Impact of pneumococcal vaccines on invasive pneumococcal disease in Taiwan

Abstract

In Taiwan, the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the 7-valent pneumococcal conjugate vaccine (PCV7) have been available since January 2001 and October 2005, respectively. A hospital-based surveillance of invasive pneumococcal disease (IPD) in a medical center was conducted from 2000 to 2008 to evaluate the epidemiologic changes after pneumococcal vaccination. A total of 337 episodes in 328 patients were identified. The cumulative coverage rate of PPV23 among persons of age >or=75 years increased from 12% in 2007 to 41% in 2008, and that of PCV7 among children aged <5 years was 0.7% in 2005 and 25.2% in 2008. The annual incidence of IPD decreased from 6.2 cases per 10,000 hospitalizations in 2000-2005 to 3.8 cases in 2006-2008 (38.5% reduction, P < 0.001), but the fatality rate did not change significantly (24.4% and 21.8%, P = 0.74). The serotype coverage rates of PPV23 and PCV7 were not significantly different between 2000-2005 and 2006-2008 (both P > 0.05). A marked increase of serotype 19A from 2000-2005 (0.5%) to 2006-2008 (11.5%) was found (P < 0.001). In summary, a decline in IPD incidence but not in fatality rate occurred after the availability of PCV7 and the increased usage of PPV23. The rapid emergence of serotype 19A during this period is alarming.

Low rate of influenza and pneumococcal vaccine coverage in rheumatoid arthritis: Data from the international COMORA cohort

“…The lack of data on adult pneumococcal disease and the doubts regarding the effectiveness of vaccination, particularly in immunocompromised patients, may be factors in the limited use of the pneumococcal vaccination [36]. However, several recent studies have shown decreases in economic burden of pneumococcal disease after the introduction of vaccinations [37,38].…”

Comparison of clinical features, antimicrobial susceptibility, serotype distribution and outcomes of patients with hospital- and community-associated invasive pneumococcal disease

“…Following the introduction of pneumococcal vaccines, a decline in the incidence of pneumococcal infections was documented [15,25]. Furthermore, our study showed that currently available pneumococcal vaccines would provide optimal efficacy both against HA-IPD and CA-IPD in Taiwan because >70% of the pneumococcal isolates from both groups were those included in the pneumococcal vaccines.…”

“…Clinical diagnoses associated with IPD were classified as invasive pneumococcal pneumonia, meningitis, primary bacteraemia and other syndromes, as described in a previous report [15]. Pneumococcal meningitis was defined as the isolation of pneumococcus from CSF, or the clinical diagnosis of meningitis and isolation of pneumococcus from any sterile site.…”

Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid)

“…69 The highest mortality rate (over 50%) of IPD was seen in older adults. 70 However, national recommendations for PPV23 use in the elderly population are controversial and are based primarily on a risk-based strategy, which likely partially explains the low vaccine coverage rates in Europe. 71 Moreover, the production of specific antibodies after vaccination decreases progressively in the extremely elderly population.…”