Pneumococcal Diseases in Colombia: Epidemiological Analysis Before and During the Universal Children Immunization against Streptococcus pneumoniae in the Light of a Vaccine Change in 2022

Abstract

Streptococcus pneumoniae causes meningitis, pneumonia and bacteremia, mainly in children under 5 years of age and in the elderly. Pneumococcal conjugate vaccines (PCVs) have been administered globally since the year 2000, contributing to substantially reduce the incidence of pneumococcal diseases (PDs). In 2012, Colombia implemented universal vaccination with PCV10 in children under 2 years of age, achieving a decrease and stabilization of the incidence of PDs. However, since 2014, replacement of vaccine serotypes by non-vaccine serotypes, such as 3 and 19A, predominantly, has been observed. Likewise, in 2019, there was an increase in the incidence of meningitis, coinciding with the increase of multi-resistant 19A clones. In July 2022, the vaccine formulation was changed to PCV13, which also has the potential to control serotypes 3, 6A, and 19A. This paper reviews the epidemiology of pneumococcus in Colombia, before and during the universal PCV10 vaccination.

Serotype distribution, clinical characteristics, and antimicrobial resistance of pediatric invasive pneumococcal disease in Colombia during PCV10 mass vaccination (2017–2022)

“…The most frequent serotype found during the study period was Spn19A (51.3%), whose proportion increased over time. The same phenomenon has been described in national surveillance data and in other studies conducted in Colombia ( 4–7 , 20 , 28–30 , 42 , 43 ) and elsewhere around the world after the universal administration of PCV10 ( 4 , 7 , 14 , 44–46 ). Serotypes Spn6C and Spn3 have also become more prevalent in all age groups, as has been observed in countries that have administered PCV10 ( 7 , 47 ).…”

“…Streptococcus pneumoniae is the leading cause of meningitis and pneumonia in children under 5 years of age worldwide and causes 735,000 annual deaths from IPD ( 1 , 2 , 13 ). After the introduction of conjugate vaccines, the incidence of IPD has decreased, but it is crucial to continue with surveillance to monitor clinical behavior, the prevalence of serotypes, and bacterial resistance ( 1 , 4 , 20 , 27 ). This study showed that the majority of patients with IPD were under 24 months of age (40.5%), followed by the 24–59 months age group (38.5%).…”

“…Based on a cost-effectiveness study ( 18 ), since January 2012, PCV10 has been administered universally, using a 2 + 1 scheme administered at 2 months, 4 months, and 12 months of age, with vaccination coverage between 85 and 89%. In July 2022, based on epidemiological data and cost-effectiveness studies ( 19 , 20 ). Colombia switched to PCV13 for the cohort of children born on or after May 1, 2022, using the same 2 + 1 scheme.…”