Tolulope A Adebanjo1,2, Tracy Pondo1, David Yankey2, Holly A Hill2, Ryan Gierke1, Mirasol Apostol3, Meghan Barnes4, Susan Petit5, Monica Farley6, Lee H Harrison7, Corinne Holtzman8, Joan Baumbach9, Nancy Bennett10, Suzanne McGuire11, Ann Thomas12, William Schaffner13, Bernard Beall2, Cynthia G Whitney2, Tamara Pilishvili14. 1. Epidemic Intelligence Service and. 2. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. 3. California Emerging Infections Program, Oakland, California. 4. Colorado Department of Public Health and Environment, Denver, Colorado. 5. Connecticut Department of Public Health, Hartford, Connecticut. 6. School of Medicine, Emory University and Atlanta Department of Veterans Affairs Medical Center, Atlanta, Georgia. 7. Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. 8. Minnesota Department of Health, St Paul, Minnesota. 9. New Mexico Department of Health, Santa Fe, New Mexico. 10. School of Medicine and Dentistry, University of Rochester, Rochester, New York. 11. New York State Department of Health, Albany, New York. 12. Oregon Public Health Division, Portland, Oregon; and. 13. Vanderbilt University, Nashville, Tennessee. 14. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; tdp4@cdc.gov.
Abstract
BACKGROUND: Most countries use 3-dose pneumococcal conjugate vaccine (PCV) schedules; a 4-dose (3 primary and 1 booster) schedule is licensed for US infants. We evaluated the invasive pneumococcal disease (IPD) breakthrough infection incidence in children receiving 2 vs 3 primary PCV doses with and without booster doses (2 + 1 vs 3 + 1; 2 + 0 vs 3 + 0). METHODS: We used 2001-2016 Active Bacterial Core surveillance data to identify breakthrough infections (vaccine-type IPD in children receiving ≥1 7-valent pneumococcal conjugate vaccine [PCV7] or 13-valent pneumococcal conjugate vaccine [PCV13] dose) among children aged <5 years. We estimated schedule-specific IPD incidence rates (IRs) per 100 000 person-years and compared incidence by schedule (2 + 1 vs 3 + 1; 2 + 0 vs 3 + 0) using rate differences (RDs) and incidence rate ratios. RESULTS: We identified 71 PCV7 and 49 PCV13 breakthrough infections among children receiving a schedule of interest. PCV13 breakthrough infection rates were higher in children aged <1 year receiving the 2 + 0 (IR: 7.8) vs 3 + 0 (IR: 0.6) schedule (incidence rate ratio: 12.9; 95% confidence interval: 4.1-40.4); PCV7 results were similar. Differences in PCV13 breakthrough infection rates by schedule in children aged <1 year were larger in 2010-2011 (2 + 0 IR: 18.6; 3 + 0 IR: 1.4; RD: 16.6) vs 2012-2016 (2 + 0 IR: 3.6; 3 + 0 IR: 0.2; RD: 3.4). No differences between schedules were detected in children aged ≥1 year for PCV13 breakthrough infections. CONCLUSIONS: Fewer PCV breakthrough infections occurred in the first year of life with 3 primary doses. Differences in breakthrough infection rates by schedule decreased as vaccine serotypes decreased in circulation.
BACKGROUND: Most countries use 3-dose pneumococcal conjugate vaccine (PCV) schedules; a 4-dose (3 primary and 1 booster) schedule is licensed for US infants. We evaluated the invasive pneumococcal disease (IPD) breakthrough infection incidence in children receiving 2 vs 3 primary PCV doses with and without booster doses (2 + 1 vs 3 + 1; 2 + 0 vs 3 + 0). METHODS: We used 2001-2016 Active Bacterial Core surveillance data to identify breakthrough infections (vaccine-type IPD in children receiving ≥1 7-valent pneumococcal conjugate vaccine [PCV7] or 13-valent pneumococcal conjugate vaccine [PCV13] dose) among children aged <5 years. We estimated schedule-specific IPD incidence rates (IRs) per 100 000 person-years and compared incidence by schedule (2 + 1 vs 3 + 1; 2 + 0 vs 3 + 0) using rate differences (RDs) and incidence rate ratios. RESULTS: We identified 71 PCV7 and 49 PCV13 breakthrough infections among children receiving a schedule of interest. PCV13 breakthrough infection rates were higher in children aged <1 year receiving the 2 + 0 (IR: 7.8) vs 3 + 0 (IR: 0.6) schedule (incidence rate ratio: 12.9; 95% confidence interval: 4.1-40.4); PCV7 results were similar. Differences in PCV13 breakthrough infection rates by schedule in children aged <1 year were larger in 2010-2011 (2 + 0 IR: 18.6; 3 + 0 IR: 1.4; RD: 16.6) vs 2012-2016 (2 + 0 IR: 3.6; 3 + 0 IR: 0.2; RD: 3.4). No differences between schedules were detected in children aged ≥1 year for PCV13 breakthrough infections. CONCLUSIONS: Fewer PCV breakthrough infections occurred in the first year of life with 3 primary doses. Differences in breakthrough infection rates by schedule decreased as vaccine serotypes decreased in circulation.
Authors: Matthew R Moore; Ruth Link-Gelles; William Schaffner; Ruth Lynfield; Corinne Holtzman; Lee H Harrison; Shelley M Zansky; Jennifer B Rosen; Arthur Reingold; Karen Scherzinger; Ann Thomas; Ramon E Guevara; Tasneem Motala; Jeffrey Eason; Meghan Barnes; Susan Petit; Monica M Farley; Lesley McGee; James H Jorgensen; Cynthia G Whitney Journal: Lancet Respir Med Date: 2016-03-14 Impact factor: 30.700
Authors: Matthew R Moore; Ruth Link-Gelles; William Schaffner; Ruth Lynfield; Catherine Lexau; Nancy M Bennett; Susan Petit; Shelley M Zansky; Lee H Harrison; Arthur Reingold; Lisa Miller; Karen Scherzinger; Ann Thomas; Monica M Farley; Elizabeth R Zell; Thomas H Taylor; Tracy Pondo; Loren Rodgers; Lesley McGee; Bernard Beall; James H Jorgensen; Cynthia G Whitney Journal: Lancet Infect Dis Date: 2015-02-03 Impact factor: 25.071
Authors: Holly A Hill; Laurie D Elam-Evans; David Yankey; James A Singleton; Yoonjae Kang Journal: MMWR Morb Mortal Wkly Rep Date: 2017-11-03 Impact factor: 17.586