Pneumococcal conjugate vaccine herd effects on non-invasive pneumococcal pneumonia in elderly |
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| Affiliation: | 1. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands;2. Pfizer Inc. (Former Employee), 500 Arcola Rd, Collegeville, PA 19426, USA;3. Department of Respiratory Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands;4. Pfizer Vaccine Clinical Research, Vanwall Rd, Maidenhead SL6 4UB, UK;5. Pfizer Vaccine Clinical Research, 500 Arcola Rd, Collegeville, PA 19426, USA;6. Department of Paediatric Immunology and Infectious Diseases, University Medical Center Utrecht Wilhelmina Children''s Hospital, Lundlaan 6, 3584 EA Utrecht, The Netherlands;7. Department of Medical Microbiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands;1. Sage Analytica, Bethesda, MD, USA;2. Department of Global Health, School of Public Health and Health Services, George Washington University, Washington DC, USA;3. Rollins School of Public Health, Atlanta, GA, USA;1. Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands;2. Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands;3. Department of Immunology and Infectious diseases, University Medical Center Utrecht, Wilhelmina Children''s Hospital, Utrecht, The Netherlands;4. Department of Medical Microbiology and the Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Center, Amsterdam, The Netherlands;1. University of Montreal Public Health Research Institute – IRSPUM, Canada;2. School of Public Health, Montreal, Québec, Canada;3. Institute of Public Health, Medical Faculty, Heidelberg University, Germany;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. Pfizer Vaccine Clinical Research, 500 Arcola Rd, Collegeville, PA, USA;2. Pfizer Vaccine Clinical Research, Maidenhead, UK;3. inVentiv Health Clinical, LLC, Austin, TX, USA;4. Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands;5. Pfizer Vaccine Clinical Research, 401 N Middletown Rd, Pearl River, NY, USA;1. National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States;2. Department of Medicine and Center for Community Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States |
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| Abstract: | BackgroundHerd protection from infant pneumococcal conjugate vaccination is well established for invasive pneumococcal disease (IPD) but not for non-IPD pneumococcal community-acquired pneumonia (PCAP). We assessed the contribution of vaccine-serotypes in non-IPD PCAP in adults 65 years and older in the period 2008–2013.MethodsThis is a post hoc analysis of two prospective studies from the Netherlands. Serotype specific urinary antigen detection and routine microbiological testing were used to categorize episodes as IPD or non-IPD PCAP caused by 7-valent pneumococcal conjugate vaccine (PCV7), PCV10-7 (three additional PCV10 serotypes), PCV13-10 (three additional PCV13 serotypes), and non-PCV13 serotypes. Proportions per vaccine-serotype group were assessed per year from June 1st to May 31st. Time trends were compared to national IPD data.ResultsOf 270 non-IPD PCAP episodes with known serotype, PCV7 serotypes decreased from 28% in 2008/2009 to 7% in 2012/2013 (p-value for trend <0.001). No change in PCV10-7 (19% overall) and PCV13-10 (29% overall) serotypes was observed. Non-PCV13 serotypes increased from 30% in 2008/2009 to 37% in 2012/2013 (p-value for trend 0.048). Trends corresponded with national IPD data.ConclusionPCV7 serotypes declined in non-IPD PCAP among elderly between 2008 and 2013, comparable to IPD data. No reduction in the additional PCV10 serotypes could be demonstrated within the first two years after PCV10 introduction. |
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| Keywords: | Pneumococcal conjugate vaccine Herd protection Invasive pneumococcal disease Pneumococcal pneumonia |
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