Invasive pneumococcal disease in children under 16 years of age: Incomplete rebound in incidence after the maximum effect of PCV13 in 2012/13 in Germany |
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| Institution: | 1. Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University Munich, Munich, Germany;2. National Reference Centre for Streptococci, Institute of Medical Microbiology, University Hospital RWTH Aachen, Germany;3. Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany;4. Charité – University Medicine Berlin, Berlin, Germany;1. The Louis Stokes VA Medical Center, Cleveland, OH, USA;2. Department of Medicine, University Hospitals Medical Center, and the Center for AIDS Research, Case Western Reserve University, Cleveland, OH, USA;3. Department of Medicine, MetroHealth Medical Center, Case Western Reserve, Cleveland, OH, USA;4. Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA;5. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, USA;6. Harvard T.H. Chan School of Public Health, Boston, MA, USA;1. Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555-0436, United States;2. Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, TX 77555-0436, United States;3. Department of Pediatrics, University of Texas Medical Branch, Galveston, TX 77555-0436, United States;4. Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555-0436, United States;1. Beijing Center for Disease Prevention and Control, Beijing, China;2. Beijing Research Center for Preventive Medicine, Beijing, China;3. School of Public Health, Capital Medical University, Beijing, China;4. Dongcheng District Center for Disease Prevention and Control, Beijing, China;5. Tongzhou District Center for Disease Prevention and Control, Beijing, China;6. Xicheng District Center for Disease Prevention and Control, Beijing, China;7. Haidian District Center for Disease Prevention and Control, Beijing, China;8. Huairou District Center for Disease Prevention and Control, Beijing, China;9. Changping District Center for Disease Prevention and Control, Beijing, China;1. Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, H-1089 Budapest, Hungary;2. Institute of Laboratory Medicine, Semmelweis University, Üllői út 78/a, H-1082 Budapest, Hungary;3. German National Reference Center for Streptococci, Department of Medical Microbiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany;4. National Public Health Institute, Albert Flórián út 2-6, H-1097 Budapest, Hungary;1. Real-time Syndromic Surveillance Team, National Infection Service, Public Health England, 1st Floor, 5 St Philips Place, Birmingham B3 2PW, United Kingdom;2. The Phoenix Partnership (TPP), TPP House, 129 Low Lane, Horsforth, Leeds LS18 5PX, United Kingdom;3. Public Health England West Midlands, 6th Floor, 5 St Philips Place, Birmingham B3 2PW, United Kingdom;4. Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, United Kingdom;5. Royal College of General Practitioners Research and Surveillance Centre, University of Surrey, Section of Clinical Medicine and Ageing, Guildford, Surrey GU2 7XH, United Kingdom |
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| Abstract: | ObjectiveTo identify a potential nadir of the impact of pneumococcal conjugate vaccination (PCV) in infancy on invasive pneumococcal diseases (IPD) in children under 16 in Germany.MethodsActive surveillance on IPD based on two independent data sources with capture-recapture correction for underreporting. Annual incidence rates by age group, serotypes, site of infection, and relative incidence reduction compared to pre-vaccination period (1997–2001) at nadir and for the most recent season are reported. We calculated vaccine coverage at the age of 24 months using health insurance claims data.Results96–97% of children had received at least two doses of PCV since 2009. The maximum impact on overall IPD incidence was achieved in 2012/13 (−48% 95% CI: −55%; −39%]) with a rebound to −26% 95% CI: −36%; −16%] in 2015/16. Non-PCV13 serotypes accounted for 84.1% of the IPD cases in 2015/16. The most frequent non-PCV serotypes in IPD in 2014/15 and 2015/16 were 10A, 24F, 15C, 12F, 38, 22F, 23B, and 15B. The impact at nadir was highest in children 0–1 years of age both in meningitis and non-meningitis cases, whereas the impact for other age groups was higher for meningitis cases. The rebound mainly pertained to non-meningitis cases.ConclusionThe maximum impact of pneumococcal conjugate vaccination has been attained and signs of a rebound are apparent. Sustained surveillance for IPD in children is warranted to assess whether these trends will continue. There may be a need for vaccines using antigens common to all serotypes. |
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| Keywords: | Invasive pneumococcal disease Pneumococcal conjugate vaccination School-aged children Germany |
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