Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project

Abstract

Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04–0.06) for all ages, 0.05 (0.04–0.05) for <5 years of age, 0.08 (0.06–0.09) for 5–17 years, 0.06 (0.05–0.08) for 18–49 years, 0.06 (0.05–0.07) for 50–64 years, and 0.05 (0.04–0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3+0 schedule constrains generalizability and data from these settings are needed.

Serotype Distribution of Remaining Pneumococcal Meningitis in the Mature PCV10/13 Period: Findings from the PSERENADE Project

“…Our findings from non-meningitis belt countries that primarily used a booster dose schedule showed serotype 1 consistently caused less than 1% of disease after 7 years of use, compared to 8% in the pre-PCV era among children <5 years [2]. In other PSERENADE analyses published separately in this issue, serotype 1 IPD incidence declined in all ages by 95% after 6 years of PCV10/13 use in non-meningitis belt countries [44]. The persistence of serotype 1 outbreaks in unvaccinated older children and adults in the meningitis belt despite 3-4 years of PCV10/13 use [41][42][43] may suggest that indirect protection may be lower than for other regions, although these results are from the "early" PCV use period so the full effects of PCV13 may not have occurred.…”

Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study

“…Introduction of the current PCVs has been highly successful in reducing the incidence of pneumococcal diseases worldwide. 36 37 Vaccine efficacy of PCV13 against vaccine-type IPD in children aged ≤5 years was 86%–96%. 38 In adults aged ≥65 years, the vaccine efficacy against vaccine-type IPD was reported as 75% and against vaccine-type community-acquired pneumonia were reported as 45.6% and 72.8%, respectively.…”

National rates and disparities in childhood vaccination and vaccine-preventable disease during the COVID-19 pandemic: English sentinel network retrospective database study

“…The programme has achieved high vaccination coverage in the population. This is important especially for measles, mumps and rubella (MMR) and pneumococcal vaccinations since these infections have high transmission rates in unvaccinated populations, and a wide range of potentially serious effects in those infected including pneumonia, meningitis and death 2–7…”