Immunogenicity Induced by the Heptavalent Pneumococcal Conjugate Vaccine among Thai Children at High Risk for Severe Pneumococcal Disease

The Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA) demonstrated the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) in preventing vaccine-type community-acquired pneumonia and vaccine-type invasive pneumococcal disease in elderly subjects. We examined the cost-effectiveness of PCV13 vaccination in the Netherlands.Using a Markov-type model, incremental cost-effectiveness ratios (ICER) of PCV13 vaccination in different age- and risk-groups for pneumococcal disease were evaluated using a societal perspective. Estimates of quality-adjusted life-years (QALYs), costs, vaccine efficacy and epidemiological data were based on the CAPiTA study and other prospective studies. The base-case was PCV13 vaccination of adults aged 65–74 years compared to no vaccination, assuming no net indirect effects in base-case due to paediatric 10-valent pneumococcal conjugate vaccine use. Analyses for age- and risk-group specific vaccination strategies and for different levels of hypothetical herd effects from a paediatric PCV programme were also conducted.The ICER for base-case was €8650 per QALY (95% CI 5750–17 100). Vaccination of high-risk individuals aged 65–74 years was cost-saving and extension to medium-risk individuals aged 65–74 years yielded an ICER of €2900. Further extension to include medium- and high-risk individuals aged ≥18 years yielded an ICER of €3100.PCV13 vaccination is highly cost-effective in the Netherlands. The transferability of our results to other countries depends upon vaccination strategies already implemented in those countries.

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Serotype and antibiotic resistance of isolates from patients with invasive pneumococcal disease in Japan

Epidemiology and Infection ◽

10.1017/s0950268809990239 ◽

2009 ◽

Vol 138 (1) ◽

pp. 61-68 ◽

Cited By ~ 66

Author(s):

N. CHIBA ◽

M. MOROZUMI ◽

K. SUNAOSHI ◽

S. TAKAHASHI ◽

M. TAKANO ◽

...

Keyword(s):

Antibiotic Resistance ◽

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Polysaccharide Vaccine ◽

Gene Alteration ◽

Antibiotic Susceptibilities ◽

Underlying Diseases ◽

Heptavalent Pneumococcal Conjugate Vaccine

SUMMARYInvasive pneumococcal disease (IPD) is of concern in Japan, where the heptavalent pneumococcal conjugate vaccine (PCV7) is unavailable. We determined serotypes, genotypes indicating β-lactam resistance, and antibiotic susceptibilities of 496 isolates from normally sterile sites in patients (193 children, 303 adults) from 186 institutions between August 2006 and July 2007. Disease presentations included sepsis (46·2%), pneumonia (31·5%), and meningitis (17·5%). Mortality was 1·4% in children and 22·1% in adults, many of whom had underlying diseases. In children, serotype 6B (22·5%) was followed by 19F (14·1%), and 14 (13·1%); potential coverages of PCV7 and PCV13 were 75·4% and 93·7%, respectively. In adults, serotype 12F (14·3%) was followed by 3 (11·3%), and 6B (10·3%); 23-valent polysaccharide vaccine (PPV23) coverage was 85·4%. Most serotype 12F strains were gPISP, withpbp2bgene alteration; carbapenem had an excellent MIC90.PCV7 is recommended for children and PPV23 for adults to increase prevention against IPD.

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