Effect of Pneumococcal Conjugate Vaccination on Serotype-Specific Carriage and Invasive Disease in England: A Cross-Sectional Study
Background:
We investigated the effect of the 7-valent pneumococcal conjugate vaccine
(PCV7) programme in England on serotype-specific carriage and invasive
disease to help understand its role in serotype replacement and predict the
impact of higher valency vaccines.
Methods and Findings:
Nasopharyngeal swabs were taken from children <5 y old and family members
(n = 400) 2 y after introduction
of PCV7 into routine immunization programs. Proportions carrying
Streptococcus pneumoniae and serotype distribution
among carried isolates were compared with a similar population prior to PCV7
introduction. Serotype-specific case∶carrier ratios (CCRs) were
estimated using national data on invasive disease. In vaccinated children
and their contacts vaccine-type (VT) carriage decreased, but was offset by
an increase in non-VT carriage, with no significant overall change in
carriage prevalence, odds ratio 1.06 (95% confidence interval
0.76–1.49). The lower CCRs of the replacing serotypes resulted in a
net reduction in invasive disease in children. The additional serotypes
covered by higher valency vaccines had low carriage but high disease
prevalence. Serotype 11C emerged as predominant in carriage but caused no
invasive disease whereas 8, 12F, and 22F emerged in disease but had very low
carriage prevalence.
Conclusion:
Because the additional serotypes included in PCV10/13 have high CCRs but low
carriage prevalence, vaccinating against them is likely to significantly
reduce invasive disease with less risk of serotype replacement. However, a
few serotypes with high CCRs could mitigate the benefits of higher valency
vaccines. Assessment of the effect of PCV on carriage as well as invasive
disease should be part of enhanced surveillance activities for PCVs.
:
Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Effect of Pneumococcal Conjugate Vaccination on Serotype-Specific Carriage and Invasive Disease in England: A Cross-Sectional Study. PLoS Med 8(4): e32767. doi:10.1371/journal.pmed.1001017
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1001017
Souhrn
Background:
We investigated the effect of the 7-valent pneumococcal conjugate vaccine
(PCV7) programme in England on serotype-specific carriage and invasive
disease to help understand its role in serotype replacement and predict the
impact of higher valency vaccines.
Methods and Findings:
Nasopharyngeal swabs were taken from children <5 y old and family members
(n = 400) 2 y after introduction
of PCV7 into routine immunization programs. Proportions carrying
Streptococcus pneumoniae and serotype distribution
among carried isolates were compared with a similar population prior to PCV7
introduction. Serotype-specific case∶carrier ratios (CCRs) were
estimated using national data on invasive disease. In vaccinated children
and their contacts vaccine-type (VT) carriage decreased, but was offset by
an increase in non-VT carriage, with no significant overall change in
carriage prevalence, odds ratio 1.06 (95% confidence interval
0.76–1.49). The lower CCRs of the replacing serotypes resulted in a
net reduction in invasive disease in children. The additional serotypes
covered by higher valency vaccines had low carriage but high disease
prevalence. Serotype 11C emerged as predominant in carriage but caused no
invasive disease whereas 8, 12F, and 22F emerged in disease but had very low
carriage prevalence.
Conclusion:
Because the additional serotypes included in PCV10/13 have high CCRs but low
carriage prevalence, vaccinating against them is likely to significantly
reduce invasive disease with less risk of serotype replacement. However, a
few serotypes with high CCRs could mitigate the benefits of higher valency
vaccines. Assessment of the effect of PCV on carriage as well as invasive
disease should be part of enhanced surveillance activities for PCVs.
:
Please see later in the article for the Editors' Summary
Zdroje
1. BrueggemannABGriffithsDTMeatsEPetoTCrookDW
2003
Clonal relationships between invasive and carriage Streptococcus
pneumoniae and serotype- and clone-specific differences in invasive disease
potential.
J Infect Dis
187
1424
1432
2. WeinbergerDMTrzcinskiKLuY-JBogaertDBrandesA
2009
Pneumococcal capsular polysaccharide structure predicts serotype
prevalence.
PLoS Pathog
5
e1000476
doi:10.1371/journal.ppat.1000476
3. CalixJJNahmMH
2010
A new pneumococcal serotype, 11E, has a variably inactivated wcjE
gene.
J Infect Dis
202
29
38
4. BlackSShinefieldHFiremanBLewisERayP
2000
Efficacy, safety and immunogenicity of heptavalent pneumococcal
conjugate vaccine in children. Northern California Kaiser Permanente Vaccine
Study Center Group.
Pediatr Infect Dis J
19
187
195
5. DaganRMelamedRMuallemMPiglanskyLGreenbergD
1996
Reduction of nasopharyngeal carriage of pneumococci during the
second year of life by a heptavalent conjugate pneumococcal
vaccine.
J Infect Dis
174
1271
1278
6. DaganRGivon-LaviNZamirOSikuler-CohenMGuyL
2002
Reduction of nasopharyngeal carriage of Streptococcus pneumoniae
after administration of a 9-valent pneumococcal conjugate vaccine to
toddlers attending day care centers.
J Infect Dis
185
927
936
7. BeutelsPThiryNDammePV
2007
Convincing or confusing? Economic evaluations of childhood
pneumococcal conjugate vaccination–a review
(2002–2006).
Vaccine
25
1355
1367
8. MelegaroAChoiYHGeorgeREdmundsWJMillerE
2010
Dynamic models of pneumococcal carriage and the impact of the
Heptavalent Pneumococcal Conjugate Vaccine on invasive pneumococcal
disease.
BMC Infect Dis
10
90
9. PilishviliTLexauCFarleyMMHadlerJHarrisonLH
2010
Sustained reductions in invasive pneumococcal disease in the era
of conjugate vaccine.
J Infect Dis
201
32
41
10. WalsPDRobinEFortinEThibeaultROuakkiM
2008
Pneumonia after implementation of the pneumococcal conjugate
vaccine program in the province of Quebec, Canada.
Pediatr Infect Dis J
27
963
968
11. RodenburgGDGreeffSC deJansenAGCSMelkerHE deSchoulsLM
2010
Effects of pneumococcal conjugate vaccine 2 years after its
introduction, the Netherlands.
Emerg Infect Dis
16
816
823
12. WHO
2010
Changing epidemiology of pneumococcal serotypes after
introduction of conjugate vaccine: July 2010 report.
Weekly Epidemiological Record
85
434
436
13. HuangSSHinrichsenVLStevensonAERifas-ShimanSLKleinmanK
2009
Continued impact of pneumococcal conjugate vaccine on carriage in
young children.
Pediatrics
124
e1
11
14. VestrheimDFHøibyEAAabergeISCaugantDA
2010
Impact of a pneumococcal conjugate vaccination program on
carriage among children in Norway.
Clin Vaccine Immunol
17
325
334
15. PeltonSIHuotHFinkelsteinJABishopCJHsuKK
2007
Emergence of 19A as virulent and multidrug resistant Pneumococcus
in Massachusetts following universal immunization of infants with
pneumococcal conjugate vaccine.
Pediatr Infect Dis J
26
468
472
16. YildirimIHanageWPLipsitchMSheaKMStevensonA
2010
Serotype specific invasive capacity and persistent reduction in
invasive pneumococcal disease.
Vaccine
29
283
288
17. HussainMMelegaroAPebodyRGGeorgeREdmundsWJ
2005
A longitudinal household study of Streptococcus pneumoniae
nasopharyngeal carriage in a UK setting.
Epidemiol Infect
133
891
898
18. LundEHendrichsenJ
1978
Laboratory diagnosis, serology and epidemiology of Streptococcus
pneumoniae. Methods in microbiology
London
Academic Press
241
262
19. TrotterCLWaightPAndrewsNJSlackMEfstratiouA
2009
Epidemiology of invasive pneumococcal disease in the
pre-conjugate vaccine era: England and Wales,
1996–2006.
J Infect
60
200
208
20. SleemanKLGriffithsDShackleyFDiggleLGuptaS
2006
Capsular serotype-specific attack rates and duration of carriage
of Streptococcus pneumoniae in a population of children.
J Infect Dis
194
682
688
21. SimpsonEH
1949
Measurement of diversity.
Nature
163
688
22. HanageWPFinkelsteinJAHuangSSPeltonSIStevensonAE
2010
Evidence that pneumococcal serotype replacement in Massachusetts
following conjugate vaccination is now complete.
Epidemics
2
80
84
23. GilsEJM vanVeenhovenRHHakERodenburgGDBogaertD
2009
Effect of reduced-dose schedules with 7-valent pneumococcal
conjugate vaccine on nasopharyngeal pneumococcal carriage in children: a
randomized controlled trial.
JAMA
302
159
67
24. MillerEAndrewsNJWaightPASlackMPEGeorgeRC
2011
Herd immunity and serotype replacement four years after
pneumococcal conjugate vaccination in England and Wales: An observational
cohort study.
Lancet Infect Dis
In press
25. HPA
2010
Pneumococcal disease.
Available: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/Pneumococcal/.
Accessed 29 July 2010
26. SalisburyD
2010
Introduction of Prevenar 13 ® into the Childhood Immunisation
Programme.
Available: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_112192.pdf.
Accessed 4 June 2010
27. TurnerPHindsJTurnerCJankhotAGouldK
2011
Improved detection of nasopharyngeal co-colonization by multiple
pneumococcal serotypes using latex agglutination or molecular serotyping by
microarray.
J Clin Microbiol
doi:10.1128/JCM.00157-11
28. AbdullahiONyiroJLewaPSlackMScottJAG
2008
The descriptive epidemiology of Streptococcus pneumoniae and
Haemophilus influenzae nasopharyngeal carriage in children and adults in
Kilifi district, Kenya.
Pediatr Infect Dis J
27
59
64
29. HillPCTownendJAntonioMAkisanyaBEbrukeC
2010
Transmission of Streptococcus pneumoniae in rural Gambian
villages: a longitudinal study.
Clin Infect Dis
50
1468
1476
30. BruggerSDFreyPAebiSHindsJMuehlemannK
2010
Multiple colonization with S. pneumoniae before and after
introduction of the seven-valent conjugated pneumococcal polysaccharide
vaccine.
PLoS One
5
e11638
doi:10.1371/journal.pone.0011638
31. HarboeZBBenfieldTLValentiner-BranthPHjulerTLambertsenL
2010
Temporal trends in invasive pneumococcal disease and pneumococcal
serotypes over 7 decades.
Clin Infect Dis
50
329
337
32. GrayBMConverseGMDillonHC
1980
Epidemiologic studies of Streptococcus pneumoniae in infants:
acquisition, carriage, and infection during the first 24 months of
life.
J Infect Dis
142
923
933
33. WeinbergerDMHarboeZBSandersEAMNdirituMKlugmanKP
2010
Association of serotype with risk of death due to pneumococcal
pneumonia: a meta-analysis.
Clin Infect Dis
51
692
699
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