Arto A Palmu1, Terhi M Kilpi2, Hanna Rinta-Kokko2, Hanna Nohynek2, Maija Toropainen3, J Pekka Nuorti4, Jukka Jokinen2. 1. Department of Health Protection, National Institute for Health and Welfare, Tampere, Finland; arto.palmu@thl.fi. 2. Department of Health Protection, National Institute for Health and Welfare, Helsinki, Finland; 3. Department of Infectious Diseases, National Institute for Health and Welfare, Helsinki, Finland; and. 4. Department of Infectious Diseases, National Institute for Health and Welfare, Helsinki, Finland; and Department of Epidemiology, School of Health Sciences, University of Tampere, Finland.
Abstract
OBJECTIVE: Ten-valent pneumococcal conjugate vaccine (PCV10) was earlier shown to reduce clinically suspected, non-laboratory-confirmed invasive pneumococcal disease (IPD) in a cluster-randomized trial (the Finnish Invasive Pneumococcal disease trial). PCV10 was introduced into the Finnish national vaccination program in September 2010 using a 3-dose schedule. We evaluated the impact of PCV10 on clinically suspected IPD among vaccine-eligible children in a population-based nationwide study. METHODS: The target cohort eligible for vaccination program (children born June 2010-September 2013) was compared with 2 season- and age-matched (ages 3-42 months) reference cohorts before PCV10 introduction. The trial period (January 2009-August 2010) was excluded. Hospitals' inpatient and outpatient discharge notifications with International Classification of Diseases, 10th Revision, diagnoses compatible with IPD (A40.3/B95.3/G00.1/M00.1) and unspecified sepsis (A40.9/A41.9/A49.9/G00/G00.9/I30.1/M00/M00.9/B95.5) were collected from the national Care Register. Laboratory-confirmed IPD cases were excluded. Rates of register-based non-laboratory-confirmed IPD (or unspecified sepsis) before and after PCV10 implementation were calculated. RESULTS: The rate of register-based non-laboratory-confirmed IPD episodes was 32 in 100 000 person-years in the vaccine-eligible target cohort and 94 in the combined reference cohorts. Relative rate reduction was 66% (95% confidence interval: 59-73) and absolute rate reduction 62 in 100 000 person-years. For the more sensitive case definition of register-based non-laboratory-confirmed IPD or unspecified sepsis, the relative rate reduction was 34% (95% confidence interval 29-39), but the absolute reduction was as high as 122 in 100 000 person-years. CONCLUSIONS: This is the first report demonstrating nationwide PCV impact on clinically suspected IPD during routine vaccination program. The large absolute rate reductions observed have major implications for cost-effectiveness of PCVs.
RCT Entities:
OBJECTIVE: Ten-valent pneumococcal conjugate vaccine (PCV10) was earlier shown to reduce clinically suspected, non-laboratory-confirmed invasive pneumococcal disease (IPD) in a cluster-randomized trial (the Finnish Invasive Pneumococcal disease trial). PCV10 was introduced into the Finnish national vaccination program in September 2010 using a 3-dose schedule. We evaluated the impact of PCV10 on clinically suspected IPD among vaccine-eligible children in a population-based nationwide study. METHODS: The target cohort eligible for vaccination program (children born June 2010-September 2013) was compared with 2 season- and age-matched (ages 3-42 months) reference cohorts before PCV10 introduction. The trial period (January 2009-August 2010) was excluded. Hospitals' inpatient and outpatient discharge notifications with International Classification of Diseases, 10th Revision, diagnoses compatible with IPD (A40.3/B95.3/G00.1/M00.1) and unspecifiedsepsis (A40.9/A41.9/A49.9/G00/G00.9/I30.1/M00/M00.9/B95.5) were collected from the national Care Register. Laboratory-confirmed IPD cases were excluded. Rates of register-based non-laboratory-confirmed IPD (or unspecifiedsepsis) before and after PCV10 implementation were calculated. RESULTS: The rate of register-based non-laboratory-confirmed IPD episodes was 32 in 100 000 person-years in the vaccine-eligible target cohort and 94 in the combined reference cohorts. Relative rate reduction was 66% (95% confidence interval: 59-73) and absolute rate reduction 62 in 100 000 person-years. For the more sensitive case definition of register-based non-laboratory-confirmed IPD or unspecifiedsepsis, the relative rate reduction was 34% (95% confidence interval 29-39), but the absolute reduction was as high as 122 in 100 000 person-years. CONCLUSIONS: This is the first report demonstrating nationwide PCV impact on clinically suspected IPD during routine vaccination program. The large absolute rate reductions observed have major implications for cost-effectiveness of PCVs.
Authors: Janepsy Diaz; Solana Terrazas; Ana L Bierrenbach; Cristiana M Toscano; Gizelton P Alencar; Andrés Alvarez; Maria T Valenzuela; Jon Andrus; Roberto del Aguila; Juan C Hormazábal; Pamela Araya; Paola Pidal; Cuauhtemoc R Matus; Lucia H de Oliveira Journal: PLoS One Date: 2016-04-08 Impact factor: 3.240
Authors: R Reyburn; E J Tuivaga; F T Ratu; E M Dunne; D Nand; J Kado; K Jenkins; L Tikoduadua; A Jenney; B P Howden; S A Ballard; K Fox; R Devi; C Satzke; E Rafai; M Kama; S Flasche; E K Mulholland; F M Russell Journal: Lancet Reg Health West Pac Date: 2022-01-05
Authors: Lucia Helena de Oliveira; Luiz Antonio B Camacho; Evandro S F Coutinho; Martha S Martinez-Silveira; Ana Flavia Carvalho; Cuauhtemoc Ruiz-Matus; Cristiana M Toscano Journal: PLoS One Date: 2016-12-12 Impact factor: 3.240