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.

Rethinking number-needed-to-vaccinate for pneumococcal conjugate vaccines in older adults: Current and future implications

Vaccine ◽  
2017 ◽  
Vol 35 (40) ◽  
pp. 5360-5365 ◽  
Author(s):  
John M. McLaughlin ◽  
David L. Swerdlow ◽  
Raul E. Isturiz ◽  
Luis Jodar
Keyword(s):  
Older Adults ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines

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.

scholarly journals Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe

2022 ◽  
Vol 28 (1) ◽  
Author(s):  
Germaine Hanquet ◽  
Pavla Krizova ◽  
Tina Dalby ◽  
Shamez N. Ladhani ◽  
J. Pekka Nuorti ◽  
...  
Keyword(s):  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Serotype Replacement

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 Neutrophils in community-acquired pneumonia: parallels in dysfunction at the extremes of age

Thorax ◽  
2019 ◽  
Vol 75 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Frances Susanna Grudzinska ◽  
Malcolm Brodlie ◽  
Barnaby R Scholefield ◽  
Thomas Jackson ◽  
Aaron Scott ◽  
...  
Keyword(s):  
Older Adults ◽  
Immune Cell ◽  
Pneumococcal Vaccination ◽  
Neutrophil Function ◽  
Community Acquired Pneumonia ◽  
High Income ◽  
Older Children ◽  
New Paradigm ◽  
Recurrent Pneumonia ◽  
Tight Rope

"Science means constantly walking a tight rope" Heinrich Rohrer, physicist, 1933. Community-acquired pneumonia (CAP) is the leading cause of death from infectious disease worldwide and disproportionately affects older adults and children. In high-income countries, pneumonia is one of the most common reasons for hospitalisation and (when recurrent) is associated with a risk of developing chronic pulmonary conditions in adulthood. Pneumococcal pneumonia is particularly prevalent in older adults, and here, pneumonia is still associated with significant mortality despite the widespread use of pneumococcal vaccination in middleand high-income countries and a low prevalence of resistant organisms. In older adults, 11% of pneumonia survivors are readmitted within months of discharge, often with a further pneumonia episode and with worse outcomes. In children, recurrent pneumonia occurs in approximately 10% of survivors and therefore is a significant cause of healthcare use. Current antibiotic trials focus on short-term outcomes and increasingly shorter courses of antibiotic therapy. However, the high requirement for further treatment for recurrent pneumonia questions the effectiveness of current strategies, and there is increasing global concern about our reliance on antibiotics to treat infections. Novel therapeutic targets and approaches are needed to improve outcomes. Neutrophils are the most abundant immune cell and among the first responders to infection. Appropriate neutrophil responses are crucial to host defence, as evidenced by the poor outcomes seen in neutropenia. Neutrophils from older adults appear to be dysfunctional, displaying a reduced ability to target infected or inflamed tissue, poor phagocytic responses and a reduced capacity to release neutrophil extracellular traps (NETs); this occurs in health, but responses are further diminished during infection and particularly during sepsis, where a reduced response to granulocyte colony-stimulating factor (G-CSF) inhibits the release of immature neutrophils from the bone marrow. Of note, neutrophil responses are similar in preterm infants. Here, the storage pool is decreased, neutrophils are less able to degranulate, have a reduced migratory capacity and are less able to release NETs. Less is known about neutrophil function from older children, but theoretically, impaired functions might increase susceptibility to infections. Targeting these blunted responses may offer a new paradigm for treating CAP, but modifying neutrophil behaviour is challenging; reducing their numbers or inhibiting their function is associated with poor clinical outcomes from infection. Uncontrolled activation and degranulation can cause significant host tissue damage. Any neutrophil-based intervention must walk the tightrope described by Heinrich Rohrer, facilitating necessary phagocytic functions while preventing bystander host damage, and this is a significant challenge which this review will explore.

scholarly journals Impact of the Conjugation Method on the Immunogenicity ofStreptococcus pneumoniaeSerotype 19F Polysaccharide in Conjugate Vaccines

2010 ◽  
Vol 18 (2) ◽  
pp. 327-336 ◽  
Author(s):  
Jan Poolman ◽  
Carl Frasch ◽  
Anu Nurkka ◽  
Helena Käyhty ◽  
Ralph Biemans ◽  
...  
Keyword(s):  
Immune Responses ◽  
Pneumococcal Disease ◽  
Reductive Amination ◽  
Acute Otitis Media ◽  
Cross Protection ◽  
Native Form ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
The Impact ◽  
Conjugation Method

ABSTRACT7vCRM (Pfizer, Inc.) and PHiD-CV (GlaxoSmithKline Biologicals) are two pneumococcal conjugate vaccines licensed for the prevention of invasive pneumococcal disease and acute otitis media caused by the vaccine serotypes ofStreptococcus pneumoniae. Neither vaccine contains serotype 19A, but both contain the closely related serotype 19F. No decrease in the incidence of serotype 19A disease has been observed following the introduction of 7vCRM, suggesting that this serotype 19F-containing vaccine provides limited cross-protection against serotype 19A. To investigate the impact that conjugation methods may have on antipolysaccharide immune responses and to determine whether this limited cross-protection is characteristic of the serotype 19F polysaccharide or rather of the 19F-CRM (cross-reacting material) conjugate, we compared naturally induced antibodies against serotypes 19F and 19A with antibodies induced after vaccination with different pneumococcal conjugate vaccines. We found that conjugation of the serotype 19F polysaccharide using reductive amination (as in 7vCRM) resulted in the formation of at least one additional epitope that is not present in the native form of the 19F polysaccharide or following 19F conjugation using a bifunctional spacer (as in the prototype vaccine 7vOMPC) or cyanylation (as in PHiD-CV). We also found that pneumococcal vaccines conjugated using cyanylation induce more opsonophagocytic antibodies against serotype 19F and a considerably higher level of cross-opsonophagocytic antibodies against serotype 19A than vaccines conjugated using reductive amination. In conclusion, these results suggest that the conjugation method can influence the functionality of the antibodies induced against the homologous serotype 19F and the cross-reactive serotype 19A ofS. pneumoniae.

scholarly journals Estimating the impact of pneumococcal conjugate vaccines on childhood pneumonia in sub-Saharan Africa: A systematic review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 765
Author(s):  
Chukwuemeka Onwuchekwa ◽  
Bassey Edem ◽  
Victor Williams ◽  
Emmanuel Oga
Keyword(s):  
Time Series ◽  
Pneumococcal Vaccination ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Conjugate Vaccines ◽  
Pneumococcal Conjugate Vaccines ◽  
Childhood Pneumonia ◽  
Routine Administration ◽  
Sub Saharan ◽  
The Impact

Background: This study aimed to summarise the evidence on the impact of routine administration of 10-valent and 13-valent pneumococcal conjugate vaccines on pneumonia in children under five years of age in sub-Saharan Africa. Methods: A systematic search of the literature was conducted including primary research reporting on the impact of 10- or 13-valent pneumococcal vaccines on childhood pneumonia in a sub-Saharan African country. Case-control, cohort, pre-post and time-series study designs were eligible for inclusion. Thematic narrative synthesis was carried out to summarise the findings. Results: Eight records were included in the final analysis, 6 records were pre-post or time-series studies, 1 was a case-control study and 1 report combined pre-post and case-control studies. Vaccine impact on clinical pneumonia measured as percentage reduction in risk (%RR) was mostly non-significant. The reduction in risk was more consistent in radiological and pneumococcal pneumonia. Conclusions: Evidence of the positive impact of routine infant pneumococcal vaccination on clinical pneumonia incidence in sub-Saharan Africa is inconclusive. Ongoing surveillance and further research is required to establish the long term trend in pneumonia epidemiology and aetiology after PCV introduction. PROSPERO registration: CRD42019142369 30/09/19

Sign in / Sign up

Export Citation Format

Share Document