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Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom.
J Infect Dis. 2020 03 28; 221(8):1361-1370.JI

Abstract

BACKGROUND

Following programmatic introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), there is residual carriage and disease due to PCV13-covered serotypes.

METHODS

PCV13-immunized children aged 13-48 months, N = 988, were enrolled between February 2014 and August 2015 ("late PCV13"), and had nasopharyngeal pneumococcal carriage compared with 7-valent pneumococcal conjugate vaccine (PCV7) immunized children, N = 567, enrolled between November 2010 and September 2011 ("early PCV13"). Nasopharyngeal pneumococci were molecular-serotyped by microarray. Invasive pneumococcal disease (IPD) cases were identified through enhanced national surveillance.

RESULTS

Compared with PCV7-immunized children, carriage among PCV13-immunized children was significantly lower for serotypes 19A (odds ratio [OR], 0.08 [95% confidence interval {CI}, .02-.25]), 6C (OR, 0.11 [95% CI, .03-.32]), and 7F (8 vs 0 cases). IPD incidence in children <5 years was significantly lower for serotypes 1 (incidence rate ratio [IRR], 0.03 [95% CI, 0-.19]) and 7F (IRR, 0.13 [95% CI, .05-.36]) but not 19A (IRR, 0.6 [95% CI, .3-1.12]) or serotype 3 (IRR, 2.3 [95% CI, .86-6.15]) in the late PCV13 period than in the early PCV13 period. The most significant rises in IPD incidence were for serotypes 8, 12F, and 24F.

CONCLUSIONS

PCV13 has reduced serotype 19A carriage among vaccinated children. We found no impact of PCV13 on serotype 3 carriage or disease, and emergence of non-PCV13-serotype disease.

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Authors+Show Affiliations

Kandasamy R
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford.
Voysey M
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford. Nuffield Department of Primary Care Health Sciences, University of Oxford.
Collins S
Public Health England, London, United Kingdom.
Berbers G
Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Robinson H
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford.
Noel I
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford.
Hughes H
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford.
Ndimah S
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford.
Gould K
Institute for Infection and Immunity, St George's, University of London. BUGS Bioscience, London Bioscience Innovation Centre, United Kingdom.
Fry N
Public Health England, London, United Kingdom.
Sheppard C
Public Health England, London, United Kingdom.
Ladhani S
Public Health England, London, United Kingdom.
Snape MD
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford.
Hinds J
Institute for Infection and Immunity, St George's, University of London. BUGS Bioscience, London Bioscience Innovation Centre, United Kingdom.
Pollard AJ
Oxford Vaccine Group, Department of Paediatrics, University of Oxford. National Institute for Health Research Oxford Biomedical Research Centre, Oxford.

MeSH

Carrier StateChild, PreschoolCross-Sectional StudiesFemaleHeptavalent Pneumococcal Conjugate VaccineHumansImmunizationIncidenceInfantMaleNasopharynxPneumococcal InfectionsPneumococcal VaccinesSerogroupStreptococcus pneumoniaeUnited KingdomVaccinationVaccines, Conjugate

Pub Type(s)

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

Language

eng

PubMed ID

31004136

Clinical Trial Links

Understanding Pneumococcal Carriage and Disease

Citation

Kandasamy, Rama, et al. "Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom." The Journal of Infectious Diseases, vol. 221, no. 8, 2020, pp. 1361-1370.
Kandasamy R, Voysey M, Collins S, et al. Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom. J Infect Dis. 2020;221(8):1361-1370.
Kandasamy, R., Voysey, M., Collins, S., Berbers, G., Robinson, H., Noel, I., Hughes, H., Ndimah, S., Gould, K., Fry, N., Sheppard, C., Ladhani, S., Snape, M. D., Hinds, J., & Pollard, A. J. (2020). Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom. The Journal of Infectious Diseases, 221(8), 1361-1370. https://doi.org/10.1093/infdis/jiz178
Kandasamy R, et al. Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom. J Infect Dis. 2020 03 28;221(8):1361-1370. PubMed PMID: 31004136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom. AU - Kandasamy,Rama, AU - Voysey,Merryn, AU - Collins,Sarah, AU - Berbers,Guy, AU - Robinson,Hannah, AU - Noel,Irene, AU - Hughes,Harri, AU - Ndimah,Susan, AU - Gould,Katherine, AU - Fry,Norman, AU - Sheppard,Carmen, AU - Ladhani,Shamez, AU - Snape,Matthew D, AU - Hinds,Jason, AU - Pollard,Andrew J, PY - 2018/11/12/received PY - 2019/04/14/accepted PY - 2019/4/21/pubmed PY - 2021/1/23/medline PY - 2019/4/21/entrez KW - adults KW - carriage KW - children KW - disease KW - invasive KW - pneumococcus KW - seroprevalence SP - 1361 EP - 1370 JF - The Journal of infectious diseases JO - J Infect Dis VL - 221 IS - 8 N2 - BACKGROUND: Following programmatic introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), there is residual carriage and disease due to PCV13-covered serotypes. METHODS: PCV13-immunized children aged 13-48 months, N = 988, were enrolled between February 2014 and August 2015 ("late PCV13"), and had nasopharyngeal pneumococcal carriage compared with 7-valent pneumococcal conjugate vaccine (PCV7) immunized children, N = 567, enrolled between November 2010 and September 2011 ("early PCV13"). Nasopharyngeal pneumococci were molecular-serotyped by microarray. Invasive pneumococcal disease (IPD) cases were identified through enhanced national surveillance. RESULTS: Compared with PCV7-immunized children, carriage among PCV13-immunized children was significantly lower for serotypes 19A (odds ratio [OR], 0.08 [95% confidence interval {CI}, .02-.25]), 6C (OR, 0.11 [95% CI, .03-.32]), and 7F (8 vs 0 cases). IPD incidence in children <5 years was significantly lower for serotypes 1 (incidence rate ratio [IRR], 0.03 [95% CI, 0-.19]) and 7F (IRR, 0.13 [95% CI, .05-.36]) but not 19A (IRR, 0.6 [95% CI, .3-1.12]) or serotype 3 (IRR, 2.3 [95% CI, .86-6.15]) in the late PCV13 period than in the early PCV13 period. The most significant rises in IPD incidence were for serotypes 8, 12F, and 24F. CONCLUSIONS: PCV13 has reduced serotype 19A carriage among vaccinated children. We found no impact of PCV13 on serotype 3 carriage or disease, and emergence of non-PCV13-serotype disease. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/31004136/Persistent_Circulation_of_Vaccine_Serotypes_and_Serotype_Replacement_After_5_Years_of_Infant_Immunization_With_13_Valent_Pneumococcal_Conjugate_Vaccine_in_the_United_Kingdom_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiz178 DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓19]

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