Pilar Ciruela1, Sonia Broner2, Conchita Izquierdo3, Roman Pallarés4, Carmen Muñoz-Almagro5, Sergi Hernández6, Imma Grau7, Angela Domínguez8, Mireia Jané9. 1. Agència de Salut Pública de Catalunya, Generalitat de Catalunya, C/Roc Boronat, 81-95, 08005 Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, 28029 Madrid, Spain. Electronic address: pilar.ciruela@gencat.cat. 2. Agència de Salut Pública de Catalunya, Generalitat de Catalunya, C/Roc Boronat, 81-95, 08005 Barcelona, Spain. Electronic address: memergents@gencat.cat. 3. Agència de Salut Pública de Catalunya, Generalitat de Catalunya, C/Roc Boronat, 81-95, 08005 Barcelona, Spain. Electronic address: controlepidemiologic@gencat.cat. 4. Hospital Universitari Bellvitge, Universitat de Barcelona, C/Feixa Llarga s/n 08907, L'Hospitalet, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, 28029 Madrid, Spain. Electronic address: rpallares@ub.edu. 5. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, 28029 Madrid, Spain; Hospital Universitari Sant Joan de Déu, Pg. Sant Joan de Déu 2, 08950 Esplugues, Barcelona, Spain; Department of Medicine, Universitat Internacional de Catalunya, C/Josep Trueta, s/n 08195 Sant Cugat del Vallès, Barcelona, Spain. Electronic address: cma@hsjdbcn.org. 6. Agència de Salut Pública de Catalunya, Generalitat de Catalunya, C/Roc Boronat, 81-95, 08005 Barcelona, Spain. Electronic address: snmc@gencat.cat. 7. Hospital Universitari Bellvitge, Universitat de Barcelona, C/Feixa Llarga s/n 08907, L'Hospitalet, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, 28029 Madrid, Spain. Electronic address: igrau@ub.edu. 8. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, 28029 Madrid, Spain; Departament de Medicina, Universitat de Barcelona, C/Casanova, 143, 08036 Barcelona, Spain. Electronic address: angela.dominguez@ub.edu. 9. Agència de Salut Pública de Catalunya, Generalitat de Catalunya, C/Roc Boronat, 81-95, 08005 Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, 28029 Madrid, Spain. Electronic address: mireia.jane@gencat.cat.
Abstract
OBJECTIVES: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people ≥65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. METHODS: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. RESULTS: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age ≥85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and ≥1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). CONCLUSIONS: The incidence of IPD in people ≥65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, ≥1 high-risk condition, and PCV13 serotypes.
OBJECTIVES: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people ≥65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. METHODS: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. RESULTS: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age ≥85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and ≥1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). CONCLUSIONS: The incidence of IPD in people ≥65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, ≥1 high-risk condition, and PCV13 serotypes.
Authors: Germaine Hanquet; Pavla Krizova; Tina Dalby; Shamez N Ladhani; J Pekka Nuorti; Kostas Danis; Jolita Mereckiene; Mirjam J Knol; Brita A Winje; Pilar Ciruela; Sara de Miguel; Maria Eugenia Portillo; Laura MacDonald; Eva Morfeldt; Jana Kozakova; Palle Valentiner-Branth; Norman K Fry; Hanna Rinta-Kokko; Emmanuelle Varon; Mary Corcoran; Arie van der Ende; Didrik F Vestrheim; Carmen Munoz-Almagro; Juan-Carlos Sanz; Jesus Castilla; Andrew Smith; Birgitta Henriques-Normark; Edoardo Colzani; Lucia Pastore-Celentano; Camelia Savulescu Journal: Emerg Infect Dis Date: 2022-01 Impact factor: 6.883