-PNA) are associated with substantial morbidity and mortality in cancer patients. IPD incidence among cancer patients at MSKCC sharply declined after the introduction of routine childhood immunization with the 7-valent pneumococcal conjugate vaccine (PCV7) (1). An indirect effect of PCV on pneumococcal pneumonia incidence has also been reported (2, 3). The impact of PCV on the incidence of NB-PNA in patients with cancer has not been well studied. Methods Retrospective review of patients treated at MSKCC, 1993–2012. Unique patient visits (UPV) per year were defined as ≥1 inpatient or outpatient encounter within one calendar year. NB-PNA was defined as Isolation of Streptococcus pneumoniae from sputum or bronchoalveolar lavage (BAL); with associated symptoms (cough, sputum production, and/or fever) and radiographic findings compatible with pneumonia on chest radiograph or computerized chest tomography. NB-PNA incidence was calculated as number of NB-PNA cases per 1000 UPV. Three-time periods were examined: “before PCV7” (1993–2000), “after PCV7” (2001–2010), “after PCV13” (2011–2012). Results Of 323 NB-PNA cases, S. pneumoniae was isolated from BAL in 64 (20%) and sputum in 259 (80%). 182 (56%), 121 (37%), and 20 (7%) NB-PNA cases occurred “before PCV7,” “after PCV7,” and “after PCV13,” respectively. The incidence of NB-PNA was highest in patients with hematologic malignancies and in patients ≥65 years during all three periods (Table 1). NB-PNA incidence was lower “after PCV7” compared with “before PCV7” (0.47 vs. 0.13, P < 0.001). A non-statistically significant lower incidence of NB-PNA was noted “after PCV13” vs. “after PCV7” (0.13 vs. 0.09, P = 0.19). The highest decline of NB-PNA after PCV7 introduction was observed in patients ≥65 years (0.67 vs. 0.16, P < 0.001). Conclusion (1) The incidence of NB-PNA in adult cancer patient declined after PCV7 compared with before PCV7. (2) The reduction in NB-PNA was highest in patients ≥65 years suggesting an indirect effect from PCV7 childhood immunization. (3) A trend toward decreased incidence in NB-PNA was noted after PCV13; further surveillance is required to ascertain this trend. Disclosures All authors: No reported disclosures.

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Continued occurrence of serotype 1 pneumococcal meningitis in two regions located in the meningitis belt in Ghana five years after introduction of 13-valent pneumococcal conjugate vaccine

PLoS ONE ◽

10.1371/journal.pone.0203205 ◽

2018 ◽

Vol 13 (9) ◽

pp. e0203205 ◽

Cited By ~ 11

Author(s):

Catherine H. Bozio ◽

Abass Abdul-Karim ◽

John Abenyeri ◽

Braimah Abubakari ◽

Winfred Ofosu ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Meningitis ◽

Meningitis Belt ◽

Serotype 1

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Pneumococcal Conjugate Vaccine Impact on Meningitis and Pneumonia Among Children Aged <5 Years—Zimbabwe, 2010–2016

Clinical Infectious Diseases ◽

10.1093/cid/ciz462 ◽

2019 ◽

Vol 69 (Supplement_2) ◽

pp. S72-S80 ◽

Cited By ~ 1

Author(s):

Vongai Dondo ◽

Hilda Mujuru ◽

Kusum Nathoo ◽

Vengai Jacha ◽

Ottias Tapfumanei ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Meningitis ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Negative Binomial Regression Model ◽

Pediatric Pneumonia ◽

Vaccine Impact ◽

Meningitis In Children ◽

The Impact

Abstract Background Streptococcus pneumoniae is a leading cause of pneumonia and meningitis in children aged <5 years. Zimbabwe introduced 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose infant schedule with no booster dose or catch-up campaign. We evaluated the impact of PCV13 on pediatric pneumonia and meningitis. Methods We examined annual changes in the proportion of hospitalizations due to pneumonia and meningitis among children aged <5 years at Harare Central Hospital (HCH) pre-PCV13 (January 2010–June 2012) and post-PCV13 (July 2013–December 2016) using a negative binomial regression model, adjusting for seasonality. We also evaluated post-PCV13 changes in serotype distribution among children with confirmed pneumococcal meningitis at HCH and acute respiratory infection (ARI) trends using Ministry of Health outpatient data. Results Pneumonia hospitalizations among children aged <5 years steadily declined pre-PCV13; no significant change in annual decline was observed post-PCV13. Post-PCV13 introduction, meningitis hospitalization decreased 30% annually (95% confidence interval [CI], –42, –14) among children aged 12–59 months, and no change was observed among children aged 0–11 months. Pneumococcal meningitis caused by PCV13 serotypes decreased from 100% in 2011 to 50% in 2016. Annual severe and moderate outpatient ARI decreased by 30% (95% CI, –33, –26) and 7% (95% CI, –11, –2), respectively, post-PCV13 introduction. Conclusions We observed declines in pediatric meningitis hospitalizations, PCV13-type pneumococcal meningitis, and severe and moderate ARI outpatient visits post-PCV13 introduction. Low specificity of discharge codes, changes in referral patterns, and improvements in human immunodeficiency virus care may have contributed to the lack of additional declines in pneumonia hospitalizations post-PCV13 introduction.

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Evaluation of the Impact of Meningococcal Serogroup A Conjugate Vaccine Introduction on Second-Year-of-Life Vaccination Coverage in Burkina Faso

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz304 ◽

2019 ◽

Vol 220 (Supplement_4) ◽

pp. S233-S243 ◽

Cited By ~ 7

Author(s):

Robert L Zoma ◽

Jenny A Walldorf ◽

Felix Tarbangdo ◽

Jaymin C Patel ◽

Alpha Oumar Diallo ◽

...

Keyword(s):

Burkina Faso ◽

Conjugate Vaccine ◽

Age Groups ◽

Immunization Coverage ◽

Vaccine Introduction ◽

Second Year Of Life ◽

Second Year ◽

Household Cluster ◽

Vaccine Availability ◽

The Impact

Abstract Background After successful meningococcal serogroup A conjugate vaccine (MACV) campaigns since 2010, Burkina Faso introduced MACV in March 2017 into the routine Expanded Programme for Immunization schedule at age 15–18 months, concomitantly with second-dose measles-containing vaccine (MCV2). We examined MCV2 coverage in pre- and post-MACV introduction cohorts to describe observed changes regionally and nationally. Methods A nationwide household cluster survey of children 18–41 months of age was conducted 1 year after MACV introduction. Coverage was assessed by verification of vaccination cards or recall. Two age groups were included to compare MCV2 coverage pre-MACV introduction (30–41 months) versus post-MACV introduction (18–26 months). Results In total, 15 925 households were surveyed; 7796 children were enrolled, including 3684 30–41 months of age and 3091 18–26 months of age. Vaccination documentation was observed for 86% of children. The MACV routine coverage was 58% (95% confidence interval [CI], 56%–61%) with variation by region (41%–76%). The MCV2 coverage was 62% (95% CI, 59%–65%) pre-MACV introduction and 67% (95% CI, 64%–69%) post-MACV introduction, an increase of 4.5% (95% CI, 1.3%–7.7%). Among children who received routine MACV and MCV2, 93% (95% CI, 91%–94%) received both at the same visit. Lack of caregiver awareness about the 15- to 18-month visit and vaccine unavailability were common reported barriers to vaccination. Conclusions A small yet significant increase in national MCV2 coverage was observed 1 year post-MACV introduction. The MACV/MCV2 coadministration was common. Findings will help inform strategies to strengthen second-year-of-life immunization coverage, including to address the communication and vaccine availability barriers identified.

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Impact of 10-valent pneumococcal conjugate vaccine on pneumococcal meningitis in children up to two years of age in Brazil

Cadernos de Saúde Pública ◽

10.1590/0102-311x00169913 ◽

2015 ◽

Vol 31 (2) ◽

pp. 276-284 ◽

Cited By ~ 15

Author(s):

Indianara Maria Grando ◽

Camile de Moraes ◽

Brendan Flannery ◽

Walter Massa Ramalho ◽

Marco Aurélio P. Horta ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Meningitis ◽

Incidence Rates ◽

Morbidity And Mortality ◽

Ecological Analysis ◽

Post Vaccination ◽

Meningitis In Children ◽

Using Data ◽

The Impact

The objective of this study was to analyze the impact of vaccination against Streptococcus pneumoniae on the morbidity and mortality from pneumococcal meningitis in children ≤ 2 years in Brazil, from 2007 to 2012. This is a descriptive study and ecological analysis using data from the Information System on Notifiable Diseases. Pre-vaccination (2007-2009) and post-vaccination (2011-2012) periods were defined to compare incidence rates and mortality. A total of 1,311 cases and 430 deaths were reported during the study period. Incidence decreased from 3.70/100,000 in 2007 to 1.84/100,000 in 2012, and mortality decreased from 1.30/100,000 to 0.40/100,000, or 50% and 69% respectively, with the greatest impact in the 6-11 month age group. This decrease in Pneumococcal meningitis morbidity and mortality rates two years after introduction of the 10-valent pneumococcal conjugate vaccine suggests its effectiveness.

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Impact of Pneumococcal Conjugate Vaccine on Pediatric Tympanostomy Tube Insertion in Partial Immunized Population

The Scientific World JOURNAL ◽

10.1155/2015/248678 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8

Author(s):

Mao-Che Wang ◽

Ying-Piao Wang ◽

Chia-Huei Chu ◽

Tzong-Yang Tu ◽

An-Suey Shiao ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Pediatric Population ◽

Age Groups ◽

Period Effect ◽

Research Database ◽

Birth Cohorts ◽

Tube Insertion ◽

Effect Analysis ◽

The Impact

Objective. To investigate the impact of seven-valent pneumococcal conjugate vaccine on tube insertions in a partial immunized pediatric population.Study Design. Retrospective ecological study.Methods. This study used Taiwan National Health Insurance Research Database for the period 2000–2009. Every child under 17 years old who received tubes during this 10-year period was identified and analyzed. The tube insertion rates in different age groups and the risk to receive tubes in different birth cohorts before and after the release of the vaccine in 2005 were compared.Results. The tube insertion rates for children under 17 years of age ranged from 21.6 to 31.9 for 100,000 persons/year. The tube insertion rate of children under 2 years old decreased significantly after 2005 in period effect analysis (β= −0.074,P< 0.05, and the negativeβvalue means a downward trend) and increased in children 2 to 9 years old throughout the study period (positiveβvalues which mean upward trends,P< 0.05). The rate of tube insertion was lower in 2004-2005 and 2006-2007 birth cohorts than that of 2002-2003 birth cohort (RR = 0.90 and 0.21, 95% CI 0.83–0.97 and 0.19–0.23, resp.).Conclusion. The seven-valent pneumococcal conjugate vaccine may reduce the risk of tube insertion for children of later birth cohorts. The vaccine may have the protective effect on tube insertions in a partial immunized pediatric population.

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Impact of 13-valent pneumococcal conjugate vaccine on laboratory-confirmed pneumococcal meningitis and purulent meningitis among children ˂5 years in Cameroon, 2011–2018

PLoS ONE ◽

10.1371/journal.pone.0250010 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250010

Author(s):

John Njuma Libwea ◽

Mark A. Fletcher ◽

Paul Koki Ndombo ◽

Angeline Boula ◽

Nadesh Taku Ashukem ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Meningitis ◽

Dose Schedule ◽

Population Based ◽

Immunization Programme ◽

Purulent Meningitis ◽

National Immunization Programme ◽

Wbc Count ◽

The Impact

Background The 13-valent pneumococcal conjugate vaccine (PCV13) entered Cameroon’s childhood national immunization programme (NIP) in July 2011 under a 3-dose schedule (6, 10, 14 weeks of age) without any catch-up. We described the impact of PCV13 onserotype distribution among pneumococcal meningitis cases over time. Methods We used laboratory-based sentinel surveillance data to identify meningitis cases among 2- to 59-month-old children with clinically-suspected bacterial meningitis (CSBM) admitted to hospitals in Yaoundé (August 2011-December 2018). Purulent meningitis cases had a cerebrospinal fluid (CSF) white blood cell (WBC) count ≥20 per mm3. Pneumococcal meningitis cases had S. pneumoniae identified from CSF, with serotyping by polymerase chain reaction. Years 2011-2014 were described as early PCV13 era (EPE) and years 2015-2018 as late PCV13 era (LPE) impact periods. Results Among children hospitalized with CSBM who had a lumbar puncture obtained, there was no significant change from the EPE versus the LPE in the percentage identified with purulent meningitis: 7.5% (112/1486) versus 9.4% (154/1645), p = 0.0846. The percentage of pneumococcal meningitis cases due to PCV13 vaccine-serotype (VST) decreased from 62.0% (31/50) during the EPE to 35.8% (19/53) in the LPE, p = 0.0081. The most frequent pneumococcal meningitis VSTs during the EPE were 6A/6B (30%) and 5 (6%), and during the LPE were 14 (13.2%), 3 (7.6%), 4 (5.6%) and 18C (5.6%). Conclusion Four to seven years after PCV13 introduction, the proportion of pneumococcal meningitis due to vaccine serotypes has declined, mainly due to reductions of serotypes 6A/6B, 1, 19A, and 23F; nevertheless, PCV13 VSTs remain common. Because the analyzed surveillance system was not consistent or population based, we could not estimate incidence or overall impact; this emphasizes the need for improved surveillance to document further the utility of PCV13 immunization in Cameroon.

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