Pneumococcal Serotypes before and after Introduction of Conjugate Vaccines, United States, 1999–20111

Abstract

Serotyping data for pneumococci causing invasive and noninvasive disease in 2008–2009 and 2010–2011 from >43 US centers were compared with data from preconjugate vaccine (1999–2000) and postconjugate vaccine (2004–2005) periods. Prevalence of 7-valent pneumococcal conjugate vaccine serotypes decreased from 64% of invasive and 50% of noninvasive isolates in 1999–2000 to 3.8% and 4.2%, respectively, in 2010–2011. Increases in serotype 19A stopped after introduction of 13-valent pneumococcal vaccine (PCV13) in 2010. Prevalences of other predominant serotypes included in or related to PCV13 (3, 6C, 7F) also remained similar for 2008–2009 and 2010–2011. The only major serotype that increased from 2008–2009 to 2010–2011 was nonvaccine serotype 35B. These data show that introduction of the 7-valent vaccine has dramatically decreased prevalence of its serotypes and that addition of serotypes in PCV13 could provide coverage of 39% of isolates that continue to cause disease.

Nasopharyngeal pneumococcal carriage rates among HIV-infected adults following widespread pediatric use of conjugate pneumococcal vaccine-13

“…While non-typeable pneumococcal isolates are more commonly associated with carriage rather than invasive disease, non-typeable pneumococci has been isolated from children with IPD. 17,30,31 Furthermore, recent evidence suggests that non-typeable pneumococci have high genetic recombination potential leading to the possibility of spreading antibiotic resistance making their identification important for surveillance studies 32,33,34 Approximately 50% of the pneumococcal isolates found during our study were non-PCV13 serotypes (with an additional 44% of the types being non-typeable). One-third of the a CLSI breakpoints used for determination of susceptibility ( 2 mg/mL penicillin, 2 mg/mL cefotaxime, 2 mg/mL trimethoprim-sulfamethoxazole).…”

“…12 By 2004, serotype replacement with non-PCV7 vaccine strains emerged resulting in both nasopharyngeal carriage and IPD among children and adults, including those infected with HIV. [13][14][15][16][17] Infections caused by the more tenacious and antibiotic resistant serotype 19A had become particularly problematic. In 2010, PCV13, offering protection against an additional 6 of the most common pneumococcal serotypes, including serotype 19A, replaced PCV-7 in the universal pediatric immunization schedule allowing an opportunity for further reductions in IPD.…”

Current status and future directions of invasive pneumococcal diseases and prophylactic approaches to control them

“…30 While data is still being acquired for the post PCV13 era, there has been a noteworthy increase in serotype 35B since introduction of the vaccine. 12 , 31 …”

Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine compared to the 23-valent pneumococcal polysaccharide vaccine in elderly Japanese adults

“…Of note, the functional OPA antibody response against serotype 6A is crossreactive with serotype 6C, 11 a serotype that was recently demonstrated to cause IPD. 6,38,39 Of interest, prevaccination antibody titers were similar across vaccine groups, but fold rises were numerically higher after PCV13 compared with PPSV23 for all serotypes except serotype 3. Although a specific level of OPA antibody responses has not been shown to correlate with protection against pneumococcal disease in adults, OPA functional antibody responses are generally accepted as a correlate of vaccine-induced protection.…”