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Distribution of serotypes causing invasive pneumococcal disease in older adults from high-income countries and impact of pediatric and adult vaccination policies
Affiliation:1. Pfizer Inc, Collegeville, PA, USA;2. School of Medicine & Dentistry, Griffith University, Gold Coast Campus, Queensland, Australia;3. Pfizer Pharma GmbH, Berlin, Germany;4. Pfizer Canada ULC, Montreal, Canada
Abstract:
BackgroundNeither indirect protection through use of 13-valent and 10-valent pneumococcal conjugate vaccines (PCV13 and PCV10) in pediatric National Immunization Programs (NIPs) nor direct vaccination with the 23-valent polysaccharide vaccine have eliminated vaccine serotype invasive pneumococcal disease (IPD) in older adults. Vaccinating older adults with higher-valency PCV15 and PCV20 could address remaining IPD due to pediatric PCV serotypes plus additional IPD due to serotypes included in these vaccines.MethodsWe collected serotype-specific IPD data in older adults (≥65 years in most countries), from national or regional surveillance systems or hospital networks of 33 high-income countries. Data were from official government websites, online databases, surveillance system reports, published literature, and personal communication with in-country investigators. Average percentages of IPD serotypes were calculated.ResultsAmong 52,905 cases of IPD with a serotype identified, PCV13 serotypes accounted for 33.7% of IPD (55.8% and 30.6% for countries with PCV10 and PCV13 in the pediatric NIP), most commonly serotypes 3 (14.9%) and 19A (7.0%). PCV15 and PCV20 would cover an additional 10.4% and 32.9% of older adult IPD beyond PCV13 serotypes (PCV10 countries: 7.7% and 23.3%; PCV13 countries: 10.6% and 34.6%). The most common of these additional serotypes were 8 (9.9%), 22F (7.9%), 12F (4.6%), and 11A (3.3%). PPSV23 policies for older adults were not correlated with lower IPD percentages due to PPSV23 serotypes.ConclusionsVaccinating older adults with higher-valency PCVs, especially PCV20, could substantially reduce the remaining IPD burden in high-income countries, regardless of current PCV use in pediatric NIPs and adult PPSV23 policies.
Keywords:Adults  Invasive pneumococcal disease  Pneumococcal conjugate vaccines  Serotype distribution  AMRO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0035"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Regional Office for the Americas  EMRO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0045"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Regional Office for the Eastern Mediterranean  EURO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0055"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Regional Office for Europe  FDA"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0065"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  US Food and Drug Administration  IPD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0075"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  invasive pneumococcal disease  NT"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0085"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  non-typeable  PCV"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0095"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  pneumococcal conjugate vaccine  PCV7"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0105"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  7-valent pneumococcal serotype  PCV10"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0115"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  10-valent pneumococcal serotype  PCV13"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0125"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  13-valent pneumococcal serotype  PCV15"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0135"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  15-valent pneumococcal serotype  PCV20"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0145"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  20-valent pneumococcal serotype  PPSV23"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0155"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  23-valent pneumococcal polysaccharide vaccine  WHO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0165"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  World Health Organization  WPRO"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  k0175"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Regional Office for the Western Pacific
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