Effect of Pneumococcal Conjugate Vaccination on Serotype-Specific Carriage and Invasive Disease in England: A Cross-Sectional Study
Background:
We investigated the effect of the 7-valent pneumococcal conjugate vaccine
(PCV7) programme in England on serotype-specific carriage and invasive
disease to help understand its role in serotype replacement and predict the
impact of higher valency vaccines.
Methods and Findings:
Nasopharyngeal swabs were taken from children <5 y old and family members
(n = 400) 2 y after introduction
of PCV7 into routine immunization programs. Proportions carrying
Streptococcus pneumoniae and serotype distribution
among carried isolates were compared with a similar population prior to PCV7
introduction. Serotype-specific case∶carrier ratios (CCRs) were
estimated using national data on invasive disease. In vaccinated children
and their contacts vaccine-type (VT) carriage decreased, but was offset by
an increase in non-VT carriage, with no significant overall change in
carriage prevalence, odds ratio 1.06 (95% confidence interval
0.76–1.49). The lower CCRs of the replacing serotypes resulted in a
net reduction in invasive disease in children. The additional serotypes
covered by higher valency vaccines had low carriage but high disease
prevalence. Serotype 11C emerged as predominant in carriage but caused no
invasive disease whereas 8, 12F, and 22F emerged in disease but had very low
carriage prevalence.
Conclusion:
Because the additional serotypes included in PCV10/13 have high CCRs but low
carriage prevalence, vaccinating against them is likely to significantly
reduce invasive disease with less risk of serotype replacement. However, a
few serotypes with high CCRs could mitigate the benefits of higher valency
vaccines. Assessment of the effect of PCV on carriage as well as invasive
disease should be part of enhanced surveillance activities for PCVs.
:
Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Effect of Pneumococcal Conjugate Vaccination on Serotype-Specific Carriage and Invasive Disease in England: A Cross-Sectional Study. PLoS Med 8(4): e32767. doi:10.1371/journal.pmed.1001017
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1001017
Souhrn
Background:
We investigated the effect of the 7-valent pneumococcal conjugate vaccine
(PCV7) programme in England on serotype-specific carriage and invasive
disease to help understand its role in serotype replacement and predict the
impact of higher valency vaccines.
Methods and Findings:
Nasopharyngeal swabs were taken from children <5 y old and family members
(n = 400) 2 y after introduction
of PCV7 into routine immunization programs. Proportions carrying
Streptococcus pneumoniae and serotype distribution
among carried isolates were compared with a similar population prior to PCV7
introduction. Serotype-specific case∶carrier ratios (CCRs) were
estimated using national data on invasive disease. In vaccinated children
and their contacts vaccine-type (VT) carriage decreased, but was offset by
an increase in non-VT carriage, with no significant overall change in
carriage prevalence, odds ratio 1.06 (95% confidence interval
0.76–1.49). The lower CCRs of the replacing serotypes resulted in a
net reduction in invasive disease in children. The additional serotypes
covered by higher valency vaccines had low carriage but high disease
prevalence. Serotype 11C emerged as predominant in carriage but caused no
invasive disease whereas 8, 12F, and 22F emerged in disease but had very low
carriage prevalence.
Conclusion:
Because the additional serotypes included in PCV10/13 have high CCRs but low
carriage prevalence, vaccinating against them is likely to significantly
reduce invasive disease with less risk of serotype replacement. However, a
few serotypes with high CCRs could mitigate the benefits of higher valency
vaccines. Assessment of the effect of PCV on carriage as well as invasive
disease should be part of enhanced surveillance activities for PCVs.
:
Please see later in the article for the Editors' Summary
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