Literature DB >> 30321313

Differences in the Impact of Pneumococcal Serotype Replacement in Individuals With and Without Underlying Medical Conditions.

Daniel M Weinberger1, Joshua L Warren2, Tine Dalby3, Eugene D Shapiro1,4, Palle Valentiner-Branth5, Hans-Christian Slotved3, Zitta Barrella Harboe3,6.   

Abstract

BACKGROUND: Pneumococcal conjugate vaccines (PCVs) have had a well-documented impact on the incidence of invasive pneumococcal disease (IPD). However, declines in IPD due to vaccine-targeted serotypes have been partially offset by increases in IPD due to nonvaccine serotypes (NVTs). The goal of this study was to quantify serotype-specific changes in the incidence of IPD that occurred in different age groups, with or without certain comorbidities, following the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) in the childhood vaccination program in Denmark.
METHODS: We used nationwide surveillance data for IPD and a hierarchical Bayesian regression framework to estimate changes in the incidence of IPD associated with the introduction of PCV7 (2007) and PCV13 (2010) while controlling for serotype-specific epidemic cycles and unrelated secular trends.
RESULTS: Following the introduction of PCV7 and PCV13 in children, the net impact of serotype replacement varied considerably by age group and comorbidities. Differences in the magnitude of serotype replacement were due to variations in the incidence of NVTs in the different risk groups before the introduction of PCVs. The relative increases in the incidence of IPD caused by specific NVTs did not differ appreciably between risk groups in the postvaccination period. Serotype replacement offset a greater proportion of the benefit of PCVs in strata in which the NVTs comprised a larger proportion of cases prior to the introduction of the vaccines.
CONCLUSIONS: These findings could help to predict the impact of next-generation PCVs in specific risk groups.
© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Entities:  

Keywords:  Bayesian hierarchical model; conjugate vaccines; pneumococcus; serotype replacement

Mesh:

Substances:

Year:  2019        PMID: 30321313      PMCID: PMC6579958          DOI: 10.1093/cid/ciy875

Source DB:  PubMed          Journal:  Clin Infect Dis        ISSN: 1058-4838            Impact factor:   9.079


  21 in total

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Authors:  Zitta B Harboe; Thomas L Benfield; Palle Valentiner-Branth; Thomas Hjuler; Lotte Lambertsen; Margit Kaltoft; Karen Krogfelt; Hans Christian Slotved; Jens Jørgen Christensen; Helle B Konradsen
Journal:  Clin Infect Dis       Date:  2010-02-01       Impact factor: 9.079

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