<i>Streptococcus pneumoniae</i> serotype 19A meningitis in well‐vaccinated immunocompetent 13‐month‐old child: a case of <scp>PCV</scp>13 failure

Kayemba-Kay’s, Simon; Badran, Abdul; Lagneaux, Cécile; Kovács, Tamás; Héron, Anne

doi:10.1002/ccr3.660

Cited by 5 publications

(4 citation statements)

References 15 publications

(22 reference statements)

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“…There are few publications about vaccine failures. In France, three cases were published of meningitis due to PCV-13 serotypes in healthy, correctly immunized pediatric patients (Godot et al, 2015;Kayemba-Kay's et al, 2016), although one of them had a cochlear implant, which is considered a risk factor. A systematic review of all cases of vaccine failures from 2000 to 2016 was published in the United Kingdom; it was concluded that 2% of IPD cases are due to pneumococcal serotypes present in the vaccines received by patients who, for the most part, had some type of immunosuppression (Oligbu et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Influence of pneumococcal vaccination on the hospitalization of healthy pediatric patients due to typical Community-Acquired Pneumonia

Martínez

Fernández

Frías

et al. 2020

International Journal of Infectious Diseases

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Introduction: Community-Acquired Pneumonia (CAP) is one of the most frequent causes of hospital admission in children. Our objective is to measure the impact of the introduction of pneumococcal conjugate vaccines on the hospitalization of previously healthy children due to CAP. Method: From 2011 to 2016, a partially retrospective, prospective, and descriptive study was carried out on healthy pediatric patients (3 months-14 years old) with CAP, who required hospital admission. Clinical, epidemiological, and demographic characteristics were collected, and vaccination status was obtained from medical records. Results: A total of 292 cases were included, with a mean age of 33.4 months, 54% males. There was a progressive and significant 42% decrease in the number of admissions each year, without significant changes in the annual percentage of parapneumonic pleural effusion (PPE). Fifty-six percent of patients were immunized with a pneumococcal conjugate vaccine (PCV). The percentage of children who were not vaccinated decreased by 14%, and the coverage with PCV-13 increased by 46%. This revealed a significant increase of PPE in vaccinated patients with PCV-7 (63%) compared with unvaccinated (45%) and with PCV-13 (57%), without association with the presence of severe PPE. Moreover, no significant differences in severity or hospital stay were observed in unvaccinated patients, compared to those who were vaccinated. In >2-year-olds, we observed a significant increase in PPE (59%) compared to 45% in younger children. Conclusions: The increase in vaccination coverage with PCV-13 resulted in a decrease in hospitalizations due to CAP and PPE. Vaccination with PCV-7 is associated in our sample with an increase in PPE but not with severe PPE nor an increase in the hospital stay. There was an epidemiological shift of severe forms of pneumonia and empyema at later ages (>2 years).

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Section: Discussionmentioning

confidence: 99%

Influence of pneumococcal vaccination on the hospitalization of healthy pediatric patients due to typical Community-Acquired Pneumonia

Martínez

Fernández

Frías

et al. 2020

International Journal of Infectious Diseases

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“…Bien que le PCV 13 contribue à réduire les infections pneumococciques sévères, la probabilité d'émergence de sérotypes non vaccinaux ne peut être exclue. En outre, les cas d'échec restent relativement rares en ce qui concerne l'étendue de la couverture réussie dans la grande majorité de la population infantile [3].…”

Section: Discussionunclassified

“…L'incidence du sérotype peut varier selon l'âge du patient, la région géographique et l'heure de la surveillance. L'avènement et la mise en place de vaccins anti-pneumococciques conjugués (PCV) ont permis d'accomplir des progrès considérables dans la prévention des méningites à PNO [3]. Au Maroc, le vaccin conjugué 13-valent contre le pneumocoque (PCV13) a été introduit dans le Programme National de Vaccination en octobre 2010 selon le calendrier 2 + 1 pour la prévention des infections pneumococciques causées par des sérotypes vaccinaux, tels que le 4, 6B, 9V, 14, 18C, 19F, 23F (inclus dans le PCV7) plus le 1, 3, 5, 6A, 7F et 19A.…”

Section: Introductionunclassified

Méningite à Streptococcus pneumoniae sérotype 7A chez un nourrisson immunisé par deux doses du vaccin pneumococcique conjugué 13-valent: à propos d’un cas

et al. 2019

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Cause majeure de morbidité et mortalité, les méningites à pneumocoque (PNO) représentent un fléau mondial. Au Maroc, le vaccin conjugué 13-valent contre le pneumocoque (PCV13) a été introduit dans le Programme National de Vaccination en octobre 2010 selon le calendrier 2 + 1 et remplacé par le PCV10 en juillet 2012, selon le même calendrier. Malgré le recours au PCV13, essentiel dans la lutte contre les maladies pneumococciques, l'émergence de nouveaux sérotypes non vaccinaux entrainent toujours des méningites chez l'enfant et engendrent de lourdes séquelles. Nous rapportons le cas d'une méningite causée par Streptococcus pneumoniae sérotype 7A chez un nourrisson immunisé avec 2 doses de PCV13. La particularité de cette observation réside dans une méningite à PNO sérotype 7A, non contenu dans le PCV13, chez un nourrisson vacciné par 2 doses du PCV13. Les auteurs insistent sur la nécessité et l'importance d'un observatoire PNO et d'une large étude épidémiologique afin de déterminer les sérotypes en circulation au Maroc depuis l'introduction du PCV13 puis PCV10.

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“…It, therefore, appears that a challenge remains, as cases of vaccine failure are being reported [32][33][34][35][36]. It has also been emphasized that some vaccine serotypes are less immunogenic, and still cause some concern in clinical practice even in wellvaccinated children [33,37].…”

Section: Where Do We Stand In the Post-pcv13 Era?mentioning

confidence: 99%

Where do we Stand After PCV13 Vaccine Introduction?

Kayemba-Kay’s¹

2020

Ann Pediatr

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Conjugate anti-pneumococcal vaccines are available in routine practice for over two decades now. They have enabled tremendous progress to be achieved in the prevention of severe Streptococcus pneumoniae infections in both children and the elderly. S. pneumoniae is a complex bacterium that has over 90 capsular serotypes each with specific virulence. The advent of PCV13 after PCV7 was expected to further reduce the burden of pneumococcal infections as non-vaccine serotypes started emerging a few years after PCV7 was introduced. Even though much has been achieved and several lives saved, we are faced, in recent years, with cases of Vaccine Break Through (VBT) and Failure (VF).Through this overview, clinicians are reminded that some vaccine serotypes are less immunogenic, therefore, wellvaccinated children may present with severe S. pneumoniae infections as shown by several reports.We believe that reporting all cases of VBT and VF is of utmost importance as it would strengthen our epidemiological knowledge and aid in public health policy decisionmaking processes.

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Streptococcus pneumoniae serotype 19A meningitis in well‐vaccinated immunocompetent 13‐month‐old child: a case of PCV13 failure

Cited by 5 publications

References 15 publications

Influence of pneumococcal vaccination on the hospitalization of healthy pediatric patients due to typical Community-Acquired Pneumonia

Influence of pneumococcal vaccination on the hospitalization of healthy pediatric patients due to typical Community-Acquired Pneumonia

Méningite à Streptococcus pneumoniae sérotype 7A chez un nourrisson immunisé par deux doses du vaccin pneumococcique conjugué 13-valent: à propos d’un cas

Where do we Stand After PCV13 Vaccine Introduction?

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