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The impact of the changing pneumococcal national immunisation program among older Australians.
Vaccine. 2021 01 22; 39(4):720-728.V

Abstract

Australia has a universal infant pneumococcal conjugate vaccination program and until recently a universal pneumococcal polysaccharide vaccine program for non-Indigenous adults aged ≥65 years and Indigenous adults aged ≥50 years. We documented the impacts of infant and adult vaccination programs on the epidemiology of invasive pneumococcal disease (IPD) in Indigenous and non-Indigenous adults. IPD notifications from the National Notifiable Disease Surveillance System were analysed from 2002 to 2017, grouped by age, vaccine serotype group and Indigenous status. Since the universal funding of infant and elderly pneumococcal vaccination programs in January 2005, total IPD decreased by 19% in non-Indigenous adults aged ≥65 years but doubled in Indigenous adults aged ≥50 years. Vaccine uptake was suboptimal in both groups but lower in Indigenous adults. IPD due to the serotypes contained in the pneumococcal conjugate vaccines (PCV) except for serotype 3 declined markedly over the study period but were replaced by non-PCV serotypes. Serotype 3 is currently the most common in older adults. In the populations eligible for the adult 23-valent pneumococcal polysaccharide vaccine (23vPPV) program, IPD rates due to its exclusive serotypes increased to a lower extent than non-vaccine types. In 2017, non-vaccine serotypes accounted for most IPD in the older population eligible for the 23vPPV program, while it's eleven exclusive serotypes accounted for the majority of IPD in younger adults. Infant and adult pneumococcal vaccination programs in Australia have shaped the serotype-specific epidemiology of IPD in older adults. IPD remains a significant health burden for the Indigenous population. Herd immunity impact is clear for PCV serotypes excluding serotype 3 and serotype replacement is evident for non-PCV serotypes. The adult 23vPPV immunisation program appears to have partially curbed replacement with IPD due to its eleven exclusive serotypes, highlighting a potential benefit of increasing adult 23vPPV coverage in Australia.

Authors+Show Affiliations

School of Public Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales 2052, Australia.Seqirus (Australia) Pty Ltd, Parkville, Victoria 3052, Australia.The University of Sydney, Faculty of Medicine and Health, School of Medicine, Sydney, New South Wales 2006, Australia.School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland 4222, Australia.Discipline of General Practice, Flinders University, Bedford Park, South Australia 5042, Australia.School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland 4222, Australia. Electronic address: allan.cripps@griffith.edu.au.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33384189

Citation

Menzies, R, et al. "The Impact of the Changing Pneumococcal National Immunisation Program Among Older Australians." Vaccine, vol. 39, no. 4, 2021, pp. 720-728.
Menzies R, Stein AN, Booy R, et al. The impact of the changing pneumococcal national immunisation program among older Australians. Vaccine. 2021;39(4):720-728.
Menzies, R., Stein, A. N., Booy, R., Van Buynder, P. G., Litt, J., & Cripps, A. W. (2021). The impact of the changing pneumococcal national immunisation program among older Australians. Vaccine, 39(4), 720-728. https://doi.org/10.1016/j.vaccine.2020.12.025
Menzies R, et al. The Impact of the Changing Pneumococcal National Immunisation Program Among Older Australians. Vaccine. 2021 01 22;39(4):720-728. PubMed PMID: 33384189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of the changing pneumococcal national immunisation program among older Australians. AU - Menzies,R, AU - Stein,A N, AU - Booy,R, AU - Van Buynder,P G, AU - Litt,J, AU - Cripps,A W, Y1 - 2020/12/29/ PY - 2020/07/20/received PY - 2020/11/26/revised PY - 2020/12/08/accepted PY - 2021/1/2/pubmed PY - 2021/4/28/medline PY - 2021/1/1/entrez KW - Adult KW - Australia KW - Conjugate vaccine KW - IPD KW - Indigenous KW - Invasive pneumococcal disease KW - Non-Indigenous KW - Pneumococcal vaccination KW - Polysaccharide vaccine SP - 720 EP - 728 JF - Vaccine JO - Vaccine VL - 39 IS - 4 N2 - Australia has a universal infant pneumococcal conjugate vaccination program and until recently a universal pneumococcal polysaccharide vaccine program for non-Indigenous adults aged ≥65 years and Indigenous adults aged ≥50 years. We documented the impacts of infant and adult vaccination programs on the epidemiology of invasive pneumococcal disease (IPD) in Indigenous and non-Indigenous adults. IPD notifications from the National Notifiable Disease Surveillance System were analysed from 2002 to 2017, grouped by age, vaccine serotype group and Indigenous status. Since the universal funding of infant and elderly pneumococcal vaccination programs in January 2005, total IPD decreased by 19% in non-Indigenous adults aged ≥65 years but doubled in Indigenous adults aged ≥50 years. Vaccine uptake was suboptimal in both groups but lower in Indigenous adults. IPD due to the serotypes contained in the pneumococcal conjugate vaccines (PCV) except for serotype 3 declined markedly over the study period but were replaced by non-PCV serotypes. Serotype 3 is currently the most common in older adults. In the populations eligible for the adult 23-valent pneumococcal polysaccharide vaccine (23vPPV) program, IPD rates due to its exclusive serotypes increased to a lower extent than non-vaccine types. In 2017, non-vaccine serotypes accounted for most IPD in the older population eligible for the 23vPPV program, while it's eleven exclusive serotypes accounted for the majority of IPD in younger adults. Infant and adult pneumococcal vaccination programs in Australia have shaped the serotype-specific epidemiology of IPD in older adults. IPD remains a significant health burden for the Indigenous population. Herd immunity impact is clear for PCV serotypes excluding serotype 3 and serotype replacement is evident for non-PCV serotypes. The adult 23vPPV immunisation program appears to have partially curbed replacement with IPD due to its eleven exclusive serotypes, highlighting a potential benefit of increasing adult 23vPPV coverage in Australia. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/33384189/The_impact_of_the_changing_pneumococcal_national_immunisation_program_among_older_Australians_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(20)31592-9 DB - PRIME DP - Unbound Medicine ER -