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Pneumococcal serotype evolution in Western Europe.
BMC Infect Dis. 2015 Oct 14; 15:419.BI

Abstract

BACKGROUND

Pneumococcal diseases remain a leading cause of vaccine-preventable death worldwide in children <5 years of age. The seven-valent pneumococcal conjugate vaccine (PCV7) was approved in 2001 in Europe and was introduced into the national immunization programmes of many European countries from 2006-2008. In 2009, higher-valent PCVs (PCV10 and PCV13) became available, replacing PCV7 from 2009-2011. This article describes the evolution of vaccine and non-vaccine serotypes causing invasive pneumococcal disease (IPD) following the introduction of PCVs in Western Europe, based on data from publicly-available medical publications and national surveillance systems from January 2010 to May 2015.

DISCUSSION

In countries with high vaccine uptake, 5-7 years after PCV7 introduction IPD caused by vaccine serotypes has almost disappeared in children. Non-PCV7 serotypes have emerged, particularly serotypes 19A, 7 F, 3 and 1. A rapid and significant reduction of the additional serotypes included in higher-valent vaccines has been observed consistently following the introduction of these vaccines. A significant and rapid decline of serotypes 19A, 7 F, 1 and 6A in both vaccine-eligible and older age groups has been observed in countries using PCV13 while serotype 19A and 3 has increased in countries using PCV10. Serotype 3 has become one of the most prevalent serotypes in adults, with some reduction only in the UK and France. Serotype diversity increased and varied by age group, the type of vaccine in use, and the time since the introduction of higher-valent PCVs. Serotypes that are currently more frequent include 24 F, 22 F, 8 and 15A in countries that use PCV13, and serotypes 19A and 3 in countries that use PCV10. Compared with the time before the introduction of higher valent PCVs, to date, there is no single '19A-like' serotype emerging across countries and most of the newly emerging non-PCV13 vaccine types are less invasive with a low case-carrier ratio.

CONCLUSIONS

It is important to closely monitor not only evolving serotypes but also the magnitude of the effect in order to evaluate the overall impact of pneumococcal vaccination programmes and to initiate the appropriate vaccination strategy. Emerging serotypes may also need to be considered for the future development of new vaccines.

Authors+Show Affiliations

Pfizer Vaccines, Medical Development Group and Scientific Affairs, 23-25 avenue du Dr. Lannelongue, F-75668, Paris, Cedex 14, France. Myint.TinTinHtar@pfizer.com.Pfizer Vaccines, Medical Development Group and Scientific Affairs, 23-25 avenue du Dr. Lannelongue, F-75668, Paris, Cedex 14, France. dina.christopoulou@pfizer.com.Pfizer Vaccines, Medical Development Group and Scientific Affairs, 23-25 avenue du Dr. Lannelongue, F-75668, Paris, Cedex 14, France. Joe.Schmitt@pfizer.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

26468008

Citation

Tin Tin Htar, Myint, et al. "Pneumococcal Serotype Evolution in Western Europe." BMC Infectious Diseases, vol. 15, 2015, p. 419.
Tin Tin Htar M, Christopoulou D, Schmitt HJ. Pneumococcal serotype evolution in Western Europe. BMC Infect Dis. 2015;15:419.
Tin Tin Htar, M., Christopoulou, D., & Schmitt, H. J. (2015). Pneumococcal serotype evolution in Western Europe. BMC Infectious Diseases, 15, 419. https://doi.org/10.1186/s12879-015-1147-x
Tin Tin Htar M, Christopoulou D, Schmitt HJ. Pneumococcal Serotype Evolution in Western Europe. BMC Infect Dis. 2015 Oct 14;15:419. PubMed PMID: 26468008.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pneumococcal serotype evolution in Western Europe. AU - Tin Tin Htar,Myint, AU - Christopoulou,Dina, AU - Schmitt,Heinz-Josef, Y1 - 2015/10/14/ PY - 2015/08/07/received PY - 2015/09/24/accepted PY - 2015/10/16/entrez PY - 2015/10/16/pubmed PY - 2016/5/18/medline SP - 419 EP - 419 JF - BMC infectious diseases JO - BMC Infect Dis VL - 15 N2 - BACKGROUND: Pneumococcal diseases remain a leading cause of vaccine-preventable death worldwide in children <5 years of age. The seven-valent pneumococcal conjugate vaccine (PCV7) was approved in 2001 in Europe and was introduced into the national immunization programmes of many European countries from 2006-2008. In 2009, higher-valent PCVs (PCV10 and PCV13) became available, replacing PCV7 from 2009-2011. This article describes the evolution of vaccine and non-vaccine serotypes causing invasive pneumococcal disease (IPD) following the introduction of PCVs in Western Europe, based on data from publicly-available medical publications and national surveillance systems from January 2010 to May 2015. DISCUSSION: In countries with high vaccine uptake, 5-7 years after PCV7 introduction IPD caused by vaccine serotypes has almost disappeared in children. Non-PCV7 serotypes have emerged, particularly serotypes 19A, 7 F, 3 and 1. A rapid and significant reduction of the additional serotypes included in higher-valent vaccines has been observed consistently following the introduction of these vaccines. A significant and rapid decline of serotypes 19A, 7 F, 1 and 6A in both vaccine-eligible and older age groups has been observed in countries using PCV13 while serotype 19A and 3 has increased in countries using PCV10. Serotype 3 has become one of the most prevalent serotypes in adults, with some reduction only in the UK and France. Serotype diversity increased and varied by age group, the type of vaccine in use, and the time since the introduction of higher-valent PCVs. Serotypes that are currently more frequent include 24 F, 22 F, 8 and 15A in countries that use PCV13, and serotypes 19A and 3 in countries that use PCV10. Compared with the time before the introduction of higher valent PCVs, to date, there is no single '19A-like' serotype emerging across countries and most of the newly emerging non-PCV13 vaccine types are less invasive with a low case-carrier ratio. CONCLUSIONS: It is important to closely monitor not only evolving serotypes but also the magnitude of the effect in order to evaluate the overall impact of pneumococcal vaccination programmes and to initiate the appropriate vaccination strategy. Emerging serotypes may also need to be considered for the future development of new vaccines. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/26468008/Pneumococcal_serotype_evolution_in_Western_Europe_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-1147-x DB - PRIME DP - Unbound Medicine ER -