The incremental burden of invasive pneumococcal disease associated with a decline in childhood vaccination using a dynamic transmission model in Japan: A secondary impact of COVID-19

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has disrupted childhood vaccinations, including pneumococcal conjugate vaccine (PCV). Evaluating the possible impact on the invasive pneumococcal disease (IPD) incidence associated with a decline in childhood pneumococcal vaccination is important to advocate the PCV programs. Using a deterministic, dynamic transmission model, the differential incidence and burden of IPD in children younger than 5 years in Japan were estimated between the rapid vaccination recovery (January 2021) and the delayed vaccination recovery (April 2022) scenarios for the next 10 years. In our model, the IPD incidence was reduced from 11.9/100,000 in 2019 to 6.3/100,000 in 2020, caused by a reduced transmission rate due to the COVID-19 mitigation measures. Assuming a recovery in the transmission rate in 2022 April, the incidence of IPD was estimated to increase with maximal incidence of 12.1 and 13.1/100,000 children under 5 years in the rapid and the delayed vaccination recovery scenarios. The difference in the total IPD incidence between these two scenarios was primarily driven by vaccine serotypes IPD incidence. The difference of incidence was not observed between the two scenarios after 2025. The persistent decline in childhood pneumococcal vaccination rates due to the impact of COVID-19 might lead to an increased IPD incidence and an incremental disease burden.

Retracted: Impact of COVID‐19 pandemic on routine vaccination coverage of children and adolescents: A systematic review

“…39,57 Also, Kitano et al warned about the consequences of a decline in Hib and pneumococcal conjugate vaccine and projected an increase in the incidence of Hib and invasive pneumococcal disease (IPD) and the related burden of the disease if the decline in vaccination persists during the pandemic. 42,43 While most of our studies reported disruptions in routine pediatric vaccination schedules, some countries sustained their immunization program via catch-up strategies, only facing brief periods of decline in immunization rate. In the Republic of Korea, the pediatric vaccination program remained sustained due to the high-powered national vaccination program and minimal cost of vaccination.…”

“…Thus, the emergence of measles outbreaks is not unimaginable, as experienced before in not highly vaccinated populations 39,57 . Also, Kitano et al warned about the consequences of a decline in Hib and pneumococcal conjugate vaccine and projected an increase in the incidence of Hib and invasive pneumococcal disease (IPD) and the related burden of the disease if the decline in vaccination persists during the pandemic 42,43 …”

“…Twenty-one of 26 studies included in this review revealed a decrease in the children vaccination rate during the pandemic or delay in vaccination, 24,[27][28][29][30][31][32][33][34][35][36][37][39][40][41][42][43][44][45][46] up to 80% decrease in some cases compared to the time before the pandemic. 29 The COVID-19 pandemic influenced the public health priorities and changed their directions inadvertently; thus, many preventive programs failed to continue and function properly as they did before.…”

Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study

“…Unfortunately, we did not have such data. In Japan, pneumococcal vaccine use decreased yet invasive pneumococcal disease in children was lower during versus COVID-19 due to containment measures 21…”

The estimated burden of 15 vaccine-preventable diseases from 2008 to 2020 in Japan: A transition by the COVID-19 pandemic

“…Vaccine coverage rates have not had a reducing trend in recent years [ 39 ]. Of note, a new method to estimate the number of cases with influenza has been applied since 2018 [ 40 ]. While this study followed the suggestion by Ministry of Health, Labour and Welfare to adjust the annual number in 2017 or before so the number is estimated with the same method throughout the study period [ 40 ], a continuous monitoring the reported number and the estimated number is crucial to find the best way to estimated the number of cases with influenza.…”