The changing epidemiology of invasive pneumococcal disease after PCV13 vaccination in a country with intermediate vaccination coverage

Pilar Ciruela, Conchita Izquierdo, Sonia Broner, Carmen Muñoz-Almagro, Sergi Hernández, Carmen Ardanuy, Roman Pallarés, Angela Domínguez, Mireia Jané, Cristina Esteva, Mariona Fernández de Sevilla, Desiree Henares, Immaculada Grau, Francesc Marco, Jaume Llaberia, Araceli González-Cuevas, Alvaro Díaz, Maria Teresa Martin, Montserrat Sierra, Margarida CurriuCarme Gallés, Pilar Hernández, Paula Gassiot, Matilde Martínez-Zurita, Carmina Martí, Montserrat Morta, Goretti Sauca, Asunción Gassós, Esther Sanfeliu, Frederic Ballester, Isabel Pujol, Montserrat Olsina, Xavier Raga, Frederic Gómez-Bertomeu, Mar Olga Pérez-Moreno, Anna Vilamala, Marian Navarro, Mercè Ribelles, Eduardo Padilla, Nuria Prim, Dionisia Fontanals, Miguel Angel Benítez, Eulalia Jou, Carmina Sanjosé, Montserrat Giménez, Maria Dolores Quesada, Jose Carlos de la Fuente, Ana Calderon, Percy Juan Ayala, Laia Vega, Josefa Pérez-Jové, Conchita Balado, Ines Valle

Research output: Contribution to journalArticleResearch

16 Citations (Scopus)

Abstract

© 2018 Elsevier Ltd Background: We studied the impact of 13-valent pneumococcal conjugate vaccine (PCV13) on the incidence of invasive pneumococcal disease (IPD) and serotype distribution in a region with intermediate levels of vaccination (around 64% in children aged <2 years). Methods: Surveillance data on IPD cases reported by microbiologists participating in the Microbiological Reporting System of Catalonia during 2006–2014 were analysed. We compared estimated incidence rate (IR) ratios for serotypes included in PCV7, PCV10non7, PCV13non10 and non-PCV13 between the PCV7 (2006–2009) and PCV13 periods (2010–2014). IR were corrected for missing serotypes according to year and age groups: <2 years, 2–4 years, 5–64 years and ≥65 years. Results: A total of 9338 IPD cases were reported. Overall IPD incidence declined by 26.2% (from 16.4 to 12.1) in the PCV13 period. The largest decrease was observed in children aged 2–4 years (44.5%, from 37.4 to 20.8). Pneumonia fell in all age groups with the largest reduction in children aged 2–4 years (49.3%) and <2 years (42%). PCV13 serotypes decreased significantly in all age groups, from 52% (31.6 to 15.1) in children aged 2–4 years to 35% (22.8 to 14.8) in adults aged ≥65 years. Non-PCV13 serotypes rose by 13% (14.8 to 16.8) in people aged ≥65 years. Conclusions: In a region with intermediate vaccination coverage, the introduction of PCV13 has reduced the overall incidence of IPD, mainly due to the decrease in PCV13 serotypes in all age groups, suggesting herd immunity. Non-PCV13 serotypes have increased in adults aged ≥65 years, suggesting serotype replacement. Higher PCV13 vaccination coverage in children will further reduce IPD incidence in all age groups.
Original languageEnglish
Pages (from-to)7744-7752
JournalVaccine
Volume36
DOIs
Publication statusPublished - 29 Nov 2018

Keywords

  • Impact
  • IPD
  • PCV13
  • PCV7
  • Serotype distribution
  • Streptococcus pneumoniae
  • Vaccine

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