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Effectiveness of the seven-valent and thirteen-valent pneumococcal conjugate vaccines in England: The indirect cohort design, 2006-2018.
Vaccine. 2019 07 26; 37(32):4491-4498.V

Abstract

BACKGROUND

The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the UK childhood immunisation programme in 2006 and replaced with a 13-valent vaccine (PCV13) in 2010. Both vaccines led to rapid declines in vaccine-serotype invasive pneumococcal disease (IPD). Here, we assessed the long-term vaccine-effectiveness (VE) of both vaccines in England.

METHODS

Public Health England conducts enhanced national surveillance of IPD in England. VE against IPD was estimated using vaccine-serotype IPD cases and non-vaccine serotype IPD controls among vaccine-eligible children from September 2006 to June 2018 (the Broome method).

RESULTS

Vaccine history was available for 3421 IPD cases, including 1299 due to the additional PCV13 serotypes and the PCV13-related serotype 6C, 274 PCV7 serotypes and 1848 non-PCV13 serotypes. For the complete 2 + 1 schedule, both PCV7 and PCV13 showed high effectiveness against PCV7 serotypes with a combined VE of 92.0% (95%CI, 81.7-96.7). For the 2 + 1 schedule, PCV13 VE against the additional PCV13 serotypes plus 6C was 73.7% (31.1-89.9) compared to 90.0% (75.3 - 96.0) for PCV7 against PCV7 serotypes, although PCV13 VE increased to 84.8% (58.7-94.4) if serotype 3 was excluded; all 36 eligible serotype 3 IPD cases were fully-vaccinated with PCV13. Case numbers were low in older ages but there was evidence of waning, which was significant for serotype 19A for which there were sufficient numbers of cases for analysis.

CONCLUSIONS

PCVs are highly effective in preventing vaccine-serotype IPD except for serotype 3 which has been increasing in incidence. Serotype 19A IPD has also persisted, likely due to a slightly lower VE and/or more rapid waning of protection.

Authors+Show Affiliations

Statistics, Modelling and Economics Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, UK.Immunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.Respiratory and Vaccine Preventable Bacterial Reference Unit, Public Health England, London, UK.Respiratory and Vaccine Preventable Bacterial Reference Unit, Public Health England, London, UK.Immunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, UK; Immunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK. Electronic address: shamez.ladhani@phe.gov.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31272872

Citation

Andrews, Nick, et al. "Effectiveness of the Seven-valent and Thirteen-valent Pneumococcal Conjugate Vaccines in England: the Indirect Cohort Design, 2006-2018." Vaccine, vol. 37, no. 32, 2019, pp. 4491-4498.
Andrews N, Kent A, Amin-Chowdhury Z, et al. Effectiveness of the seven-valent and thirteen-valent pneumococcal conjugate vaccines in England: The indirect cohort design, 2006-2018. Vaccine. 2019;37(32):4491-4498.
Andrews, N., Kent, A., Amin-Chowdhury, Z., Sheppard, C., Fry, N., Ramsay, M., & Ladhani, S. N. (2019). Effectiveness of the seven-valent and thirteen-valent pneumococcal conjugate vaccines in England: The indirect cohort design, 2006-2018. Vaccine, 37(32), 4491-4498. https://doi.org/10.1016/j.vaccine.2019.06.071
Andrews N, et al. Effectiveness of the Seven-valent and Thirteen-valent Pneumococcal Conjugate Vaccines in England: the Indirect Cohort Design, 2006-2018. Vaccine. 2019 07 26;37(32):4491-4498. PubMed PMID: 31272872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of the seven-valent and thirteen-valent pneumococcal conjugate vaccines in England: The indirect cohort design, 2006-2018. AU - Andrews,Nick, AU - Kent,Alison, AU - Amin-Chowdhury,Zahin, AU - Sheppard,Carmen, AU - Fry,Norman, AU - Ramsay,Mary, AU - Ladhani,Shamez N, Y1 - 2019/07/02/ PY - 2019/05/13/received PY - 2019/06/20/revised PY - 2019/06/23/accepted PY - 2019/7/6/pubmed PY - 2020/9/17/medline PY - 2019/7/6/entrez KW - Invasive pneumococcal disease KW - PCV13 KW - PCV7 KW - Pneumococcal conjugate vaccine KW - Vaccine effectiveness KW - Waning SP - 4491 EP - 4498 JF - Vaccine JO - Vaccine VL - 37 IS - 32 N2 - BACKGROUND: The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the UK childhood immunisation programme in 2006 and replaced with a 13-valent vaccine (PCV13) in 2010. Both vaccines led to rapid declines in vaccine-serotype invasive pneumococcal disease (IPD). Here, we assessed the long-term vaccine-effectiveness (VE) of both vaccines in England. METHODS: Public Health England conducts enhanced national surveillance of IPD in England. VE against IPD was estimated using vaccine-serotype IPD cases and non-vaccine serotype IPD controls among vaccine-eligible children from September 2006 to June 2018 (the Broome method). RESULTS: Vaccine history was available for 3421 IPD cases, including 1299 due to the additional PCV13 serotypes and the PCV13-related serotype 6C, 274 PCV7 serotypes and 1848 non-PCV13 serotypes. For the complete 2 + 1 schedule, both PCV7 and PCV13 showed high effectiveness against PCV7 serotypes with a combined VE of 92.0% (95%CI, 81.7-96.7). For the 2 + 1 schedule, PCV13 VE against the additional PCV13 serotypes plus 6C was 73.7% (31.1-89.9) compared to 90.0% (75.3 - 96.0) for PCV7 against PCV7 serotypes, although PCV13 VE increased to 84.8% (58.7-94.4) if serotype 3 was excluded; all 36 eligible serotype 3 IPD cases were fully-vaccinated with PCV13. Case numbers were low in older ages but there was evidence of waning, which was significant for serotype 19A for which there were sufficient numbers of cases for analysis. CONCLUSIONS: PCVs are highly effective in preventing vaccine-serotype IPD except for serotype 3 which has been increasing in incidence. Serotype 19A IPD has also persisted, likely due to a slightly lower VE and/or more rapid waning of protection. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/31272872/Effectiveness_of_the_seven_valent_and_thirteen_valent_pneumococcal_conjugate_vaccines_in_England:_The_indirect_cohort_design_2006_2018_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(19)30848-5 DB - PRIME DP - Unbound Medicine ER -