Use of Pneumococcal Disease Epidemiology to Set Policy and Prevent Disease during 20 Years of the Emerging Infections Program

Moore, Matthew R.; Whitney, Cynthia G.

doi:10.3201/eid2109.150395

Cited by 14 publications

(9 citation statements)

References 33 publications

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“…15,23,26,40,41 However, France saw important serotype replacement after PCV7 implementation. The prevalence of non-vaccine serotypes before PCV implementation was probably a major factor in determining the replacement.…”

Section: Discussionmentioning

confidence: 99%

The multifaceted impact of pneumococcal conjugate vaccine implementation in children in France between 2001 to 2014

Cohen

Biscardi

Lévy

2016

Human Vaccines & Immunotherapeutics

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In 2003, France was the first European country to recommend 7-valent pneumococcal conjugate vaccine (PCV7) for a large proportion of healthy children. With complicated recommendations, the vaccine coverage during the first 4 y of implementation was low, then progressively increased to reach 90% in 2008. The aim of this review was to describe the particular impact of PCVs in a country where the vaccine coverage was initially suboptimal.After PCV7 implementation, the PCV7 serotypes nearly disappeared among pneumococci isolated from meningitis (¡73%), other invasive pneumococcal disease (IPD; ¡90%) and pneumococcal carriage (¡97%). Consequently, the rates of penicillin-resistant strains declined. However, because of important serotype replacement, the global effect on the incidence of meningitis (¡31%) or other IPD (¡14%) was modest and observed only in young children < 2 y old. After PCV13 transition, with immediate high vaccine coverage, the vaccine had an important impact on all pneumococcal disease: reduction of ¡20% for pneumococcal meningitis, ¡36% for non-meningitis IPD, ¡32% for community acquired pneumonia and ¡15% for S. pneumoniae carriage.These findings underline the complexity of pneumococcal epidemiology and the importance of high and fast vaccination coverage to obtain the optimal effect of PCVs.

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Section: Discussionmentioning

confidence: 99%

The multifaceted impact of pneumococcal conjugate vaccine implementation in children in France between 2001 to 2014

Cohen

Biscardi

Lévy

2016

Human Vaccines & Immunotherapeutics

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“…We excluded studies before 2000, to circumvent temporal variations in pneumococcal seroepidemiology that can occur over a period of decades. 10 Prospective studies and prospectively collected surveillance on both invasive pneumococcal disease and nonbacteremic pneumonia that met our inclusion and exclusion criteria were selected. IPD was defined as pneumococcal isolates from a normally sterile source, and meningitis was considered a subset of IPD.…”

Section: Methodsmentioning

confidence: 99%

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

Tam

Thielen

Obaro

et al. 2017

Vaccine

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Background Determining the incidence, disease-associated serotypes and antimicrobial susceptibility of invasive pneumococcal disease (IPD) among children in Africa is essential in order to monitor the impact of these infections prior to widespread introduction of the pneumococcal conjugate vaccine (PCV). Methods To provide updated estimates of the incidence, serotype distribution, and antimicrobial susceptibility profile of Streptococcus pneumoniae causing disease in Africa, we performed a systematic review of articles published from 2000–2015 using Ovid Medline and Embase. We included prospective and surveillance studies that applied predefined diagnostic criteria. Meta-analysis for all pooled analyses was based on random-effects models. Results We included 38 studies consisting of 386,880 participants in 21 countries over a total of 350,613 person-years. The pooled incidence of IPD was 62.6 (95% CI 16.9, 226.5) per 100,000 person-years, including meningitis which had a pooled incidence of 24.7 (95% CI 11.9, 51.6) per 100,000 person-years. The pooled prevalence of penicillin susceptibility was 78.1% (95% CI 61.9, 89.2). Cumulatively, PCV10 and PCV13 included 66.9% (95% CI 55.9, 76.7) and 80.6% (95% CI 66.3, 90.5) of IPD serotypes, respectively. Conclusions Our study provides an integrated and robust summary of incidence data, serotype distribution and antimicrobial susceptibility for S. pneumoniae in children ≤5 years of age in Africa prior to widespread introduction of PCV on the continent. The heterogeneity of studies and wide range of incidence rates across the continent indicate that surveillance efforts should be intensified in all regions of Africa to improve the integrity of epidemiologic data, vaccine impact and cost benefit. Although the incidence of IPD in young children in Africa is substantial, currently available conjugate vaccines are estimated to cover the majority of invasive disease-causing pneumococcal serotypes. These data provide a reliable baseline from which to monitor the impact of the broad introduction of PCV.

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“…The majority of these deaths occur in developing countries. 2 Furthermore, hospitalization for pneumonia and use of medical services for otitis media constitute a considerable economic burden, particularly among the very young population (<5 years old). 3,4 Nasopharyngeal (NP) carriage of S. pneumoniae precedes disease and is the source of pneumococcal spread in the community.…”

Section: Introductionmentioning

confidence: 99%

Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

Ben‐Shimol

Givon-Lavi

Greenberg

et al. 2015

Human Vaccines & Immunotherapeutics

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The 7-valent and the 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) were introduced to the Israeli National Immunization plan in July 2009 and November 2010, respectively. Our aim was to assess pneumococcal conjugate vaccines (PCVs) uptake and dynamics in serotype-specific pneumococcal nasopharyngeal (NP) carriage in children <5 years old in southern Israel, during the immediate 5 y following PCV introduction. This was an ongoing, prospective, population-based, active surveillance, from July 2009 through December 2014. PCVs uptake and NP cultures were obtained daily from children seen at the Pediatric Emergency Room for any reason. Overall, 10,702 vaccine status and 7,610 NP swabs were obtained. Both PCV7 and PCV13 uptake were high, reaching~90% by July 2012 and December 2013, respectively. All-pneumococcal carriage rates significantly declined by 10%, from 54.3% in the early-PCV7 period, to 49.1% in the PCV13 impact period. The respective declines for PCV7, 6A and additional PCV13 serotypes carriage rates were 76%, 90% and 66%. In contrast, non-PCV13 serotypes carriage rates increased significantly throughout the study by 71%. All-pneumococcal carriage rates in children <12 months old decreased significantly by 15%, with similar trends observed in other age groups. Initially, all-pneumococcal carriage rates were 45.7%, and 61.9% in Jewish and Bedouin children, respectively (P < 0.001), with a significant 17% reduction throughout the study observed only in Bedouins. While early carriage rates were higher in unvaccinated children compared to vaccinated children, PCV impact on carriage were similar in both groups. In conclusion, a relatively moderate decline in pneumococcal carriage rates, facilitated by a substantial decrease of vaccine-serotypes and increase of non-vaccine serotypes was observed in the immediate period following PCVs introduction in southern Israel.

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Use of Pneumococcal Disease Epidemiology to Set Policy and Prevent Disease during 20 Years of the Emerging Infections Program

Abstract: This program has been a flexible platform for following trends of this disease and evaluating vaccine effectiveness.

Cited by 14 publications

References 33 publications

The multifaceted impact of pneumococcal conjugate vaccine implementation in children in France between 2001 to 2014

The multifaceted impact of pneumococcal conjugate vaccine implementation in children in France between 2001 to 2014

Childhood pneumococcal disease in Africa – A systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility

Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

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