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Long-term Impact of Pneumococcal Conjugate Vaccines on Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians.
Clin Infect Dis. 2020 06 10; 70(12):2607-2615.CI

Abstract

BACKGROUND

Universal pneumococcal conjugate vaccine (PCV) programs began in Indigenous Australian children in 2001 and all children in 2005, changing to 13-valent PCV (PCV13) in 2011. We used laboratory data for invasive pneumococcal disease (IPD) and coded hospitalizations for noninvasive pneumococcal community-acquired pneumonia (PnCAP) to evaluate long-term impact.

METHODS

Annual incidence (per 100 000 population) was calculated for age-specific total IPD, PCV13 non-7-valent PCV (PCV7) serotypes, and PnCAP by Indigenous status. Incidence in the pre-universal PCV7 (2002-2004), early PCV7 (2005-2007), pre-PCV13 (2008 to mid-2011), and post-PCV13 (mid-2011 to 2016) periods was used to calculate incidence rate ratios (IRRs).

RESULTS

In the total population, all-age incidence of IPD declined from 11.8 pre-PCV7 to 7.1 post-PCV13 (IRR, 0.61 [95% confidence interval {CI}, .59-.63]) but for PnCAP declined among ages <1 year (IRR, 0.34 [95% CI, .25-.45]) and 1-4 years (IRR, 0.50 [95% CI, .43-.57]) but increased significantly among age ≥5 years (IRRs, 1.08-1.14). In Indigenous people, baseline PCV13 non-PCV7 IPD incidence was 3-fold higher, amplified by a serotype 1 epidemic in 2011. By 2015-2016, although incidence of IPD and PnCAP in children aged <5 years decreased by 38%, neither decreased in people aged ≥5 years.

CONCLUSIONS

Fifteen years post-PCV and 5 years post-PCV13, direct and indirect impact on IPD and PnCAP differed by age and between Indigenous and non-Indigenous people, with potential implications for long-term PCV impact in comparable settings.Fifteen years after pneumococcal conjugate vaccine (PCV) introduction and 5 years post-PCV13, direct and indirect impact on invasive pneumococcal disease and pneumococcal community-acquired pneumonia differed by age and between Indigenous and non-Indigenous people, with potential implications for long-term PCV impact in comparable settings.

Authors+Show Affiliations

National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead, Sydney, Australia. National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead, Sydney, Australia. University of Sydney, Sydney, Australia.National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead, Sydney, Australia. University of Sydney, Sydney, Australia.National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead, Sydney, Australia. University of Sydney, Sydney, Australia.National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.Centre for Disease Control, Northern Territory Department of Health, Darwin, Australia.Communicable Disease Epidemiology and Surveillance, Department of Health and Human Services, Melbourne, Australia.University of Sydney, Sydney, Australia. Centre for Infectious Diseases and Microbiology-Public Health, The Institute for Clinical Pathology and Medical Research , Westmead Hospital, Sydney, Australia.Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Australia.Public Health Division, Department of Health Western Australia, Perth, Australia.Microbiological Diagnostic Unit, Public Health Laboratory, Department of Microbiology and Immunology, University of Melbourne, Melbourne, Australia.Centre for Disease Control, Northern Territory Department of Health, Darwin, Australia.National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead, Sydney, Australia.

Pub Type(s)

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

Language

eng

PubMed ID

31388670

Citation

Meder, Kelley N., et al. "Long-term Impact of Pneumococcal Conjugate Vaccines On Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 70, no. 12, 2020, pp. 2607-2615.
Meder KN, Jayasinghe S, Beard F, et al. Long-term Impact of Pneumococcal Conjugate Vaccines on Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians. Clin Infect Dis. 2020;70(12):2607-2615.
Meder, K. N., Jayasinghe, S., Beard, F., Dey, A., Kirk, M., Cook, H., Strachan, J., Sintchenko, V., Smith, H., Giele, C., Howden, B., Krause, V., & Mcintyre, P. (2020). Long-term Impact of Pneumococcal Conjugate Vaccines on Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 70(12), 2607-2615. https://doi.org/10.1093/cid/ciz731
Meder KN, et al. Long-term Impact of Pneumococcal Conjugate Vaccines On Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians. Clin Infect Dis. 2020 06 10;70(12):2607-2615. PubMed PMID: 31388670.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term Impact of Pneumococcal Conjugate Vaccines on Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians. AU - Meder,Kelley N, AU - Jayasinghe,Sanjay, AU - Beard,Frank, AU - Dey,Aditi, AU - Kirk,Martyn, AU - Cook,Heather, AU - Strachan,Janet, AU - Sintchenko,Vitali, AU - Smith,Helen, AU - Giele,Carolien, AU - Howden,Benjamin, AU - Krause,Vicki, AU - Mcintyre,Peter, PY - 2018/10/28/received PY - 2019/07/31/accepted PY - 2019/8/8/pubmed PY - 2021/1/7/medline PY - 2019/8/8/entrez KW - Australia KW - impact KW - invasive pneumococcal disease KW - pneumococcal conjugate vaccines KW - pneumococcal pneumonia SP - 2607 EP - 2615 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 70 IS - 12 N2 - BACKGROUND: Universal pneumococcal conjugate vaccine (PCV) programs began in Indigenous Australian children in 2001 and all children in 2005, changing to 13-valent PCV (PCV13) in 2011. We used laboratory data for invasive pneumococcal disease (IPD) and coded hospitalizations for noninvasive pneumococcal community-acquired pneumonia (PnCAP) to evaluate long-term impact. METHODS: Annual incidence (per 100 000 population) was calculated for age-specific total IPD, PCV13 non-7-valent PCV (PCV7) serotypes, and PnCAP by Indigenous status. Incidence in the pre-universal PCV7 (2002-2004), early PCV7 (2005-2007), pre-PCV13 (2008 to mid-2011), and post-PCV13 (mid-2011 to 2016) periods was used to calculate incidence rate ratios (IRRs). RESULTS: In the total population, all-age incidence of IPD declined from 11.8 pre-PCV7 to 7.1 post-PCV13 (IRR, 0.61 [95% confidence interval {CI}, .59-.63]) but for PnCAP declined among ages <1 year (IRR, 0.34 [95% CI, .25-.45]) and 1-4 years (IRR, 0.50 [95% CI, .43-.57]) but increased significantly among age ≥5 years (IRRs, 1.08-1.14). In Indigenous people, baseline PCV13 non-PCV7 IPD incidence was 3-fold higher, amplified by a serotype 1 epidemic in 2011. By 2015-2016, although incidence of IPD and PnCAP in children aged <5 years decreased by 38%, neither decreased in people aged ≥5 years. CONCLUSIONS: Fifteen years post-PCV and 5 years post-PCV13, direct and indirect impact on IPD and PnCAP differed by age and between Indigenous and non-Indigenous people, with potential implications for long-term PCV impact in comparable settings.Fifteen years after pneumococcal conjugate vaccine (PCV) introduction and 5 years post-PCV13, direct and indirect impact on invasive pneumococcal disease and pneumococcal community-acquired pneumonia differed by age and between Indigenous and non-Indigenous people, with potential implications for long-term PCV impact in comparable settings. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/31388670/Long_term_Impact_of_Pneumococcal_Conjugate_Vaccines_on_Invasive_Disease_and_Pneumonia_Hospitalizations_in_Indigenous_and_Non_Indigenous_Australians_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciz731 DB - PRIME DP - Unbound Medicine ER -