Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination.



Hanquet, Germaine, Krizova, Pavla, Valentiner-Branth, Palle, Ladhani, Shamez N, Nuorti, J Pekka, Lepoutre, Agnes, Mereckiene, Jolita, Knol, Mirjam, Winje, Brita A, Ciruela, Pilar
et al (show 21 more authors) (2019) Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination. Thorax, 74 (5). 473 - 482.

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Abstract

<h4>Background</h4>Pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies.<h4>Methods</h4>For each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100.<h4>Results</h4>After five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively.<h4>Conclusion</h4>Overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.

Item Type: Article
Uncontrolled Keywords: SpIDnet/I-MOVE+ Pneumo Group, Humans, Streptococcus pneumoniae, Pneumococcal Vaccines, Vaccination, Incidence, Retrospective Studies, Follow-Up Studies, Aged, Europe, Female, Male, Serogroup
Depositing User: Symplectic Admin
Date Deposited: 09 Dec 2019 09:59
Last Modified: 24 Aug 2022 18:11
DOI: 10.1136/thoraxjnl-2018-211767
URI: https://livrepository.liverpool.ac.uk/id/eprint/3065201