Association Between Local Pediatric Vaccination Rates and Patterns of Pneumococcal Disease in Adults

Pingali, Cassandra; Warren, Joshua L.; Mead, Aimee Marie; Sharova, Nancy; Petit, Susan

doi:10.1093/infdis/jiv431

Cited by 12 publications

(9 citation statements)

References 10 publications

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“…Therefore, direct protection of toddlers and preschool-aged children is the main causal driver of declines of IPD in adults, and carriage in infants <6 months old is either an intermediate step on the causal pathway or due to confounding, but is probably not the main causal driver (Figure S1). Such a mechanism is consistent with the delays in indirect protection observed in adults in several high-income populations following the introduction of PCV (15,27).…”

Section: Discussionsupporting

confidence: 80%

“…(27). Likewise, previous analyses demonstrated that the decline in IPD in adults in the US was delayed by ~1 year compared to the decline in IPD in children <5 years old (15). These patterns reinforce the notion that it is important to maintain strong immunity to colonization in these older children in order to maintain indirect protection of younger children and adults.…”

Section: Discussionsupporting

confidence: 55%

“…Likewise, the decline in IPD due to vaccine-targeted serotypes in adults is delayed and slower than the decline observed in vaccinated children (15). This might indicate that the transmission benefit (i.e.…”

mentioning

confidence: 98%

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Decline in pneumococcal disease in unimmunized adults is associated with vaccine-associated protection against colonization in toddlers and preschool-aged children

Pitzer

Regev‐Yochay

Givon-Lavi

et al. 2018

Preprint

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Conflicts of Interest: Within the last two years, DMW has received consulting fees from Affinivax and Pfizer. RD has received grants and consulting and speaker fees from Pfizer; grant and consulting fees from MSD and consulting fees from MeMed. GRY has received consulting fees from Pfizer and research support from Pfizer and MSD. ABSTRACTVaccinating children with pneumococcal conjugate vaccines disrupts transmission, reducing disease rates in unvaccinated adults. When considering changes in vaccine dosing strategies (e.g., removing doses), it is critical to understand which groups of children contribute most to transmission to adults. We used data from children and adults in Israel to evaluate how the buildup of vaccine-associated immunity in children was associated with declines in IPD due to vaccine-targeted serotypes in unimmunized adults. Data on vaccine uptake and prevalence of colonization with PCV-targeted serotypes were obtained from a unique study conducted among children visiting an emergency department in southern Israel and from surveys of colonization from central Israel. Data on invasive pneumococcal disease in adults were obtained from a nationwide surveillance study. We compared the trajectory of decline of IPD due to PCVtargeted serotypes in adults with the trajectory of decline of colonization prevalence and trajectory of increase in vaccine-derived protection against pneumococcal carriage among different age groupings of children. The declines in IPD in adults were most closely associated with the declines in colonization and increased vaccination coverage in children in the range of 36-59 months of age. This suggests that preschool-aged children, rather than infants and young toddlers, are responsible for maintaining the indirect benefits of PCVs.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 55%

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Decline in pneumococcal disease in unimmunized adults is associated with vaccine-associated protection against colonization in toddlers and preschool-aged children

Pitzer

Regev‐Yochay

Givon-Lavi

et al. 2018

Preprint

Self Cite

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“…For each ZIP code during each month/year, we estimated the number of children eligible to receive PCV7 and the number of children who received three and/or four doses using a cohort approach while assuming a constant birth rate over the year and that vaccinations for children who received three or four doses were administered according to schedule. 5,9 …”

Section: Methodsmentioning

confidence: 99%

“…This reduction was observed among children who received the vaccine and within the adult population, which was not vaccinated but which benefitted indirectly. 1-5 …”

Section: Introductionmentioning

confidence: 99%

Spatial Variability in the Persistence of Pneumococcal Conjugate Vaccine-targeted Pneumococcal Serotypes Among Adults

Warren

Pingali²,

Weinberger³

2017

Epidemiology

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Invasive pneumococcal disease is a leading cause of morbidity worldwide. Pneumococcal conjugate vaccine effectively reduces the number of cases caused by vaccine-targeted serotypes among children who receive the vaccine and adults who are not directly vaccinated. Recently, there has been debate as to whether adults should receive the same conjugate vaccine as children. In settings where vaccine uptake in children is high, the vaccine serotypes cause a small fraction of disease cases, and direct vaccination might have a small effect. However, direct vaccination might be warranted if geographic regions or subpopulations exist where the targeted serotypes persist at higher levels than expected. To detect such geographic variability, new methodology is required. We introduce an innovative, spatially varying change points model, combined with spatially varying intercepts and slopes, to jointly determine whether the beginning date of the vaccine-associated decline, the initial baseline proportion of invasive pneumococcal disease cases caused by vaccine-targeted serotypes, and/or the rate of decline of vaccine-targeted serotypes vary in the adult population across Connecticut, 1998-2009. Results indicate that there is substantial spatial variability in the pattern with which vaccine-targeted serotypes decline, suggesting that the fraction of invasive pneumococcal disease cases that could have been preventable by direct vaccination of adults in Connecticut during the study period differed over time and space. The newly developed model is shown to outperform a number of competitors in terms of explanatory and predictive ability.

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Population-based incidence of invasive pneumococcal disease in children and adults in Ontario and British Columbia, 2002–2018: A Canadian Immunization Research Network (CIRN) study

Nasreen¹,

Wang²,

Kwong³

et al. 2021

Vaccine

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Association Between Local Pediatric Vaccination Rates and Patterns of Pneumococcal Disease in Adults

Abstract: Local variations in PCV uptake (and receipt of the booster dose) might influence the effectiveness of PCVs in preventing pneumococcal disease in adults.

Cited by 12 publications

References 10 publications

Decline in pneumococcal disease in unimmunized adults is associated with vaccine-associated protection against colonization in toddlers and preschool-aged children

Decline in pneumococcal disease in unimmunized adults is associated with vaccine-associated protection against colonization in toddlers and preschool-aged children

Spatial Variability in the Persistence of Pneumococcal Conjugate Vaccine-targeted Pneumococcal Serotypes Among Adults

Population-based incidence of invasive pneumococcal disease in children and adults in Ontario and British Columbia, 2002–2018: A Canadian Immunization Research Network (CIRN) study

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