Population-based incidence of invasive pneumococcal disease in children and adults in Ontario and British Columbia, 2002–2018: A Canadian Immunization Research Network (CIRN) study

Nasreen, Sharifa; Wang, Jun; Kwong, Jeffrey C.; Crowcroft, Natasha S.; Sadarangani, Manish; Wilson, Sarah E.; McGeer, Allison; Kellner, James D.; Quach, Caroline; Morris, Shaun K.; Sander, Beate; Kus, Julianne V.; Naus, Monika; Hoang, Linda; Rudzicz, Frank; Fadel, Shaza A; Marra, Fawziah

doi:10.1016/j.vaccine.2021.11.032

Cited by 10 publications

(10 citation statements)

References 26 publications

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“…In adults, incidence and mortality related to IPD increase with age [4]. National surveillance data from Canada indicate an annual incidence of 21.1 cases per 100,000 among individuals aged �60 years in 2017, and-according to provincial data-even higher estimates are reported for older age groups (57.5 cases per 100,000 people for those aged �85 years, versus an average estimated incidence rate of 10.8 per 100,000 among all age groups in Ontario between 2010 and 2018) [5,6].…”

Section: Introductionmentioning

confidence: 96%

Pneumococcal vaccination uptake and missed opportunities for vaccination among Canadian adults: A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA)

et al. 2022

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Introduction In Canada, pneumococcal vaccination is recommended to all adults aged ≥65 and those <65 who have one or more chronic medical conditions (CMCs). Understanding vaccine uptake and its determinants among eligible groups has important implications for reducing the burden of pneumococcal disease. Methods Using data from a large national cohort of Canadian residents aged ≥47 years between 2015–2018, we calculated self-reported pneumococcal vaccine uptake among eligible groups, estimated associations between key factors and non-vaccination, assessed missed opportunities for vaccination (MOV) and examined risk factors for MOV. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for relevant associations were estimated through logistic regression. Results 45.8% (95% CI: 45.2–46.5) of 22,246 participants aged ≥65 and 81.3% (95% CI: 80.5–82.0) of 10,815 individuals aged 47–64 with ≥1 CMC reported never having received a pneumococcal vaccine. Receipt of influenza vaccination in the previous year was associated with the lowest odds of pneumococcal non-vaccination (aOR = 0.14 [95% CI: 0.13–0.15] for older adults and aOR = 0.23 [95% CI: 0.20–0.26] for those aged 47–64 with ≥1 CMC). Pneumococcal vaccine uptake was also more likely in case of contact with a family doctor in the previous year (versus no contact), increased with age and varied widely across provinces. Among individuals recently vaccinated against influenza, 32.6% (95% CI: 31.9–33.4) of those aged ≥65 and 71.1% (95% CI: 69.9–72.3) of those aged 47–64 with ≥1 CMC missed an opportunity to get a pneumococcal vaccine. Among individuals who had contact with a family doctor, 44.8% (95% CI: 44.1–45.5) of those aged ≥65 and 80.4% (95% CI: 79.6–81.2) of those aged 47–64 with ≥1 CMC experienced a MOV. Conclusions Pneumococcal vaccine uptake remains suboptimal among at-risk Canadian adults who are eligible for vaccination. Further research is needed to clarify the reasons behind missed opportunities for vaccination and adequately address the main barriers to pneumococcal vaccination.

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Section: Introductionmentioning

confidence: 96%

Pneumococcal vaccination uptake and missed opportunities for vaccination among Canadian adults: A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA)

et al. 2022

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“…PCVs have had an impact in reducing the pneumococcal disease burden when used as a part of a routine immunization program in children aged <2 years. 4–7 The use of the 7-valent PCV (PCV7) in the pediatric immunization program in Canada beginning in 2001 substantially decreased the incidence of invasive pneumococcal disease (IPD). 4 A 10-valent PCV (PCV10) was introduced in some provinces in 2009, followed by a switch to a 13-valent PCV (PCV13) 8 in 2010, which was followed by further reductions in the incidence of IPD.…”

Section: Introductionmentioning

confidence: 99%

“… 4–7 The use of the 7-valent PCV (PCV7) in the pediatric immunization program in Canada beginning in 2001 substantially decreased the incidence of invasive pneumococcal disease (IPD). 4 A 10-valent PCV (PCV10) was introduced in some provinces in 2009, followed by a switch to a 13-valent PCV (PCV13) 8 in 2010, which was followed by further reductions in the incidence of IPD. Following the implementation of publicly funded pediatric immunization programs, the incidence of IPD in children aged <2 years decreased from 73 cases per 100,000 population in 2003 to 16.2 cases per 100,000 population in 2019.…”

Section: Introductionmentioning

confidence: 99%

“…Following the implementation of publicly funded pediatric immunization programs, the incidence of IPD in children aged <2 years decreased from 73 cases per 100,000 population in 2003 to 16.2 cases per 100,000 population in 2019. 9 While PCV13 vaccine-type incidence has substantially decreased following the implementation of publicly funded programs, 4 , 10 non-vaccine serotype incidence remains, causing the majority of the remaining disease cases in Canada. 4 …”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness analysis of PCV20 to prevent pneumococcal disease in the Canadian pediatric population

Lytle,

Grajales Beltrán,

Perdrizet

et al. 2023

Human Vaccines & Immunotherapeutics

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This study assessed the cost-effectiveness of the 20-valent pneumococcal conjugate vaccine (PCV20) in Canadian infants aged <2 years versus the standard of care (SoC), a 13-valent pneumococcal conjugate vaccine (PCV13), or a potential 15-valent pneumococcal conjugate vaccine (PCV15). A decision-analytic Markov model was developed to compare PCV20 with PCV13 or PCV15 in a 2 + 1 schedule over 10 years. Vaccine effect estimates (direct and indirect) across all ages were informed by PCV13 clinical effectiveness and impact studies as well as PCV7 efficacy studies. Epidemiologic, clinical, health state utilities, utility decrements, cost per event, and list price data were from Canadian sources where available. Clinical and economic outcomes related to invasive pneumococcal disease (IPD), hospitalized and non-hospitalized pneumonia, and simple and complex otitis media (OM) were calculated for each strategy. Cost-effectiveness was evaluated from the publicly funded healthcare system perspective. Over 10 years, PCV20 versus PCV13 was estimated to avert over 11,000 IPD cases, 316,000 hospitalized and non-hospitalized pneumonia cases, 335,000 simple and complex OM cases, and 15,000 deaths, resulting in cost savings of over 3.2 billion Canadian dollars (CAD) and 47,000 more quality-adjusted life years (i.e. dominant strategy). Compared with PCV15, PCV20 was estimated to result in over 1.4 billion CAD in cost savings and 21,000 more QALYs (i.e. dominant strategy). PCV20 was dominant over both PCV13 and PCV15. Given broader serotype coverage, substantial incremental benefits and cost-savings, PCV20 should be considered as a replacement for the SoC in the publicly funded Canadian infant immunization program.

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“…Community-acquired pneumonia (CAP) is commonly diagnosed in North American children1 2 and is a leading reason for paediatric hospitalisation 3 4…”

Section: Introductionmentioning

confidence: 99%

Caregiver knowledge and attitudes relating to paediatric pneumonia and antimicrobial stewardship: a qualitative study

Huang,

Murphy,

Kandasamy

et al. 2023

Arch Dis Child

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ObjectiveThe objective of this study was to understand caregiver perspectives and experiences relating to the treatment of paediatric community-acquired pneumonia (CAP).Design, setting and patientsThis was a phenomenological qualitative study involving interviews with caregivers of young children in Hamilton, Ontario. Caregivers were asked open-ended questions relating to germ theory, pneumonia and the role of antibiotic treatment. The principles of conventional content analysis guided the coding and synthesis of the transcribed interviews.ResultsEleven caregivers were interviewed. Many knew that antibiotics were not effective against all types of infections and stated that there was an increased risk of developing resistance with frequent use. However, there were misconceptions that probiotics effectively mitigated antibiotic side effects, and few were familiar with the potential long-term consequences of antibiotic use in children.There was variability in the perceived severity of paediatric CAP. Some participants thought that antibiotic treatment would accelerate recovery and prevent caregivers from feeling helpless. However, others also thought it was inappropriate for physicians to prescribe antibiotics solely to make the caregiver feel better. Many caregivers also felt strongly that clinical follow-up and discussions on treatment risks/benefits would be desirable to counteract feelings of helplessness that result from being sent home without a prescription.ConclusionRecognising that parents may have misperceptions about antibiotic use for CAP (and may seek antibiotics without strong rationale) can inform clinicians’ efforts to better educate and support caregivers in the emergency department. Care strategies informed by caregiver experiences can improve parent–provider communication and reduce antibiotic misuse

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Population-based incidence of invasive pneumococcal disease in children and adults in Ontario and British Columbia, 2002–2018: A Canadian Immunization Research Network (CIRN) study

Cited by 10 publications

References 26 publications

Pneumococcal vaccination uptake and missed opportunities for vaccination among Canadian adults: A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA)

Pneumococcal vaccination uptake and missed opportunities for vaccination among Canadian adults: A cross-sectional analysis of the Canadian Longitudinal Study on Aging (CLSA)

Cost-effectiveness analysis of PCV20 to prevent pneumococcal disease in the Canadian pediatric population

Caregiver knowledge and attitudes relating to paediatric pneumonia and antimicrobial stewardship: a qualitative study

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