Impact of 13-valent pneumococcal conjugate vaccine on the incidence of hospitalizations for all-cause pneumonia among children aged less than 5 years in Burkina Faso: An interrupted time-series analysis

Kaboré, Lassané; Ouattara, Seydou; Sawadogo, François; Gervaix, Alain; Galetto-Lacour, Annick; Karama, Robert; Traoré, Amado T.; Méda, Bertrand; Tall, Haoua; Essoh, Alima; Gessner, Bradford D.; Moïsi, Jennifer C

doi:10.1016/j.ijid.2020.03.051

Cited by 13 publications

(13 citation statements)

References 21 publications

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“…Among Brazilian children aged <2 years annual declines were 4%, among children aged 2-4 years annual declines were 11% and among children aged 5-9 years there was no change [ 25 ]. Among children aged <5 years in Burkina Faso there was a 0.66 (95% confidence interval (CI) = 0.51, 0.84) change in intercept and a 0.97 (95% CI = 0.96, 0.98) change in slope, with sub-analysis by age groups; 0-23 months showed a 0.76 (95% CI = 0.59, 0.98) change in intercept and a 0.96 (95% CI = 0.95, 0.97) change in slope and 24-59 months showed a 0.50 (95% CI = 0.36, 0.70) change in intercept and a 0.98 (95% CI = 0.97, 1.002) change in slope [ 38 ]. Eight studies showed no change in one of the age groups reviewed.…”

Section: Resultsmentioning

confidence: 99%

“…One study used a time series analysis. Among children aged <5 years in Burkina Faso, there was a 0.64 (95% CI = 0.49, 0.84) change in intercept and a 0.970 (95% CI = 0.96, 0.98) change in slope, with sub-analysis by age groups; 0-23 months showed a 0.74 (95% CI = 0.56; 0.98) change in intercept and a 0.959 (95% CI = 0.944; 0.974) change in slope and 24-59 months showed a 0.45 (95% CI = 0.30, 0.68) change in intercept and a 0.996 (95% CI = 0.97, 1.02) change in slope [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among children aged <5 years in Burkina Faso, there was a 0.49 (95% CI = 0.31, 0.78) change in intercept and a 0.97 (95% CI = 0.94, 0.99) change in slope. When further sub-analyzed by age groups, the following was observed; the 0-23 months age group showed a 0.60 (95% CI = 0.37, 0.99) change in intercept and a 0.95 (95% CI = 0.92, 0.97) change in slope and 24-59 months showed a 0.22 (95% CI = 0.08, 0.60) change in intercept and a 1.03 (95% CI = 0.98, 1.08) change in slope [ 38 ]. Among Spanish children <18 years in-hospital mortality fell by an odds ratio of 0.82 (95% CI = 0.77, 0.89) [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

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Systematic review on the impact of the pneumococcal conjugate vaccine ten valent (PCV10) or thirteen valent (PCV13) on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates and pneumonia mortality in children 0-9 years old

et al. 2023

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Background There is an ongoing need to assess the impact of pneumococcal conjugate vaccines (PCVs) to guide the use of these potentially valuable but under-utilized vaccines against pneumonia, which is one of the most common causes of post-neonatal mortality. Methods We conducted a systematic review of the literature on PCV10 and PCV13 impact on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates as well as all-cause and pneumonia-specific mortality rates. We included studies that were published from 2003 onwards, had a post-licensure observational study design, and reported on any of our defined outcomes in children aged between 0-9 years. We derived incidence rates (IRs), incidence rate ratios (IRRs) or percent differences (%). We assessed all studies for risk of bias using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Results We identified a total of 1885 studies and included 43 comparing one or more of the following hospitalised outcomes of interest: all-cause pneumonia (n = 27), severe pneumonia (n = 6), all-cause empyema (n = 8), radiologically confirmed pneumonia (n = 8), pneumococcal pneumonia (n = 7), and pneumonia mortality (n = 10). No studies evaluated all-cause mortality. Studies were conducted in all WHO regions except South East Asia Region (SEAR) and low- or middle-income countries (LMICs) in the Western Pacific Region (WPR). Among children <5 years old, PCV impact ranged from 7% to 60% for all-cause pneumonia hospitalisation, 8% to 90% for severe pneumonia hospitalisation, 12% to 79% for radiologically confirmed pneumonia, and 45% to 85% for pneumococcal confirmed pneumonia. For pneumonia-related mortality, impact was found in three studies and ranged from 10% to 78%. No obvious differences were found in vaccine impact between PCV10 and PCV13. One study found a 17% reduction in all-cause pneumonia among children aged 5-9 years, while another found a reduction of 81% among those aged 5-17 years. A third study found a 57% reduction in all-cause empyema among children 5-14 years of age. Conclusion We found clear evidence of declines in hospitalisation rates due to all-cause, severe, radiologically confirmed, and bacteraemic pneumococcal pneumonia in children aged <5 years, supporting ongoing use of PCV10 and PCV13. However, there were few studies from countries with the highest <5-year mortality and no studies from SEAR and LMICs in the WPR. Standardising methods of future PCV impact studies is recommended.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review on the impact of the pneumococcal conjugate vaccine ten valent (PCV10) or thirteen valent (PCV13) on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates and pneumonia mortality in children 0-9 years old

et al. 2023

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“…When PCV7 was licensed for pediatric use in 2000, randomized controlled trials determining vaccine efficacy against pneumonia found that PCV7 provided approximately 27% protection against all-cause inpatient/hospitalized pneumonia and 6% protection against all-cause outpatient pneumonia in children under two years of age [52][53][54][55]. Following widespread use of PCV7 and the introduction of higher valent PCVs, real-world effectiveness studies have continued to show an association between PCV use and declines in nonspecific, all-cause pneumonia incidence in children [56][57][58]. Depending on the country of study and case definition, all-cause pneumonia hospitalizations have been reduced by 13% to 72% among children under five years of age as a result of PCV vaccination programs, with a significantly sharper decline in cases observed following the replacement of a lower valent PCV with a higher valent PCV [51,56].…”

Section: Pneumoniamentioning

confidence: 99%

“…If all-cause pneumonia had been used instead, the additional global disease cases and consequent deaths prevented by PCV13 vaccination is estimated to be substantially larger. For example, assuming that 34% of all-cause pneumonia cases are pneumococcal as reported by Wahl et al [21] and applying Kaboré et al's [57] estimate that PCV13 vaccination reduces all-cause pneumonia incidence in children by 34% (selected within the range of 13% to 72%), we estimate that approximately 21.1 million cases of all-cause pneumonia may have been prevented in children under five years of age with PCV13, nearly 1.5 times greater than the 14.8 million pneumococcal pneumonia cases previously estimated [6].…”

Section: Pneumoniamentioning

confidence: 99%

Public health impact of pneumococcal conjugate vaccination: a review of measurement challenges

Horn

Wasserman

Hall-Murray

et al. 2021

Expert Review of Vaccines

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Introduction: Modeling analyses have attempted to quantify the global impact of pneumococcal conjugate vaccines (PCVs) on pneumococcal disease (PD), however these pediatric models face several challenges in obtaining comprehensive impact measurements. Areas Covered: We present several measurement challenges and discuss examples from recently published pediatric modeling evaluations. Challenges include estimating the number of infants fully or partially vaccinated with PCVs, inclusion of indirect effects of vaccination, accounting for various dosing schedules, capturing effect of PCVs on nonspecific, noninvasive PD, and inclusion of adult PCV use. Expert Opinion: The true impact of PCVs has been consistently underestimated in published analyses due to multiple measurement challenges. Nearly 100 million adults are estimated to have received PCV13 over the last decade globally, potentially preventing up to 662 thousand cases of PD. Approximately 4.1 million cases of invasive PD alone may have been averted through indirect protection. Estimates of PCV impact on noninvasive PD remain a challenge due to altered epidemiology. Program switches, incomplete vaccination, and private market uptake among children also confound PD impact estimates. Taken together, the number of averted PD cases from PCV use in the last ten years may be up to three times higher than estimated in previous studies.

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Pneumonia hospitalization after introduction of pneumococcal conjugate vaccine in Japan: Descriptive study using a nationwide claims database

Yanai

Yoshida

Takeuchi

et al. 2023

Vaccine

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Impact of 13-valent pneumococcal conjugate vaccine on the incidence of hospitalizations for all-cause pneumonia among children aged less than 5 years in Burkina Faso: An interrupted time-series analysis

Cited by 13 publications

References 21 publications

Systematic review on the impact of the pneumococcal conjugate vaccine ten valent (PCV10) or thirteen valent (PCV13) on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates and pneumonia mortality in children 0-9 years old

Systematic review on the impact of the pneumococcal conjugate vaccine ten valent (PCV10) or thirteen valent (PCV13) on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates and pneumonia mortality in children 0-9 years old

Public health impact of pneumococcal conjugate vaccination: a review of measurement challenges

Pneumonia hospitalization after introduction of pneumococcal conjugate vaccine in Japan: Descriptive study using a nationwide claims database

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