A reflection on invasive pneumococcal disease and pneumococcal conjugate vaccination coverage in children in Southern Europe (2009–2016)

Abstract

Higher-valent pneumococcal conjugate vaccines (PCVs) were licensed from 2009 in Europe; similar worldwide clinical effectiveness was observed for PCVs in routine use. Despite a proven medical need, PCV vaccination in Southern Europe remained suboptimal until 2015/16.We searched PubMed for manuscripts published between 2009 and mid-2016. Included manuscripts had to contain data about invasive pneumococcal disease (IPD) incidence, or vaccination coverage with higher-valent PCVs. This review represents the first analysis of vaccination coverage and impact of higher-valent PCVs on overall IPD in Southern European countries (Portugal, Spain, Italy, Greece, Cyprus).Vaccination coverage in the Portuguese private market peaked around 2008 at 75% (children ≤ 2 years) but declined to 63% in 2012. In Madrid, coverage was 95% (2007–2012) but dropped to 67% (2013/14; children ≤ 2 years) after funding termination in May 2012. PCVs were recently introduced in the national immunisation program (NIP) of Portugal (2015) and Spain (2015/16). In Italy, coverage for the complete PCV schedule (children ≤ 2 years) was 88% in 2013, although highly variable between regions (45–99%). In Greece, in 2013, 82.3% had received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months. Overall IPD (net benefit: effect on vaccine types, vaccine-related types, and non-vaccine types) has decreased; in Greece, pneumococcal meningitis incidence remained stable.Continued IPD surveillance or national registers using ICD-10 codes of clinically suspected IPD are necessary, with timely publicly available reports and adequate national vaccination registers to assess trends in vaccination coverage, allowing evaluation of PCVs in NIPs.

Determinants of human papillomavirus vaccine attitudes: an interview of Wisconsin parents

“…The cancer prevention message most discernably promoted with HPV vaccination was widely recognized across interviewees, but was not universally convincing as some parents considered the likelihood of HPV vaccine-preventable cancer remote in their adolescent child (overall and in light of regular cancer screenings such as pap smears). This theme was generally consistent with at least two prior studies as well, where parents voiced limited concern about their adolescents’ susceptibility to HPV infection [ 9 , 13 ]. One parent who refused the HPV vaccine for her daughter also considered the cervical cancer risk a worthwhile deterrent to unsafe sexual practices.…”

“…It was clear from our interviews, as in other prior investigations [ 7 , 9 , 13 , 23 ], that parents often look to their healthcare provider for advice about the HPV vaccine and this informs their attitudes. But this educational burden may be more nuanced than previously appreciated.…”

“…Prior research suggests parent acceptability of the HPV vaccine is largely driven by their attitudes and beliefs regarding the vaccine’s effectiveness, safety, and ease of access [ 6 – 9 ]. Although parental attitudes may be a modifiable factor, most research on this topic has relied on cross-sectional surveys focused on general beliefs about the HPV vaccine’s propensity to cause harm or deliver benefits, with some studies examining sociodemographic predictors of HPV vaccine hesitancy [ 10 , 11 ].…”

Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae causing invasive diseases in China: a meta-analysis

“…It has been reported that approximately 1 million people die of pneumococcal diseases annually, most of whom are children under 5 years old [2–4]. Pneumococcal conjugate vaccines (PCVs) targeting 7, 10, or 13 of more than 90 serotypes of S. pneumoniae have been successively introduced to reduce the burden of invasive pneumococcal disease (IPD) in vaccinated children in developed countries [5, 6]. In fact, it has been reported that after licensing PCV13, pneumococcal diseases of any cause, but especially those caused by PCV13 minus PCV7 serotypes, were further decreased across each age group in the UK [7].…”

Clinical and Economic Burden of Pneumococcal Disease Due to Serotypes Contained in Current and Investigational Pneumococcal Conjugate Vaccines in Children Under Five Years of Age

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