scholarly journals Potential impact of Covid-19 response measures on invasive pneumococcal disease in England and Wales

2020 ◽  
Author(s):  
Yoon Hong Choi ◽  
Elizabeth Miller
Keyword(s):  
Sensitivity Analysis ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
England And Wales ◽  
Social Distancing ◽  
Pneumococcal Carriage ◽  
Potential Impact ◽  
The Uk ◽  
The Impact

AbstractObjectivesIn January 2020, the United Kingdom (UK) removed one of the two infant doses of the 13-valent pneumococcal conjugate vaccine (PCV13), leaving a single priming dose at 3 months and a 12 month booster. We modelled the potential impact on invasive pneumococcal disease (IPD) of a drop in PCV13 coverage associated with the restrictions on non-essential health care visits introduced to combat COVID-19 in the UK on 23 March 2020.DesignUsing a previously published model of pneumococcal transmission in England and Wales we simulated the impact of reducing PCV13 coverage by 50% for 3 months from 23 March without subsequent catch-up vaccination. To implement social distancing, we reduced mixing between and within age-groups by either 10% or 50%. In a sensitivity analysis we explored the effect of complete cessation of PCV13 vaccination during the “lockdown” and of extending its duration to 6 months.Main outcome measuresAnnual numbers of IPD cases predicted by the model under different vaccination and “lockdown” scenarios with uncertainty intervals (UI) generated from the minimum and maximum values of the model predictions using 500 parameter sets with values within a pre-specified range of the maximum likelihood set.ResultsThe model predicted that any increase in IPD cases from a reduction in PCV13 coverage would be more than offset by a reduction in pneumococcal transmission due to social distancing, with a net reduction in cumulative IPD cases (UI –1,479, –1,061, all ages) over the next five years. Similar results were obtained in the sensitivity analysis, though with a greater reduction with a 6 month “lockdown”.ConclusionCOVID-19 social distancing measures are predicted to have had a profound effect on pneumococcal transmission resulting in a reduction in pneumococcal carriage prevalence and IPD incidence over the first two years after the “lockdown”. Carriage studies will be informative in confirming the predicted impact of the social distancing measures after they have been lifted.

scholarly journals Impact of COVID-19 social distancing measures on future incidence of invasive pneumococcal disease in England and Wales: a mathematical modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045380
Author(s):  
Yoon Hong Choi ◽  
Elizabeth Miller
Keyword(s):  
Sensitivity Analysis ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
England And Wales ◽  
Population Mixing ◽  
Social Distancing ◽  
Pneumococcal Carriage ◽  
The Uk ◽  
The Impact

ObjectivesIn January 2020, the UK moved to a 1+1 schedule for the 13-valent pneumococcal conjugate vaccine (PCV13) with a single priming dose at 3-month and a 12-month booster. We modelled the impact on invasive pneumococcal disease (IPD) out to 2030/2031 of reductions in PCV13 coverage and population mixing associated with restrictions on non-essential healthcare visits and social distancing measures introduced in 2020/2021 to reduce SARS-CoV-2 transmission.DesignUsing an existing model of pneumococcal transmission in England and Wales, we simulated the impact of a 40% reduction in coverage and a 40% reduction in mixing between and within age groups during two lockdowns in spring 2020 and autumn/winter 2020/2021. More and less extreme reductions in coverage and mixing were explored in a sensitivity analysis.Main outcome measuresPredicted annual numbers of IPD cases under different coverage and mixing reduction scenarios with uncertainty intervals (UIs) generated from minimum and maximum values of the model predictions using 500 parameter sets.ResultsThe model predicted that any increase in IPD cases resulting from a reduction in PCV13 coverage would be more than offset by a reduction in pneumococcal transmission due to social distancing measures and that overall reductions in IPD cases will persist for a few years after resumption of normal mixing. The net reduction in cumulative IPD cases over the five epidemiological years from July 2019 was predicted to be 13 494 (UI 12 211, 14 676) all ages. Similar results were obtained in the sensitivity analysis.ConclusionCOVID-19 lockdowns are predicted to have had a profound effect on pneumococcal transmission resulting in a reduction in pneumococcal carriage prevalence and IPD incidence for up to 5 years after the end of the lockdown period. Carriage studies will be informative in confirming the predicted impact of the lockdown measures after they have been lifted.

scholarly journals Sex differences in invasive pneumococcal disease and the impact of pneumococcal conjugate vaccination in the Netherlands, 2004 to 2015

2017 ◽  
Vol 22 (10) ◽  
Author(s):  
Gertjan H J Wagenvoort ◽  
Elisabeth A M Sanders ◽  
Bart J Vlaminckx ◽  
Hester E de Melker ◽  
Arie van der Ende ◽  
...  
Keyword(s):  
Sex Differences ◽  
The Netherlands ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
Temporary Increase ◽  
Long Term Effects ◽  
Vaccine Introduction ◽  
Ongoing Surveillance ◽  
The Impact

Implementation of pneumococcal conjugate vaccines in the Netherlands (PCV7 in 2006 and PCV10 in 2011) for infants caused a shift in serotypes in invasive pneumococcal disease (IPD). We explored sex differences in serotype-specific IPD incidence before and after vaccine introduction. Incidences in the pre-PCV7 (June 2004–May 2006), post-PCV7 (June 2008–May 2011) and post-PCV10 period (June 2013–May 2015), stratified by age, were compared. Incidence was higher in men for all age groups (overall in men: 16.7, 15.5 and 14.4/100,000 and women: 15.4, 13.6 and 13.9/100,000 pre-PCV7, post-PCV7 and post-PCV10, respectively), except for 20–39 year-olds after PCV7 and 40–64 year-olds after PCV10 introduction. After PCV7 and PCV10 introduction, the overall IPD incidence decreased in men aged 20–39 years (from 5.3 pre-PCV7 to 4.7 and 2.6/100,000 post-PCV7 and post-PCV10, respectively), whereas it showed a temporary increase in women (from 3.9/100,000 pre-PCV7 to 5.0/100,000 post-PCV7 and back to 4.0/100,000 post-PCV10) due to replacement disease. PCV10 herd effects were observed throughout, but in women older than 40 years, a significant increase in non-PCV10 serotype offset a decrease in overall IPD incidence. Ongoing surveillance of IPD incidence by sex is important to evaluate the long-term effects of PCV implementation.

scholarly journals Predictions of COVID-19 dynamics in the UK: Short-term forecasting and analysis of potential exit strategies

2021 ◽  
Vol 17 (1) ◽  
pp. e1008619
Author(s):  
Matt J. Keeling ◽  
Edward M. Hill ◽  
Erin E. Gorsich ◽  
Bridget Penman ◽  
Glen Guyver-Fletcher ◽  
...  
Keyword(s):  
Critical Care ◽  
Health Service ◽  
Age Groups ◽  
Transmission Model ◽  
Bed Occupancy ◽  
Time Data ◽  
Social Distancing ◽  
Number Of Patients ◽  
The Uk ◽  
The Impact

Efforts to suppress transmission of SARS-CoV-2 in the UK have seen non-pharmaceutical interventions being invoked. The most severe measures to date include all restaurants, pubs and cafes being ordered to close on 20th March, followed by a “stay at home” order on the 23rd March and the closure of all non-essential retail outlets for an indefinite period. Government agencies are presently analysing how best to develop an exit strategy from these measures and to determine how the epidemic may progress once measures are lifted. Mathematical models are currently providing short and long term forecasts regarding the future course of the COVID-19 outbreak in the UK to support evidence-based policymaking. We present a deterministic, age-structured transmission model that uses real-time data on confirmed cases requiring hospital care and mortality to provide up-to-date predictions on epidemic spread in ten regions of the UK. The model captures a range of age-dependent heterogeneities, reduced transmission from asymptomatic infections and produces a good fit to the key epidemic features over time. We simulated a suite of scenarios to assess the impact of differing approaches to relaxing social distancing measures from 7th May 2020 on the estimated number of patients requiring inpatient and critical care treatment, and deaths. With regard to future epidemic outcomes, we investigated the impact of reducing compliance, ongoing shielding of elder age groups, reapplying stringent social distancing measures using region based triggers and the role of asymptomatic transmission. We find that significant relaxation of social distancing measures from 7th May onwards can lead to a rapid resurgence of COVID-19 disease and the health system being quickly overwhelmed by a sizeable, second epidemic wave. In all considered age-shielding based strategies, we projected serious demand on critical care resources during the course of the pandemic. The reintroduction and release of strict measures on a regional basis, based on ICU bed occupancy, results in a long epidemic tail, until the second half of 2021, but ensures that the health service is protected by reintroducing social distancing measures for all individuals in a region when required. Our work confirms the effectiveness of stringent non-pharmaceutical measures in March 2020 to suppress the epidemic. It also provides strong evidence to support the need for a cautious, measured approach to relaxation of lockdown measures, to protect the most vulnerable members of society and support the health service through subduing demand on hospital beds, in particular bed occupancy in intensive care units.

scholarly journals The Impact of Pneumococcal Conjugate Vaccine (PCV) Coverage Heterogeneities on the Changing Epidemiology of Invasive Pneumococcal Disease in Switzerland, 2005–2019

2021 ◽  
Vol 9 (5) ◽  
pp. 1078
Author(s):  
Oluwaseun Rume-Abiola Oyewole ◽  
Phung Lang ◽  
Werner C. Albrich ◽  
Kerstin Wissel ◽  
Stephen L. Leib ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Vaccine Coverage ◽  
Age Groups ◽  
Nationwide Survey ◽  
Vaccine Uptake ◽  
Dependent Manner ◽  
Beneficial Effects ◽  
Vaccine Type ◽  
The Impact

Pneumococcal conjugate vaccines (PCVs) have lowered the incidence of invasive pneumococcal disease (IPD) worldwide. However, the influence of regional vaccine uptake differences on the changing epidemiology of IPD remains unclear. We aimed to examine the overall impact of both seven- and 13-valent PCVs (PCV7 and PCV13) on IPD in Switzerland. Three-year periods from 2005–2010 and 2011–2019 were considered, respectively, as (early and late) PCV7 eras and (early, mid and late) PCV13 eras. Vaccine coverage was estimated from a nationwide survey according to east (German-speaking) and west (French/Italian-speaking) regions for each period. Reported incidence rate ratios (IRRs) were compared between successive periods and regions using nationwide IPD surveillance data. Overall IPD incidence across all ages was only 16% lower in the late PCV13 era compared to the early PCV7 era (IRR 0.83, 95% CI 0.79–0.88), due to increasing incidence of non-PCV-type IPD (2.59, 2.37–2.83) in all age groups, except children <5 years. PCV uptake rates in swiss children were slightly higher in the west than the east (p < 0.001), and were accompanied by lower IPD incidences across all age groups in the former region. Post-PCV13, non-PCV serotypes 8, 22F and 9N were the major cause of IPD in adults ≥65 years. Increased PCV coverage in both areas of Switzerland resulted in a decrease in vaccine-type and overall IPD incidence across all age groups, in a regionally dependent manner. However, the rising incidence of non-vaccine-type IPD, exclusive to older adults, may undermine indirect beneficial effects.

scholarly journals Serotype patterns of pneumococcal disease in adults are correlated with carriage patterns in older children

2019 ◽  
Author(s):  
Anne L. Wyllie ◽  
Joshua L. Warren ◽  
Gili Regev-Yochay ◽  
Noga Givon-Lavi ◽  
Ron Dagan ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
Deviance Information Criterion ◽  
Information Criterion ◽  
Older Children ◽  
Disease Patterns ◽  
Pneumococcal Carriage ◽  
Age Related ◽  
Carriage Prevalence

ABSTRACTBackgroundThe importance of specific serotypes causing invasive pneumococcal disease (IPD) differs by age. Data on pneumococcal carriage in different age groups, along with data on serotype-specific invasiveness, could help to explain these age-related patterns and their implications for vaccination.MethodsUsing pneumococcal carriage and disease data from Israel, we evaluated the association between serotype-specific IPD in adults and serotype-specific carriage prevalence among children in different age categories, while adjusting for serotype-specific invasiveness. We used a sliding window approach to estimate carriage prevalence using different age groupings. Deviance Information Criterion was used to determine which age groupings of carriage data best fit the adult IPD data. Serotype-specific disease patterns were further evaluated by stratifying IPD data by comorbidity status.ResultsThe relative frequency of serotypes causing IPD differed between adults and children, and also differed between older and younger adults and between adults with and without comorbidities. Serotypes over-represented as causes of IPD in adults were more commonly carried in older children as compared to younger children. In line with this, the serotype-specific frequency of carriage in older children (aged 36-59 months), rather than infants, best correlated with serotype-specific IPD in adults.ConclusionsThese analyses suggest that older children, rather than infants, are the main drivers of disease patterns in adults. These insights could help in optimizing vaccination strategies to reduce disease burden across all ages.40-word summary of the article’s main pointSerotype-specific rates of invasive pneumococcal disease in adults are better correlated with serotype-specific carriage patterns in older children (36-59 months of age) than those in infants.

scholarly journals Reduction in invasive pneumococcal disease following implementation of the conjugate vaccine in the Oxfordshire region, England

2011 ◽  
Vol 60 (1) ◽  
pp. 91-97 ◽  
Author(s):  
Dona Foster ◽  
A. Sarah Walker ◽  
John Paul ◽  
David Griffiths ◽  
Kyle Knox ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Rate Ratio ◽  
Pneumococcal Disease ◽  
Incidence Rate Ratio ◽  
Herd Effect ◽  
The Us ◽  
Ongoing Surveillance ◽  
The Uk ◽  
The Impact

Pneumococcal conjugate vaccine to seven capsular types has been highly effective in the US since its introduction in 2000. The same vaccine was adopted by the UK in 2006. Ongoing surveillance since 1995 of invasive pneumococcal disease (IPD) in Oxfordshire, UK, allowed assessment of the impact of vaccine intervention. The vaccine significantly reduced IPD among the target group, children under 2 years of age; incidence rate ratio (IRR)=0.62 (95 % CI 0.43–0.90) (P=0.008) comparing the 3 years pre- and post-implementation with a residual incidence of 22.4/100 000 children. The reduction was even greater when comparing 11 years pre- with the 3 years post-implementation of vaccine; IRR=0.53 (0.39–0.70) (P<0.0001). There was a marked direct effect of the vaccine evidenced by substantial reductions in the seven serotypes contained in the vaccine. There was also a clear reduction in IPD for those serotypes contained in the vaccine among those older than 2 years when comparing both the 3 and 11 year pre-PCV7 time periods, with IRR=0.57 (0.47–0.69) (P<0.0001) and IRR=0.50 (0.43–0.58) (P<0.0001), respectively, indicating a strong herd effect. There was a significant, though moderate, rise in the serotypes not contained in the vaccine, with clear evidence for replacement in some serotypes.

scholarly journals Short-term Projections based on Early Omicron Variant Dynamics in England.

2021 ◽  
Author(s):  
Matt J Keeling ◽  
Ellen Brooks-Pollock ◽  
Robert J Challen ◽  
Leon Danon ◽  
Louise Dyson ◽  
...  
Keyword(s):  
South Africa ◽  
Sensitivity Analysis ◽  
Virus Transmission ◽  
Transmission Characteristics ◽  
Short Term ◽  
Severity Of Disease ◽  
Future Risk ◽  
Potential Impact ◽  
The Uk ◽  
The Impact

Throughout the ongoing COVID-19 pandemic, the worldwide transmission and replication of SARS- COV-2, the causative agent of COVID-19 disease, has resulted in the opportunity for multiple mutations to occur that may alter the virus transmission characteristics, the effectiveness of vaccines and the severity of disease upon infection. The Omicron variant (B.1.1.529) was first reported to the WHO by South Africa on 24 November 2021 and was declared a variant of concern by the WHO on 26 November 2021. The variant was first detected in the UK on 27 November 2021 and has since been reported in a number of countries globally where it is frequently associated with rapid increase in cases. Here we present analyses of UK data showing the earliest signatures of the Omicron variant and mathematical modelling that uses the UK data to simulate the potential impact of this variant in the UK. In order to account for the uncertainty in transmission advantage, vaccine escape and severity at the time of writing, we carry out a sensitivity analysis to assess the impact of these variant characteristics on future risk.

Serotype dynamics of invasive pneumococcal disease post-PCV7 and pre-PCV13 introduction in North East England

2012 ◽  
Vol 141 (2) ◽  
pp. 344-352 ◽  
Author(s):  
K. E. CHAPMAN ◽  
D. WILSON ◽  
R. GORTON
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
Population Based ◽  
Childhood Immunization ◽  
Population Based Study ◽  
North East ◽  
Immunization Programme ◽  
Using Data ◽  
The Uk

SUMMARYThe 7-valent pneumococcal conjugate vaccine (PCV7) has been included in the routine childhood immunization programme in the UK since September 2006. A population-based study of serotypes causing invasive pneumococcal disease (IPD) post-PCV7 in North East England was conducted using data from a regional enhanced IPD surveillance system. Overall, there was a 20% reduction [95% confidence interval (CI) 5–32] from 12·1 cases/100 000 population in 2006/2007 to 9·7 in 2009/2010. There was a fall in IPD caused by PCV7 serotypes in all age groups, with reductions of 90% (95% CI 61–99) in children aged <5 years, 50% (95% CI 4–75) in persons aged 5–64 years and 66% (95% CI 40–82) in adults aged ⩾65 years. There was a non-significant increase in IPD caused by non-PCV7 serotypes in children aged <5 years of 88% (95% CI −10 to 312) and adults aged ⩾65 years of 12% (95% CI −19 to 50), which was largely caused by serotypes 7F, 19A and 22F. Replacement disease appears to have reduced the benefits of PCV7 in North East England.

scholarly journals Predictions of COVID-19 dynamics in the UK: short-term forecasting and analysis of potential exit strategies

2020 ◽  
Author(s):  
Matt J. Keeling ◽  
Edward M. Hill ◽  
Erin E. Gorsich ◽  
Bridget Penman ◽  
Glen Guyver-Fletcher ◽  
...  
Keyword(s):  
Critical Care ◽  
Health Service ◽  
Age Groups ◽  
Transmission Model ◽  
Bed Occupancy ◽  
Time Data ◽  
Social Distancing ◽  
Number Of Patients ◽  
The Uk ◽  
The Impact

AbstractBackgroundEfforts to suppress transmission of SARS-CoV-2 in the UK have seen non-pharmaceutical interventions being invoked. The most severe measures to date include all restaurants, pubs and cafes being ordered to close on 20th March, followed by a “stay at home” order on the 23rd March and the closure of all non-essential retail outlets for an indefinite period. Government agencies are presently analysing how best to develop an exit strategy from these measures and to determine how the epidemic may progress once measures are lifted. Mathematical models are currently providing short and long term forecasts regarding the future course of the COVID-19 outbreak in the UK to support evidence-based policymaking.MethodsWe present a deterministic, age-structured transmission model that uses real-time data on confirmed cases requiring hospital care and mortality to provide up-to-date predictions on epidemic spread in ten regions of the UK. The model captures a range of age-dependent heterogeneities, reduced transmission from asymptomatic infections and produces a good fit to the key epidemic features over time. We simulated a suite of scenarios to assess the impact of differing approaches to relaxing social distancing measures from 7th May 2020 on the estimated number of patients requiring inpatient and critical care treatment, and deaths. With regard to future epidemic outcomes, we investigated the impact of reducing compliance, ongoing shielding of elder age groups, reapplying stringent social distancing measures using region based triggers and the role of asymptomatic transmission.FindingsWe find that significant relaxation of social distancing measures from 7th May onwards can lead to a rapid resurgence of COVID-19 disease and the health system being quickly overwhelmed by a sizeable, second epidemic wave. In all considered age-shielding based strategies, we projected serious demand on critical care resources during the course of the pandemic. The reintroduction and release of strict measures on a regional basis, based on ICU bed occupancy, results in a long epidemic tail, until the second half of 2021, but ensures that the health service is protected by reintroducing social distancing measures for all individuals in a region when required.DiscussionOur work confirms the effectiveness of stringent non-pharmaceutical measures in March 2020 to suppress the epidemic. It also provides strong evidence to support the need for a cautious, measured approach to relaxation of lockdown measures, to protect the most vulnerable members of society and support the health service through subduing demand on hospital beds, in particular bed occupancy in intensive care units.

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