Early impact of sequential introduction of 7-valent and 13-valent pneumococcal conjugate vaccine on IPD in Israeli children <5 years: An active prospective nationwide surveillance |
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| Affiliation: | 1. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Ben-Gurion University, Beer-Sheva, Israel;2. Shaare Zedek Medical Center, Jerusalem, Israel;3. Wolfson Medical Center, Holon, Israel;4. The Barzilai Medical Center, Ashkelon, Israel;5. The Pediatric Infectious Disease Service, HaEmek Medical Center, Afula, Israel;1. Sheba Med Ctr, Ramat-Gan, Israel;2. Tel-Aviv University, Tel-Aviv, Israel;3. Meir Med Ctr, Kfar Saba, Israel;4. Haddassah Med Ctr, Jerusalem, Israel;5. Tel-Aviv Med Ctr, Tel-Aviv, Israel;6. Rivka Ziv Med Ctr, Sefed, Israel;7. Wolfson Med Ctr, Holon, Israel;8. Emek Med Ctr, Afula, Israel;9. Maayanei Hayeshua Hosp, Bnei-Brak, Israel;10. Ben-Gurion University, Beer-Sheva, Israel;1. Department of Social and Preventive Medicine, Laval University, Quebec City, Canada;2. Quebec National Public Health Institute (Institut national de Santé publique du Québec), Quebec City, Canada;3. Quebec University Hospital Research Centre, Quebec City, Canada;4. Quebec Public Health Laboratory (Laboratoire de santé publique du Québec), Quebec National Public Health Institute (Institut national de Santé publique du Québec), Montreal, Canada;5. Quebec Ministry of Health and Social Services (Ministère de la Santé et des Services sociaux du Québec), Montreal, Canada;1. Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region, China;2. Centre for Paediatric Pharmacy Research Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom;3. Department of Primary Care & Health Services, Brighton and Sussex Medical School, Brighton, United Kingdom;4. School of Public Health Imperial College London and Chartfield Surgery, London, United Kingdom;5. Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, United Kingdom;6. Institute of Pharmaceutical Science & Department of Chemistry, King''s College London, London, United Kingdom;7. Paediatric Infectious Disease Research Group, St George''s University of London, London, United Kingdom;1. Sheba Med Ctr., Ramat Gan, Israel;2. Tel-Aviv Med Ctr., Tel Aviv, Israel;3. Rabin Med Ctr., Petah Tikva, Israel;4. Rambam Med Ctr., Haifa, Israel;5. Meir Med Ctr., Kfar Saba, Israel;6. Barzilai Med Ctr., Ashkelon, Israel;7. Hillel Yaffe Med Ctr., Hadera, Israel;8. Assaf Harofe Med Ctr., Tsrifin, Israel;9. Rivka Ziv Med Ctr., Safed, Israel;10. Haddassah Med Ctr., Jerusalem, Israel;11. Soroka University Med Ctr., affiliated to the Ben-Gurion University of the Negev., Beersheba, Israel;1. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel;2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;3. Pediatric Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem, Israel;4. Pediatric Infectious Diseases Service, Emek Medical Center, Afula, Israel;5. Department of Pediatrics, The Barzilai University Medical Center, Ashkelon, Israel |
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| Abstract: | BackgroundThe 7-valent pneumococcal conjugated vaccine (PCV7) was introduced to the Israeli national immunization plan (NIP) in July 2009 (administered at age 2, 4 and 12 months), with a fast reduction of invasive pneumococcal disease (IPD) caused by PCV7 serotypes. Starting in November 2010, PCV13 gradually replaced PCV7.AimTo report the impact of PCV7/PCV13 sequential introduction on IPD in Israeli children <5 years.MethodsAn ongoing nationwide, prospective, population-based, active surveillance. All IPD episodes (Streptococcus pneumoniae isolated from blood and/or cerebrospinal fluid) from July 2004 through June 2013 were included.ResultsOverall, 2670 IPD episodes were recorded. Incidence of IPD caused by PCV7 + 6A serotypes during the PCV13 period vs. pre-PCV period decreased by 95% (Incidence Rate Ratio [IRR] = 0.05; 95% CI = 0.03–0.09). This reduction was observed in a two-step manner: 90% in the PCV7-period and further 5% in the PCV13-period. The rates of IPD caused by the 5 additional PCV13-serotypes (1, 3, 5, 7F, 19A; 5VT) increased initially by 47%, but subsequently decreased by 79%, resulting in an overall 70% reduction during the entire study period (IRR = 0.30; 0.21–0.44). A two-fold increase in non-PCV13 serotypes IPD was observed (IRR = 2.43; 1.73–3.66). In total, a 63% reduction of all-serotype IPD episodes was observed in children <5 years (69% and 48% in children <2 and 2–4 years old, respectively).ConclusionsAfter initiation of PCV NIP, a rapid and substantial 2-step IPD reduction was observed in children <5 years. The serotype-specific rate reduction reflected the sequential introduction of PCV7/PCV13. |
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| Keywords: | Invasive pneumococcal disease (IPD) Children Surveillance Pneumococcal conjugate vaccine (PCV) |
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