Effect of Pneumococcal Conjugate Vaccination on Serotype-Specific Carriage and Invasive Disease in England: A Cross-Sectional Study

English version České info

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

disease should be part of enhanced surveillance activities for PCVs.

:
Please see later in the article for the Editors' Summary

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