Invasive Pneumococcal Disease in Latvia in PCV10 Vaccination Era, 2012–2018

In 2010 in Latvia, invasive pneumococcal disease (IPD) became a cause for concern and vaccination of infants with four doses of 7–valent pneumococcal conjugate vaccine (PCV7) commenced. In 2012, 10–valent pneumococcal conjugate vaccine (PCV10) (three doses at 2, 4, and 12–15 month of age) vaccination was introduced. We described incidence and serotype distribution of IPD in Latvia and investigated serotypes associated with death from IPD based on surveillance data. Adult vaccination against pneumococcal infection is not included in the national immunization program. Laboratory confirmed IPD cases are passively notified to the Center for Disease Prevention and Control of Latvia (CDPC) by laboratories and clinicians. We calculated incidence by age, sex, case fatality, and trend in serotypes by conducting a retrospective population-based cross-sectional study based on national IPD surveillance data. From 2012 to 2018 466 cases of IPD were reported. The highest notified incidence was in 2015 at 4.4/100,000, which fell to 3.9 in 2018. The highest mean annual IPD incidence was in infants (4.8) and in the elderly (6.0). PCV10 vaccine serotypes were the most prevalent in IPD cases up to 2015 with a decreasing trend from 50% (20/40) in 2012 to 19% (14/74) in 2018 (chi2 test for trend of odds = 0.000). PCV23nonPCV13 vaccine serotypes had an increasing trend and rose from 18% (7/40) to 34% (25/74) (chi2 test for trend of odds = 0.000). Non-Vaccine serotypes had an increasing trend and rose from 13% (5/40) to 27% (20/74) (chi2 test for trend of odds = 0.038). Reported total case fatality was 19% (87/466). The highest, at 36% (20/56), was reported in 2013. After adjusting for age, Streptococcus pneumoniae serotype 3 was associated with death from IPD (adjusted OR 2.3 95%CI 1.25–4.12 p 0.007). Surveillance data indicate evidence of serotype replacement with an increasing trend of serotype 19A and PPV23nonPCV13 and Non-Vaccine serotypes. Serotype 3 and age were associated with fatal IPD outcome. Further studies of S. pneumoniae carriage would be useful in providing more evidence to characterize serotypes' circulation.

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Invasive pneumococcal disease in Latvia seven years after PCV10 introduction

European Journal of Public Health ◽

10.1093/eurpub/ckz187.078 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

L Savrasova ◽

I Zeltina ◽

A Villerusha ◽

S Balasegaram

Keyword(s):

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Case Fatality ◽

Annual Incidence ◽

Surveillance Data ◽

Serotype Distribution ◽

Vaccine Serotypes ◽

Serotype Replacement ◽

Increasing Trend ◽

And Control

Abstract Background In 2009 in Latvia, invasive pneumococcal disease (IPD) became notifiable for physicians and in 2010 vaccination of infants with PCV7 commenced. In 2012 PCV10 vaccination was introduced. The objectives of our study were to evaluate trend of incidence and trend serotype distribution of IPD in Latvia and to investigate factors associated with death from IPD. Methods Laboratory confirmed IPD cases are passively notified to the Centre for Disease Prevention and Control of Latvia by laboratories and clinicians. We calculated incidence by age, sex, case fatality and trend in serotypes. Results From 2012 to 2018, 466 cases of IPD were reported, mean annual incidence 3.4/100,000. The notified incidence remained stable from 2012-2014 (2.7), peaked in 2015 (4.4) and fell to 3.9 in 2018. The highest mean annual IPD incidence was in infants (4.8) and in elderly (6). The highest mean annual incidence was reported in males (4.5) in comparison to females (2.4) (IR-1.8 95%CI 1.6-2.4). Case fatality was 19% (87/466) and 23% (37/162) in cases aged > =65 years. 90% (421/466) of isolates were serotyped. The proportion of PCV10 vaccine serotypes fell from 50% (20/40) in 2012 to 19% (14/74) in 2018 (chi2 test for trend =0.000). Since year 2017, PPV23nonPCV13 and Non-vaccine serotypes become more common. We detected PCV13 serotype (RR 2.04 95%CI 1.37-3.02), S.pneumoniae serotype 3 (RR 1. 91 95% CI 1.25-2.93) significantly associated with IPD death. Conclusions Surveillance data indicate evidence of serotype replacement. Surveillance evaluation should asses the representativeness of notification. Furthermore S. pneumoniae carriage study may be useful to characterise serotype circulation. Serotype 3 and age demonstrate independent and significant association with fatal IPD outcome. Key messages IPD surveillance data analysis indicated evidence of serotype replacement with PPV23nonPCV13, NonVaccine serotypes. Serotype 19A becomes more common with significant increasing trend. Serotype 3 and age independently and significantly associated with fatal IPD outcome. S.pneumoniae carriage study would be very useful providing more evidence of characterizing serotypes circulation.

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Eradication of Invasive Pneumococcal Disease due to the Seven-valent Pneumococcal Conjugate Vaccine Serotypes in Calgary, Alberta

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0b013e3182624a40 ◽

2012 ◽

Vol 31 (9) ◽

pp. e169-e175 ◽

Cited By ~ 25

Author(s):

Jenine Leal ◽

Otto G. Vanderkooi ◽

Deirdre L. Church ◽

Judy MacDonald ◽

Gregory J. Tyrrell ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Vaccine Serotypes

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Evolution of pneumococcal serotype epidemiology in Botswana following introduction of 13-valent pneumococcal conjugate vaccine

PLoS ONE ◽

10.1371/journal.pone.0262225 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262225

Author(s):

Sweta M. Patel ◽

Yazdani B. Shaik-Dasthagirisaheb ◽

Morgan Congdon ◽

Rebecca R. Young ◽

Mohamed Z. Patel ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Conjugate Vaccines ◽

Vaccine Serotypes ◽

Vaccine Introduction ◽

Molecular Serotyping ◽

Sustained Effect ◽

Pneumococcal Serotype

Pneumococcal conjugate vaccines reduce the burden of invasive pneumococcal disease, but the sustained effect of these vaccines can be diminished by an increase in disease caused by non-vaccine serotypes. To describe pneumococcal serotype epidemiology in Botswana following introduction of 13-valent pneumococcal conjugate vaccine (PCV-13) in July 2012, we performed molecular serotyping of 268 pneumococcal strains isolated from 221 children between 2012 and 2017. The median (interquartile range) age of the children included in this analysis was 6 (3,12) months. Fifty-nine percent of the children had received at least one dose of PCV-13 and 35% were fully vaccinated with PCV-13. While colonization by vaccine serotypes steadily declined following PCV-13 introduction, 25% of strains isolated more than 3 years after vaccine introduction were PCV-13 serotypes. We also observed an increase in colonization by non-vaccine serotypes 21 and 23B, which have been associated with invasive pneumococcal disease and antibiotic resistance in other settings.

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Characteristics of Invasive Pneumococcal Disease Caused by Emerging Serotypes After the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in England: A Prospective Observational Cohort Study, 2014–2018

Clinical Infectious Diseases ◽

10.1093/cid/ciaa043 ◽

2020 ◽

Vol 71 (8) ◽

pp. e235-e243 ◽

Cited By ~ 3

Author(s):

Zahin Amin-Chowdhury ◽

Sarah Collins ◽

Carmen Sheppard ◽

David Litt ◽

Norman K Fry ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Clinical Characteristics ◽

Pneumococcal Disease ◽

Case Fatality ◽

Observational Cohort Study ◽

Prospective Observational Cohort Study ◽

Common Presentation ◽

Observational Cohort

Abstract Background England is experiencing a rapid increase in invasive pneumococcal disease (IPD) caused by serotypes 8, 12F, and 9N; their clinical characteristics and outcomes have not been described. Methods Public Health England conducts national IPD surveillance. Cases due to emerging serotypes were compared with those included in the 13-valent pneumococcal conjugate vaccine (PCV13) and the remaining non-PCV13 serotypes. Results There were 21 592 IPD cases during 2014–15 to 2017–18, including 20 108 (93.1%) with serotyped isolates and 17 450 (86.8%) with completed questionnaires. PCV13 serotypes were responsible for 20.1% (n = 4033), while serotype 8 (3881/20 108 [19.3%]), 12F (2365/20 108 [11.8%]), and 9N (1 296/20 108 [6.4%]) were together responsible for 37.5% of cases. Invasive pneumonia was the most common presentation (11 424/16 346 [69.9%]) and, overall, 67.0% (n = 11 033) had an underlying comorbidity. The median age (interquartile range) at IPD due to serotypes 8 (59 [45–72] years) and 12F (56 [41–70] years) was lower than serotype 9N (67 [53–80] years), PCV13 serotypes (68 [52–81] years), and remaining non-PCV13 serotypes (70 [53–82] years). Serotype 9N IPD cases also had higher comorbidity prevalence (748/1087 [68.8%]) compared to serotype 8 (1901/3228 [58.9%]) or 12F (1042/1994 [52.3%]), and higher case fatality (212/1128 [18.8%]) compared to 8.6% (291/3365) or 10.0% (209/2086), respectively. Conclusions Serotypes 8 and 12F were more likely to cause IPD in younger, healthier individuals and less likely to be fatal, while serotype 9N affected older adults with comorbidities and had higher case fatality.

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Impact of the 13-Valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease After Introduction Into Routine Pediatric Use

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piaa035 ◽

2020 ◽

Author(s):

Roger Baxter ◽

Laurie Aukes ◽

Stephen I Pelton ◽

Arnold Yee ◽

Nicola P Klein ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Surveillance Data ◽

Age Group ◽

Northern California ◽

Surveillance Period ◽

Kaiser Permanente ◽

Before And After

Abstract Background In 2010, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced 7-valent PCV (PCV7) for protection against invasive pneumococcal disease (IPD). This study used laboratory surveillance data to examine the effect of PCV13 on IPD before and after PCV13 introduction among children aged 6 weeks to <6 years and those aged ≥6 weeks. Methods Observational laboratory-based IPD surveillance data were compared for the periods May 2010–April 2018 and May 2008–April 2010 (the PCV7 period) using a database of Kaiser Permanente Northern California (KPNC) members with laboratory-confirmed IPD. Results Among children aged 6 weeks to 6 years, overall IPD incidence decreased from 11.57 per 100 000 during the PCV7 period to 4.09 per 100 000 after PCV13 introduction; PCV13-type IPD incidence decreased from 5.12 to 0.84 per 100 000. Non-PCV13−serotype IPD did not change significantly in this age group (PCV7 period, 1.71 per 100 000 and after PCV13, 2.52 per 100 000). Of cases occurring in this group, bacteremia was the most common clinical diagnosis. Across all ages, IPD decreased from 9.49 to 6.23 per 100 000 and PCV13-type IPD decreased from 4.67 to 1.89 per 100 000, changes being mostly due to decreases in serotypes 19A and 7F. IPD caused by non-PCV13 serotypes did not change (3.34 and 3.35 per 100 000). Overall, pneumococci isolated after PCV13 introduction had increased susceptibility to penicillin, cefotaxime, and ceftriaxone. This prospective, laboratory-based surveillance study in Kaiser Permanente Northern California members examined annual IPD incidence before and after PCV13 introduction. In children aged 6 weeks to <6 years, IPD caused by PCV13 serotypes decreased significantly (84%) during the surveillance period. Conclusions IPD incidence decreased further in every age group after PCV13 introduction, suggesting both direct vaccination effects in the infant population and indirect effects in adults. Clinical Trials Registration NCT01128439.

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Changing incidence of invasive pneumococcal disease in infants less than 90 days of age before and after introduction of the 13-valent Pneumococcal Conjugate Vaccine in Blantyre, Malawi: a 14-year hospital based surveillance study

10.1101/2021.08.18.21262215 ◽

2021 ◽

Author(s):

Marianne Koenraads ◽

Todd D. Swarthout ◽

Naor Bar-Zeev ◽

Comfort Brown ◽

Jacquline Msefula ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Low Income ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

High Morbidity ◽

Vaccine Serotypes ◽

Young Infants ◽

Before And After ◽

The Impact

AbstractBackgroundInvasive pneumococcal disease (IPD) in young infants is uncommon but associated with high morbidity and mortality. Accurate data on the burden of IPD in young infants in low-income countries are lacking. We examined the burden of IPD in infants aged <90 days in Blantyre, Malawi over a 14 year period and evaluated the impact of the 12 November 2011 introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) on vaccine-serotype IPD (VT-IPD) in this population.MethodsWe conducted laboratory-based prospective IPD surveillance in infants aged <90 days admitted to Queen Elizabeth Central Hospital (QECH) in Blantyre between 2005 and 2018, including 7 years pre- and 7 years post-PCV13 introduction. IPD was defined as Streptococcus pneumoniae identified by culture from blood or cerebrospinal fluid. Serotypes were determined by multiplex PCR and latex agglutination testing.ResultsWe identified 130 cases of culture-confirmed IPD in infants <90 days old between 2005-2018. Total IPD incidence was declining prior to PCV13 introduction. The mean incidence of IPD was significantly lower in the post-PCV era. Serotypes 5 (27.8%) and 1(15.6%), were most prevalent. Even after PCV13 introduction, VT-IPD remained dominant with serotype 5 accounting for 17.4% and serotype 1 for 13% of cases in young infants.ConclusionVaccine serotypes were the main cause of IPD in neonates and young infants, both before and after PCV13 introduction. Further strategies need to be considered to protect this vulnerable population, including maternal or neonatal immunization and implementation of an alternative PCV schedule with a booster dose.SummaryThe incidence of invasive pneumococcal disease in infants in Blantyre, Malawi has declined over the past decade and more significantly after introduction of the pneumococcal conjugate vaccine. Vaccine serotypes have remained the main cause of disease in this population.

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Association of Pneumococcal Conjugate Vaccine Coverage With Pneumococcal Meningitis: An Analysis of French Administrative Areas, 2001–2016

American Journal of Epidemiology ◽

10.1093/aje/kwz071 ◽

2019 ◽

Vol 188 (8) ◽

pp. 1466-1474

Author(s):

Anna Alari ◽

Félix Cheysson ◽

Lénaig Le Fouler ◽

Philippe Lanotte ◽

Emmanuelle Varon ◽

...

Keyword(s):

Conjugate Vaccine ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Conjugate Vaccine ◽

Pneumococcal Disease ◽

Pneumococcal Meningitis ◽

Vaccine Coverage ◽

Mixed Effect ◽

Cumulative Impact ◽

Vaccine Serotypes ◽

Vaccine Impact

Abstract Geographic variations of invasive pneumococcal disease incidence and serotype distributions were observed after pneumococcal conjugate vaccine introduction at regional levels and among French administrative areas. The variations could be related to regional vaccine coverage (VC) variations that might have direct consequences for vaccination-policy impact on invasive pneumococcal disease, particularly pneumococcal meningitis (PM) incidence. We assessed vaccine impact from 2001 to 2016 in France by estimating the contribution of regional VC differences to variations of annual local PM incidence. Using a mixed-effect Poisson model, we showed that, despite some variations of VC among administrative areas, vaccine impact on vaccine-serotype PM was homogeneously confirmed among administrative areas. Compared with the prevaccine era, the cumulative VC impact on vaccine serotypes led, in 2016, to PM reductions ranging among regions from 87% (25th percentile) to 91% (75th percentile) for 7-valent pneumococcal conjugate vaccine serotypes and from 58% to 63% for the 6 additional 13-valent pneumococcal conjugate vaccine serotypes. Nonvaccine-serotype PM increases from the prevaccine era ranged among areas from 98% to 127%. By taking into account the cumulative impact of growing VC and VC differences, our analyses confirmed high vaccine impact on vaccine-serotype PM case rates and suggest that VC variations cannot explain PM administrative area differences.

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