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de Melo Araujo AC, da Silva Aragão J, de Souza WV, Rodrigues LC, de Barros Miranda-Filho D. The impact of implementing the 10-valent pneumococcal conjugate vaccine on hospitalizations for pneumonia among children. Vaccine 2023:S0264-410X(23)00724-7. [PMID: 37353456 DOI: 10.1016/j.vaccine.2023.06.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/19/2023] [Accepted: 06/13/2023] [Indexed: 06/25/2023]
Abstract
Pneumonia is a major cause of morbidity and mortality in children, with pneumococcus as the main etiologic agent. In Brazil, the 10-valent pneumococcal conjugate vaccine (PCV-10) was introduced into the childhood immunization schedule in 2010. The aim of this study was to assess the impact caused by implementing PCV-10 on the hospitalizations of children with pneumonia, between 2005 and 2015, in the state of Pernambuco, Brazil. An ecological time series study and a forecasting analysis were conducted. A comparison was made between the hospitalizations of children aged between seven months and four years due to pneumonia in the Brazilian Unified Health System, in the 5 years before (2005-2009) and after (2011-2015) implementation of PCV-10. Descriptive analysis included absolute and relative values, means and rates of hospitalization. The chi-square test was used to compare the annual incidence of hospitalizations and the t-Student test to compare the five-year mean values. For the temporal modeling of hospitalizations, an autoregressive integrated moving average was used, adjusted with seasonal-SARIMA (Box-Jenkins methodology), with a prediction of the monthly number of hospitalizations for 2011-2015. The predicted and observed values for 2011-2015 were then compared. The number of hospitalizations after implementing PCV-10 was reduced by 24.5 %. The monthly average of hospitalizations dropped from 681 (2005-2009) to 514 (2011-2015). The hospitalization rate dropped from 56.1 per thousand live births in the five-year period prior to PCV-10 to 43.4 in the following five-year period (a 22.7% reduction). Comparing the values predicted by the SARIMA model for a scenario without PCV-10 in the second five-year period, with those reported after implementing PCV-10, the estimated number of prevented hospitalizations was 8,682 in the five years following the introduction of the vaccine. In conclusion, in the five years following implementation of PCV-10, hospitalizations of children with pneumonia in Pernambuco decrease by 22%.
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Affiliation(s)
- Ana Catarina de Melo Araujo
- Programa Associado de Pós-Graduação em Enfermagem UPE/UEPB, Universidade de Pernambuco (UPE), Av. Agamenon Magalhães, s/n, Santo Amaro, Recife, PE 50100-010, Brazil.
| | - Jamilly da Silva Aragão
- Programa Associado de Pós-Graduação em Enfermagem UPE/UEPB, Universidade de Pernambuco (UPE), Av. Agamenon Magalhães, s/n, Santo Amaro, Recife, PE 50100-010, Brazil
| | - Wayner Vieira de Souza
- Programa de Pós-Graduação em Saúde Pública, Instituto Aggeu Magalhães, Fiocruz Pernambuco, Av. Professor Moraes Rego, s/n, Cidade Universitária, Recife, PE 50740-465, Brazil
| | - Laura Cunha Rodrigues
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
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The Cost-Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine in Seven Chinese Cities. Vaccines (Basel) 2021; 9:vaccines9111368. [PMID: 34835299 PMCID: PMC8624982 DOI: 10.3390/vaccines9111368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: This study estimates the cost-effectiveness of vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) among infants in Beijing, Shanghai, Shenzhen, Chengdu, Karamay, Qingdao, and Suzhou. Methods: A previously published cost-effectiveness model comparing vaccination with PCV13 to no vaccination was localized to the included Chinese cities. A systematic literature review was undertaken to identify age-specific incidence rates for pneumococcal bacteremia, pneumococcal meningitis, pneumonia, and otitis media (AOM). Age-specific direct medical costs of treating the included pneumococcal diseases were taken from the Chinese Health Insurance Association database. The base case analysis evaluated vaccine efficacy using direct effect and indirect effects (DE+ IDE). A subsequent scenario analysis evaluated the model outcomes if only DE was considered. A vaccination rate of 70% was used. The model reported outcomes over a one-year period after it was assumed the vaccine effects had reached a steady state (5–7 years after vaccine introduction) to include the direct and indirect effects of vaccination. Health outcomes were discounted at 5% during the steady-state period. Results: Vaccination with PCV13 was cost-effective in the base case analysis for all included cities with the incremental cost-effectiveness ratio (ICER) ranging from 1145 CNY(Shenzhen) to 15,422 CNY (Qingdao) per quality-adjusted life-year (QALY) gained. PCV13 was the dominant strategy in Shanghai with lower incremental costs and higher incremental QALYs. PCV13 remained cost-effective in the DE-only analysis with all ICERs falling below a cost-effectiveness threshold of three times GDP per capita in each city. Conclusions: Vaccination with PCV13 was a cost-effective strategy in the analyzed cities for both the DE-only and DE + IDE analyses. PCV13 became very cost-effective when a vaccination rate was reached where IDE is observed.
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Shen K, Wasserman M, Liu D, Yang YH, Yang J, Guzauskas GF, Wang BCM, Hilton B, Farkouh R. Estimating the cost-effectiveness of an infant 13-valent pneumococcal conjugate vaccine national immunization program in China. PLoS One 2018; 13:e0201245. [PMID: 30044865 PMCID: PMC6059448 DOI: 10.1371/journal.pone.0201245] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 07/11/2018] [Indexed: 01/29/2023] Open
Abstract
Background The burden of pneumococcal disease in China is high, and a 13-valent pneumococcal conjugate vaccine (PCV13) recently received regulatory approval and is available to Chinese infants. PCV13 protects against the most prevalent serotypes causing invasive pneumococcal disease (IPD) in China, but will not provide full societal benefits until made broadly available through a national immunization program (NIP). Objective To estimate clinical and economic benefits of introducing PCV13 into a NIP in China using local cost estimates and accounting for variability in vaccine uptake and indirect (herd protection) effects. Methods We developed a population model to estimate the effect of PCV13 introduction in China. Modeled health states included meningitis, bacteremia, pneumonia (PNE), acute otitis media, death and sequelae, and no disease. Direct healthcare costs and disease incidence data for IPD and PNE were derived from the China Health Insurance and Research Association database; all other parameters were derived from published literature. We estimated total disease cases and associated costs, quality-adjusted life years (QALYs), and deaths for three scenarios from a Chinese Payer Perspective: (1) direct effects only, (2) direct+indirect effects for IPD only, and (3) direct+indirect effects for IPD and inpatient PNE. Results Scenario (1) resulted in 370.3 thousand QALYs gained and 12.8 thousand deaths avoided versus no vaccination. In scenarios (2) and (3), the PCV13 NIP gained 383.2 thousand and 3,580 thousand QALYs, and avoided 13.1 thousand and 147.5 thousand deaths versus no vaccination, respectively. In all three scenarios, the vaccination cost was offset by cost reductions from prevented disease yielding net costs of ¥29,362.32 million, ¥29,334.29 million, and ¥13,524.72 million, respectively. All resulting incremental cost-effectiveness ratios fell below a 2x China GDP cost-effectiveness threshold across a range of potential vaccine prices. Discussion Initiation of a PCV13 NIP in China incurs large upfront costs but is good value for money, and is likely to prevent substantial cases of disease among children and non-vaccinated individuals.
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Affiliation(s)
- Kunling Shen
- Department of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | | | | | - Yong-Hong Yang
- Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, National Clinical Research Centre for Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Laboratory of Microbiology, Beijing Children's Hospital, Beijing Pediatric Research Institute, Capital Medical University, Beijing, China
| | | | | | | | - Betsy Hilton
- Pfizer Inc. Collegeville, PA, United States of America
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Pneumococcal Colonization in the Familial Context and Implications for Anti-Pneumococcal Immunization in Adults: Results from the BINOCOLO Project in Sicily. Int J Mol Sci 2017; 18:ijms18010105. [PMID: 28067813 PMCID: PMC5297739 DOI: 10.3390/ijms18010105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/29/2016] [Accepted: 12/29/2016] [Indexed: 01/23/2023] Open
Abstract
The spread of Streptococcus pneumoniae within families has been scarcely investigated so far. This feasibility study aimed to estimate the prevalence of pneumococcal carriage in school-aged children and co-habiting relatives and to explore the potential link between the family environment and the sharing of pneumococcal serotypes covered by the vaccine. Oropharyngeal samples of 146 subjects belonging to 36 different family groups were molecularly tested for pneumococcal detection and serotyping. The overall prevalence of pneumococcal carriage was 65.8% (n = 96/146), whereas it was higher among schoolchildren (77.8%, n = 28/36); subjects of seven years of age had the highest odds of being colonized (odds ratio, OR = 5.176; p = 0.145). Pneumococcal serotypes included in the 13-valent conjugate vaccine formulation were largely detected in the study population and multiple serotypes colonization was considerable. Factors relating to a close proximity among people at the family level were statistically associated with pneumococcal carriage (OR = 2.121; p = 0.049), as well as active smoking habit with a clear dose-response effect (ORs = 1.017–3.326). About half of family clusters evidenced similar patterns of carried pneumococcal serotypes and the odds of sustaining a high level of intrafamilial sharing increased with household size (ORs = 1.083–5.000). This study highlighted the potential role played by the family environment in sustaining both the circulation and horizontal transmission of pneumococcus.
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Azzari C, Cortimiglia M, Nieddu F, Moriondo M, Indolfi G, Mattei R, Zuliani M, Adriani B, Degl'Innocenti R, Consales G, Aquilini D, Bini G, Di Natale ME, Canessa C, Ricci S, de Vitis E, Mangone G, Bechini A, Bonanni P, Pasinato A, Resti M. Pneumococcal serotype distribution in adults with invasive disease and in carrier children in Italy: Should we expect herd protection of adults through infants' vaccination? Hum Vaccin Immunother 2016; 12:344-50. [PMID: 26647277 PMCID: PMC5049737 DOI: 10.1080/21645515.2015.1102811] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The 7-valent pneumococcal conjugate vaccine (PCV7) produced a significant herd protection in unvaccinated adult population mostly because of pneumococcus carriage decrease in vaccinated children. It is not known if the 13-valent pneumococcal vaccine can give similar effect on adults. Aims of the work were to evaluate whether the 6 additional serotypes are present in nasopharynx of children and serotype distribution in invasive pneumococcal infections (IPD) in adults. Realtime-PCR was used to evaluate pneumococcal serotypes in adults with confirmed IPD and in nasopharyngeal swabs (NP) from 629 children not vaccinated or vaccinated with PCV7 and resident in the same geographical areas. Two hundred twenty-one patients (116 males, median 67.9 years) with IPD were studied (pneumonia n = 103, meningitis n = 61 sepsis n = 50, other n = 7). Two hundred twelve were serotyped. The most frequent serotypes were 3, (31/212; 14.6%), 19A, (19/212; 9.0%), 12 (17/212; 8.0%), 7F, (14/212; 6.6%). In NP of children, the frequency of those serotypes causing over 50% of IPD in adults was very low, ranging from 0.48% for serotype 7F to 7.9% for serotype 19A. On the other side serotype 5, very frequent in NP (18.7%) caused <1% IPD. In conclusion serotypes causing IPD in adults are very rarely found in children NP. We suggest that herd protection obtainable with the additional 6 serotypes included in PCV13 may be more limited than that demonstrated with PCV7 in the past. In order to reduce the burden of disease in adults, adults should be offered a specific vaccination program with highly immunogenic PCV.
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Affiliation(s)
- Chiara Azzari
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Martina Cortimiglia
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Francesco Nieddu
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Maria Moriondo
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Giuseppe Indolfi
- b Pediatric Division; Anna Meyer Children's Hospital ; Florence , Italy
| | - Romano Mattei
- c Operative Unit of Chemical-Clinical and Microbiological Analysis; Campo di Marte Hospital; ASL2 Lucca , Italy
| | - Massimo Zuliani
- d Division of Hygiene and Public Health; Invasive Disease Prevention and Surveillance; Prevention Department; ASS5 Friuli , Italy
| | | | | | | | | | - Giancarlo Bini
- h Division of General Medicine 1; New Hospital ; Prato , Italy
| | | | - Clementina Canessa
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Silvia Ricci
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Elisa de Vitis
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Giusi Mangone
- a Division of Immunology; Section of Pediatrics ; Department of Health Sciences; University of Florence and Anna Meyer Children's Hospital ; Florence , Italy
| | - Angela Bechini
- j Department of Health Sciences ; University of Florence ; Florence , Italy
| | - Paolo Bonanni
- j Department of Health Sciences ; University of Florence ; Florence , Italy
| | - Angela Pasinato
- k Center for Research and Education of Family Pediatricians (CESPER) ; Padova , Italy
| | - Massimo Resti
- b Pediatric Division; Anna Meyer Children's Hospital ; Florence , Italy
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Cost-effectiveness and Health Benefits of Pediatric 23-valent Pneumococcal Polysaccharide Vaccine, 7-valent Pneumococcal Conjugate Vaccine and Forecasting 13-valent Pneumococcal Conjugate Vaccine in China. Pediatr Infect Dis J 2016; 35:e353-e361. [PMID: 27753771 DOI: 10.1097/inf.0000000000001288] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Each year in China, approximately 700,000 children under 5 years old are diagnosed with pneumonia, and 30,000 die of the disease. Although 7-valent pneumococcal conjugate vaccine (PCV-7) and 23-valent pneumococcal polysaccharide vaccine (PPV-23) are available in China, the costs are borne by the consumer, resulting in low coverage for PCV-7. We aimed to conduct a simulation study to assess the cost-effectiveness and health benefits of PCV-7, 13-valent pneumococcal conjugate vaccine (PCV-13) and PPV-23 to prevent childhood pneumonia and other vaccine-preventive diseases in China. METHODS An economic evaluation was performed using a Markov simulation model. Parameters including demographic, epidemiological data, costs and efficacy of vaccines were obtained from previous studies. A hypothetical cohort of 100,000 newborns (focusing on pneumococcal diseases ≤7 years old) was followed up until death or 100 years of age. The model incorporated the impact of vaccination on reduction of incidence of pneumococcal diseases and mortality of children ≤7 years. Outcomes are presented in terms of disease cases averted, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio. RESULTS Under baseline assumptions, PPV-23 is currently the only cost-effective option, whereas PCV-13 showed the greatest impact on pneumococcal disease burden, reducing invasive pneumococcal diseases by 31.3%, pneumonia by 15.3% and gaining 73.8 QALYs (10,000 individuals at discount rate of 3%). Incremental cost-effectiveness ratios of PCV-13 and PCV-7 are US$29,460/QALY and US$104,094/QALY, respectively, showing no cost-effectiveness based on the World Health Organization recommended willingness-to-pay threshold. On the other hand, the incremental cost-effectiveness ratios of PCVs were most sensitive to vaccination costs; if it reduces 4.7% and 32.2% for PCV-7 and PCV-13, respectively, the vaccination will be cost-effective. CONCLUSIONS To scale up current vaccination strategies and achieve potential health benefits, the replacement of PCV-7 with PCV-13 should be considered. As well, PCV's costs need to be reduced by increasing public subsidies and providing financial support to poor families.
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Pneumococcus and the Elderly in Italy: A Summary of Available Evidence Regarding Carriage, Clinical Burden of Lower Respiratory Tract Infections and On-Field Effectiveness of PCV13 Vaccination. Int J Mol Sci 2016; 17:ijms17071140. [PMID: 27428964 PMCID: PMC4964513 DOI: 10.3390/ijms17071140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 11/17/2022] Open
Abstract
Streptococcus pneumoniae is currently the leading cause of community-acquired pneumonia (CAP) and lower respiratory tract infections (LRTI) in adults, elderly and high-risk subjects worldwide. The clear benefits of pneumococcal conjugate vaccination in childhood have been accompanied by a decrease of vaccine-serotype invasive diseases among adults in several countries, mainly due to the herd effect mediated by the reduction of vaccine-serotype nasopharyngeal colonization in both age groups, but this reduction in the incidence of pneumonia has not been observed. The "Community Acquired Pneumonia Immunization Trial in Adults" (CAPITA) study provided conclusive evidence about 13-valent pneumococcal conjugate vaccine (PCV13) efficacy in preventing CAP in adults and led Western countries to issue new recommendations for pneumococcal immunization targeting subjects >50 years and high-risk groups, with marked differences with respect to age and/or risk groups immunized, eligibility for reimbursement and national, regional or local implementation. Several Italian regions implemented PCV13 immunization programs in adults and interesting data have been come available in the last years, especially from Liguria, a Northern region with a high and long-lasting pneumococcal vaccine immunological pressure in infants. In this review, currently available evidence from Italy and Liguria regarding pneumococcal carriage, burden of CAP and LRTI, and on-field effectiveness of PCV13 immunization in adults and elderly will be summarized.
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Choline Binding Proteins from Streptococcus pneumoniae: A Dual Role as Enzybiotics and Targets for the Design of New Antimicrobials. Antibiotics (Basel) 2016; 5:antibiotics5020021. [PMID: 27314398 PMCID: PMC4929436 DOI: 10.3390/antibiotics5020021] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 05/04/2016] [Accepted: 05/16/2016] [Indexed: 12/20/2022] Open
Abstract
Streptococcus pneumoniae (pneumococcus) is an important pathogen responsible for acute invasive and non-invasive infections such as meningitis, sepsis and otitis media, being the major cause of community-acquired pneumonia. The fight against pneumococcus is currently hampered both by insufficient vaccine coverage and by rising antimicrobial resistances to traditional antibiotics, making necessary the research on novel targets. Choline binding proteins (CBPs) are a family of polypeptides found in pneumococcus and related species, as well as in some of their associated bacteriophages. They are characterized by a structural organization in two modules: a functional module (FM), and a choline-binding module (CBM) that anchors the protein to the choline residues present in the cell wall through non-covalent interactions. Pneumococcal CBPs include cell wall hydrolases, adhesins and other virulence factors, all playing relevant physiological roles for bacterial viability and virulence. Moreover, many pneumococcal phages also make use of hydrolytic CBPs to fulfill their infectivity cycle. Consequently, CBPs may play a dual role for the development of novel antipneumococcal drugs, both as targets for inhibitors of their binding to the cell wall and as active cell lytic agents (enzybiotics). In this article, we review the current state of knowledge about host- and phage-encoded pneumococcal CBPs, with a special focus on structural issues, together with their perspectives for effective anti-infectious treatments.
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Huang S, Liu X, Lao W, Zeng S, Liang H, Zhong R, Dai X, Wu X, Li H, Yao Y. Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates collected at a Chinese hospital from 2011 to 2013. BMC Infect Dis 2015; 15:312. [PMID: 26243258 PMCID: PMC4526307 DOI: 10.1186/s12879-015-1042-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 07/21/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Streptococcus pneumoniae infections are a major cause of global morbidity and mortality, and the emergence of antibiotic-resistant Streptococcus pneumoniae strains has been increasingly reported. This study provides up-to-date information on bacterial serotype distribution and drug resistance from S. pneumoniae clinical isolates that could guide prevention and treatment strategies for pneumococcal disease in China. METHODS A total of 94 S. pneumoniae isolates were collected from outpatients and inpatients at one Chinese hospital from 2011-2013. Drug susceptibility and resistance was determined by minimum inhibitory concentrations (MICs). Capsular serotypes were identified by the quellung reaction test and multiplex polymerase chain reaction. RESULTS Fifteen serotypes were identified among the 94 S. pneumoniae clinical isolates that were collected. Prevalent serotypes were 19F (42.6 %), 19A (8.5 %), 3 (8.5 %), and 6B (7.4 %). Potential immunization coverage rates for the 7-, 10- and 13-valent pneumococcal polysaccharide conjugate vaccines were 59.6, 62.6, and 79.6 %, respectively. Resistance rates to tetracycline, erythromycin, and trimethoprim/sulfamethoxazole were 91.2, 80.2 and 63.8 %, respectively. Resistance rates to penicillin, amoxicillin, ceftriaxone, and cefotaxime were 47.3, 34.1, 19.8, and 18.7 %, respectively. In almost all cases, antimicrobial resistance of the S. pneumoniae isolates in patients five years or younger was higher than isolates collected from patients aged 51 years or older. CONCLUSION Prevalent serotypes among the 94 S. pneumoniae clinical isolates were 19F, 19A, 3, and 6B. The 13-valent pneumococcal polysaccharide conjugate vaccine covered the majority of the serotypes identified in this sample. Drug resistance varied among different serotypes and age groups. Clinical precautions should be taken to avoid the development of multidrug resistance in this potential human pathogen.
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Affiliation(s)
- Songyin Huang
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Xiaoqiang Liu
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Weisi Lao
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Suhua Zeng
- Department of Ophthalmic Surgery, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China.
| | - Huiqi Liang
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Rihui Zhong
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Xinlu Dai
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Xiquan Wu
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Hongyu Li
- Department of Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
| | - Yandan Yao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
- Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
- General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China.
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Mameli C, Fabiano V, Daprai L, Bedogni G, Faccini M, Garlaschi ML, Penagini F, Dilillo D, Torresani E, Gramegna M, Zuccotti GV. A longitudinal study of streptococcus pneumoniae carriage in healthy children in the 13-valent pneumococcal conjugate vaccine era. Hum Vaccin Immunother 2015; 11:811-7. [PMID: 25751237 PMCID: PMC4514434 DOI: 10.1080/21645515.2015.1010945] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 12/29/2014] [Accepted: 01/11/2015] [Indexed: 01/27/2023] Open
Abstract
Few epidemiological data are available after the introduction of the 13-valent pneumococcal vaccine (PCV13) in 2010. We performed repeat nasopharyngeal swabs and evaluated the serotype distribution of Streptococcus pneumoniae (SP) and its association with PCV13 vaccine status in healthy Italian children aged 3-59 months. SP serotypes were assessed by the Quellung reaction. 618 children appropriately (28%) or incompletely (72%) vaccinated for age with PCV13 were available at baseline (T0). 515 were re-evaluated at 6 months from baseline (T6) and 436 at 12 months from baseline (T12). The percentage of appropriately vaccinated subjects at T0, T6 and T12 was 28%, 67% and 92%, respectively. Random effects logistic regression models with robust 95% confidence intervals was used to estimate the time-related changes in SP and PCV13 carriage and marginal probabilities were obtained from such models. The age-corrected probability of SP carriage was 0.31 (95% CI 0.22 - 0.41) at T0, 0.32 (0.24 - 0.40) at T6 and 0.28 (0.20 - 0.35) at T12. The probability of PCV13 serotypes carriage was 0.025 (0.001 - 0.050) at T0, 0.018 (0.001 - 0.039) at T6 and 0.010 (0.001 - 0.023) at T12. A decrease in PCV13 serotypes and a shift in non-PCV13 serotypes colonization was observed. In particular, the 15A serotype accounted for 4%, 8% and 23% of SP isolates at T0, T6 and T12, respectively. In conclusion, the benefits of the PCV13 vaccination on SP carriage increase with increasing coverage rates. The shift of SP isolates toward non-PCV13 serotypes needs to be studied further.
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Affiliation(s)
- Chiara Mameli
- Department of Pediatrics; Children's Hospital “V. Buzzi"; University of Milan; Milan, Italy
| | - Valentina Fabiano
- Department of Pediatrics; Children's Hospital “V. Buzzi"; University of Milan; Milan, Italy
| | - Laura Daprai
- Microbiology Laboratory; IRCCS Cà Granda Ospedale Maggiore Policlinico Foundation; Milan, Italy
| | - Giorgio Bedogni
- Clinical Epidemiology Unit; Liver Research Center; Basovizza, Trieste, Italy
| | - Marino Faccini
- Prevention Department; Local Health Authority; Milan, Italy
| | - Maria Laura Garlaschi
- Microbiology Laboratory; IRCCS Cà Granda Ospedale Maggiore Policlinico Foundation; Milan, Italy
| | - Francesca Penagini
- Department of Pediatrics; Children's Hospital “V. Buzzi"; University of Milan; Milan, Italy
| | - Dario Dilillo
- Department of Pediatrics; Children's Hospital “V. Buzzi"; University of Milan; Milan, Italy
| | - Erminio Torresani
- Microbiology Laboratory; IRCCS Cà Granda Ospedale Maggiore Policlinico Foundation; Milan, Italy
| | - Maria Gramegna
- Unità Organizzativa Governo della Prevenzione e Tutela sanitaria; Direzione Generale Sanità; Milan, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics; Children's Hospital “V. Buzzi"; University of Milan; Milan, Italy
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Shiragami M, Mizukami A, Leeuwenkamp O, Mrkvan T, Delgleize E, Kurono Y, Iwata S. Cost-Effectiveness Evaluation of the 10-Valent Pneumococcal Non-typeable Haemophilus influenzae Protein D Conjugate Vaccine and 13-Valent Pneumococcal Vaccine in Japanese Children. Infect Dis Ther 2014; 4:93-112. [PMID: 25527448 PMCID: PMC4363214 DOI: 10.1007/s40121-014-0053-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Diseases caused by Streptococcus pneumoniae represent a major public health problem. The purpose of this study was to compare, in the Japanese context, the projected health benefits, costs and cost-effectiveness of the latest generation of pneumococcal conjugate vaccines which may provide important insight into the potential public health impact of interventions in the context of local disease-specific epidemiology. METHODS A Markov model was used to compare two vaccination strategies which involve routine infant immunization with either the 13-valent pneumococcal conjugate vaccine (PCV-13; Prevenar 13™, Pfizer, Pearl River, NY, USA) or the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV; Synflorix™, GlaxoSmithKline Biologicals SA, Rixensart, Belgium) over a time horizon of 5 years from the healthcare provider and societal perspectives. Estimates for key model parameters were obtained from locally available databases and published literature. Incremental benefits in terms of costs and quality-adjusted life-year and cost-effectiveness were assessed. RESULTS A 3 + 1 vaccination schedule for infants with PHiD-CV is expected to have a similar impact on invasive pneumococcal disease and pneumonia and a larger impact on acute otitis media-related outcomes compared with PCV-13. Assuming price parity for these vaccines, the model projected that vaccination with PHiD-CV would result in cost savings of 1.9 and 3.9 billion Japanese yen from the provider and societal perspectives, respectively. This was largely due to a reduction in highly prevalent acute otitis media. Vaccination with PHiD-CV was expected to generate a gain of 433 quality-adjusted life-years compared to PCV-13 translating into dominance over PCV-13. Sensitivity analyses showed robustness of model outcome to changes in key model parameters and substantiated that the model outcome was consistently driven by the incremental benefit of PHiD-CV in averting acute otitis media. CONCLUSION In comparison to PCV-13, vaccination with PHiD-CV is projected to be cost saving for Japan from both the healthcare provider and societal perspectives.
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Affiliation(s)
- Makoto Shiragami
- Social and Administrative Pharmacy Science, School of Pharmacy, Nihon University, Funabashi-shi, Chiba Japan
| | - Akiko Mizukami
- Healthoutcomes Department, Development and Medical Affairs Division, GlaxoSmithKline K.K., Shibuya-ku, Tokyo, Japan
| | | | - Tomas Mrkvan
- Vaccine Value and Health Science, GSK Vaccines, Wavre, Belgium
| | | | - Yuichi Kurono
- Department of Otolaryngology, Faculty of Medicine, Kagoshima University, Kagoshima-shi, Kagoshima Japan
| | - Satoshi Iwata
- Department of Infectious Diseases, Keio University School of Medicine, Shinjuku-ku, Tokyo Japan
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Regev-Yochay G, Rahav G, Riesenberg K, Wiener-Well Y, Strahilevitz J, Stein M, Glikman D, Weber G, Potasman I, Dagan R. Initial effects of the National PCV7 Childhood Immunization Program on adult invasive pneumococcal disease in Israel. PLoS One 2014; 9:e88406. [PMID: 24516649 PMCID: PMC3917916 DOI: 10.1371/journal.pone.0088406] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 01/06/2014] [Indexed: 11/19/2022] Open
Abstract
Background PCV7 was introduced as universal childhood vaccination in Israel in July 2009 and PCV13 in November 2010. Here we report data on adult invasive pneumococcal disease (IPD), two years post PCV7 implementation and before an expected effect of PCV13. Methods An ongoing nationwide active-surveillance (all 27 laboratories performing blood cultures in Israel), providing all blood & CSF S. pneumoniae isolates from persons >18 y was initiated in July 2009. Capture-recapture method assured reporting of >95% cases. All isolates were serotyped in one central laboratory. IPD outcome and medical history were recorded in 90%. Second year post PCV implementation is compared to the first year. Results During July 2009 to June 2011, 970 IPD cases were reported (annual incidence [/100,000] of 9.17 and 10.16 in the two consecutive years, respectively). Respective case fatality rates (CFRs) were 20% and 19.1%. Incidence of IPD and CFR increased with age and number of comorbidities. Incidence rate was significantly greater during the second winter, 7.79/100,000 vs. 6.14/100,000 in first winter, p = 0.004, with a non-significant decrease during summer months (3.02 to 2.48/100,000). The proportion of IPD cases due to PCV7-serotypes decreased from 27.5% to 13.1% (first to second year) (p<0.001). Yet, non-PCV13-strains increased from 32.7% to 40.2% (p = 0.017). The increase in non-PCV13-strains was highly significant in immunocompromised patients and to a lesser degree in non-immunocompromised at risk or in older patients (>64 y). Among younger/healthier patients serotype 5 was the major increasing serotype. Penicillin and ceftriaxone resistance decreased significantly in the second year. Conclusions While overall annual incidence of IPD did not change, the indirect effect of PCV7 vaccination was evident by the significant decrease in PCV7 serotypes across all age groups. Increase in non-VT13 strains was significant in immunocompromised patients. A longer follow-up is required to appreciate the full effect of infant vaccination on annual IPD.
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Affiliation(s)
- Gili Regev-Yochay
- Infectious Disease Unit, Sheba Medical Center, Ramat-Gan, Israel
- * E-mail:
| | - Galia Rahav
- Infectious Disease Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Klaris Riesenberg
- Infectious Disease Soroka University Medical Center, Beer-Sheva, Israel
| | - Yonit Wiener-Well
- Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Jacob Strahilevitz
- Department of Clinical Microbiology & Infectious Disease, Hadassah-Hebrew University, Jerusalem, Israel
| | - Michal Stein
- Pediatric Infectious Disease Unit, Wolfson Medical Center, Holon, Israel
| | - Daniel Glikman
- Pediatric Infectious Disease Service, Western Galilee Hospital, Nahariya, Israel
| | - Gabriel Weber
- Infectious Disease Unit, Carmel Medical Center, Haifa, Israel
| | - Israel Potasman
- Infectious Disease Unit, Bnei-Zion Medical Center, Haifa, Israel
| | - Ron Dagan
- Pediatric Infectious Diseases Unit, Soroka University Medical Center & Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Che D, Zhou H, He J, Wu B. Modeling the impact of the 7-valent pneumococcal conjugate vaccine in Chinese infants: an economic analysis of a compulsory vaccination. BMC Health Serv Res 2014; 14:56. [PMID: 24507480 PMCID: PMC3918139 DOI: 10.1186/1472-6963-14-56] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 01/28/2014] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to compare, from a Chinese societal perspective, the projected health benefits, costs, and cost-effectiveness of adding pneumococcal conjugate heptavalent vaccine (PCV-7) to the routine compulsory child immunization schedule. Methods A decision-tree model, with data and assumptions adapted for relevance to China, was developed to project the health outcomes of PCV-7 vaccination (compared with no vaccination) over a 5-year period as well as a lifetime. The vaccinated birth cohort included 16,000,000 children in China. A 2 + 1 dose schedule at US$136.51 per vaccine dose was used in the base-case analysis. One-way sensitivity analysis was used to test the robustness of the model. The impact of a net indirect effect (herd immunity) was evaluated. Outcomes are presented in terms of the saved disease burden, costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio. Results In a Chinese birth cohort, a PCV-7 vaccination program would reduce the number of pneumococcus-related infections by at least 32% and would prevent 2,682 deaths in the first 5 years of life, saving $1,190 million in total costs and gaining an additional 9,895 QALYs (discounted by 3%). The incremental cost per QALY was estimated to be $530,354. When herd immunity was taken into account, the cost per QALY was estimated to be $95,319. The robustness of the model was influenced mainly by the PCV-7 cost per dose, effectiveness herd immunity and incidence of pneumococcal diseases. With and without herd immunity, the break-even costs in China were $29.05 and $25.87, respectively. Conclusions Compulsory routine infant vaccination with PCV-7 is projected to substantially reduce pneumococcal disease morbidity, mortality, and related costs in China. However, a universal vaccination program with PCV-7 is not cost-effective at the willingness-to-pay threshold that is currently recommended for China by the World Health Organization.
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Affiliation(s)
| | | | | | - Bin Wu
- Medical Decision and Economic Group, Department of Pharmacy, Renji Hospital, affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China.
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14
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Respiratory infection and otitis media visits in relation to pneumococcal conjugate vaccine use in Saskatchewan. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2014; 24:179-84. [PMID: 24489558 DOI: 10.1155/2013/385652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Saskatchewan, pneumococcal conjugate vaccination (PCV) was offered to high-risk children in 2002 and to all infants in 2005. OBJECTIVE To describe trends in the frequency of medical visits for lower respiratory tract infection (LRI) and otitis media (OM) in relation to PCV use during the period 1990 to 2008. METHODS Statistics regarding the number of children covered by the health insurance plan, PCV administration, and medical visits with a diagnostic code associated with LRI and OM were provided by Saskatchewan Health. Monthly rates were analyzed using dynamic state space models. RESULTS In all series, there was a marked seasonal cycle and some higher-than-expected winter peak values, possibly associated with epidemics of specific respiratory viruses. Three abrupt decreases in baseline rate were observed for LRI and the final one, in February 2007, could be related to the increased proportion of children vaccinated with PCV. There was no statistical correlation between PCV use and OM visit frequency. CONCLUSION Many environmental, biological and administrative factors may influence health services use, and an effect of low magnitude of a particular vaccine pertaining to nonspecific outcomes could be obscured in time-series analyses.
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Zuccotti G, Mameli C, Daprai L, Garlaschi ML, Dilillo D, Bedogni G, Faccini M, Gramegna M, Torresani E, Ballerini E, Benincaso A, Bonvissuto M, Bricalli D, Brioschi M, Calloni CS, Camiletti MI, Colella G, De Angelis L, Decarlis S, Di Nello F, Dozzi M, Galli E, Gandini V, Giuliani MG, Laviola F, Loda B, Macedoni M, Mazzucchi E, Metta MG, Moscatiello A, Nannini P, Petruzzi M, Picicco D, Picciotti M, Pisanelli S, Porta N, Ramponi G, Redaelli F, Rubini R, Sala N, Saitta V, Scelza G, Tiso RM, Tomasetto M, Torcoletti M, Travaini M, Valentini M, Vessia C. Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era. Vaccine 2013; 32:527-34. [PMID: 24342249 DOI: 10.1016/j.vaccine.2013.12.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/25/2013] [Accepted: 12/02/2013] [Indexed: 10/25/2022]
Abstract
Few epidemiological data are available since the introduction of 13-valent pneumococcal vaccine (PCV13) in 2010. We conducted a cross-sectional study to estimate the prevalence of Streptococcus pneumoniae (SP) nasopharyngeal carriage in healthy Italian infants and young children and to evaluate the impact of PCV13 on pneumococcal colonization. In the trimester September-December 2011 nasopharyngeal swabs were collected from healthy children aged 3-59 months presenting for routine well careat 16 primary care pediatricians in Milan. SP carriage isolates were serotyped and tested for antimicrobial resistance using EUCAST breakpoints. Among 1250 enrolled children, 618 had received at least 1 dose of PCV13, 292 at least 1 dose of PCV7, 94 a combination of the two vaccines and 246 were not vaccinated. The prevalence of SP carriage was 27% (95% confidence interval [CI] 25-30). At multivariable analysis, age≥25 months (prevalence ratio [PR]=0.74) and use of antibiotics in the previous 3 months (PR=0.67) were associated with lower SP carriage prevalence. Having siblings (PR=1.79 for 1 sibling and PR=2.23 for ≥2 siblings), day-care attendance (PR=2.27) and respiratory tract infections in the previous 3 months (PR=1.39) were associated with higher SP carriage prevalence. The immunization status for SP was not associated with SP carriage at univariable or at multivariable analysis. The most common carriage isolates were 6C, 19A and 23A. The prevalence of the six additional PCV13 serotypes carriage in children appropriately vaccinated with PCV13 was lower than in children appropriately vaccinated with PCV7 (0 vs. 0.060); the greater reduction in prevalence of carriage was observed for serotype 19A (0 vs. 0.041). Serotype 6C was the most common drug-resistant serotype (17.2%). Further epidemiological studies are needed to assess changes in circulating SP serotypes following the large-scale introduction of PCV13.
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Affiliation(s)
| | - Chiara Mameli
- Department of Paediatrics, L. Sacco Hospital, University of Milan, Italy
| | - Laura Daprai
- Microbiology Laboratory, Policlinico, Cà Granda Ospedale Maggiore Foundation, Milan, Italy
| | - Maria Laura Garlaschi
- Microbiology Laboratory, Policlinico, Cà Granda Ospedale Maggiore Foundation, Milan, Italy
| | - Dario Dilillo
- Department of Paediatrics, L. Sacco Hospital, University of Milan, Italy
| | - Giorgio Bedogni
- Clinical Epidemiology Unit, Liver Research Center, Trieste, Italy
| | - Marino Faccini
- Prevention Department, Local Health Authority, Milan, Italy
| | - Maria Gramegna
- Unità Organizzativa Governo della prevenzione e tutela sanitaria, Direzione Generale Sanità, Regione Lombardia, Milan, Italy
| | - Erminio Torresani
- Microbiology Laboratory, Policlinico, Cà Granda Ospedale Maggiore Foundation, Milan, Italy
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Oikawa J, Ishiwada N, Takahashi Y, Hishiki H, Nagasawa K, Takahashi S, Watanabe M, Chang B, Kohno Y. Changes in nasopharyngeal carriage of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis among healthy children attending a day-care centre before and after official financial support for the 7-valent pneumococcal conjugate vaccine and H. influenzae type b vaccine in Japan. J Infect Chemother 2013; 20:146-9. [PMID: 24582389 DOI: 10.1016/j.jiac.2013.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/16/2013] [Accepted: 10/19/2013] [Indexed: 12/01/2022]
Abstract
The 7-valent pneumococcal conjugate vaccine (PCV7) and Haemophilus influenzae type b (Hib) vaccine reduce nasopharyngeal carriage of vaccine-type bacteria, which may in turn influence the presence of other nasopharyngeal bacterial pathogens. To investigate this possibility, nasopharyngeal carriage of potential pathogens was examined before and after official financial support was provided to offer the PCV7 and Hib vaccines in healthy children attending a day care centre in Japan during 2011-2012. Despite a virtual disappearance of PCV7 serotypes over time, the overall pneumococcal carriage rate remained unchanged. Although others have reported an increase in PCV13 serotypes following PCV7 vaccination, only non-PCV13 serotypes were observed to have increased in this study. The majority of H. influenzae isolates were non-typeable and Hib was not found. Our data identified an unexpected pattern of pneumococcal serotype replacement following PCV7. Continuous monitoring of pneumococcal carriage is important for decisions regarding the future of national vaccination policy in Japan.
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Affiliation(s)
- Junko Oikawa
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Naruhiko Ishiwada
- Division of Control and Treatment of Infectious Diseases, Chiba University Hospital, Chiba, Japan
| | - Yoshiko Takahashi
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Haruka Hishiki
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Koo Nagasawa
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Sachiko Takahashi
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masaharu Watanabe
- Division of Laboratory Medicine, Chiba University Hospital, Chiba, Japan
| | - Bin Chang
- Department of Bacteriology Ⅰ, National Institute of Infection Diseases, Tokyo, Japan
| | - Yoichi Kohno
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
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Wick JY. Preventing pneumococcal disease: intergenerational issues. THE CONSULTANT PHARMACIST : THE JOURNAL OF THE AMERICAN SOCIETY OF CONSULTANT PHARMACISTS 2013; 28:220-227. [PMID: 23552703 DOI: 10.4140/tcp.n.2013.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In the United States, approximately four million people contract pneumococcal infections each year, and elders and children are at an increased risk of contracting these infections. Since the late 1800s, researchers have searched for a vaccine that covers the many serotypes of Streptococcus pneumoniae. Today, three vaccines are available, and each possesses subtle differences. Notwithstanding the positive impact from each vaccine type, the incidence of diseases caused by serotypes that are not included in specific vaccines tends to increase in children and certain adult populations with underlying illnesses. While these increases are usually small compared with the overall reduction in disease, some clinicians and patients question the effectiveness of vaccinations. Pharmacists need to promote pneumococcal vaccination and emphasize the need to also receive annual influenza vaccine.
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Affiliation(s)
- Jeannette Y Wick
- University of Connecticut School of Pharmacy, Storrs, Connecticut Arlington, Virginia, USA
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18
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Nanogel-based PspA intranasal vaccine prevents invasive disease and nasal colonization by Streptococcus pneumoniae. Infect Immun 2013; 81:1625-34. [PMID: 23460513 DOI: 10.1128/iai.00240-13] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
To establish a safer and more effective vaccine against pneumococcal respiratory infections, current knowledge regarding the antigens common among pneumococcal strains and improvements to the system for delivering these antigens across the mucosal barrier must be integrated. We developed a pneumococcal vaccine that combines the advantages of pneumococcal surface protein A (PspA) with a nontoxic intranasal vaccine delivery system based on a nanometer-sized hydrogel (nanogel) consisting of a cationic cholesteryl group-bearing pullulan (cCHP). The efficacy of the nanogel-based PspA nasal vaccine (cCHP-PspA) was tested in murine pneumococcal airway infection models. Intranasal vaccination with cCHP-PspA provided protective immunity against lethal challenge with Streptococcus pneumoniae Xen10, reduced colonization and invasion by bacteria in the upper and lower respiratory tracts, and induced systemic and nasal mucosal Th17 responses, high levels of PspA-specific serum immunoglobulin G (IgG), and nasal and bronchial IgA antibody responses. Moreover, there was no sign of PspA delivery by nanogel to either the olfactory bulbs or the central nervous system after intranasal administration. These results demonstrate the effectiveness and safety of the nanogel-based PspA nasal vaccine system as a universal mucosal vaccine against pneumococcal respiratory infection.
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The impact of 7-valent pneumococcal conjugate vaccine on invasive pneumococcal disease: a literature review. Adv Ther 2013; 30:127-51. [PMID: 23397399 DOI: 10.1007/s12325-013-0007-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Streptococcus pneumoniae can cause invasive pneumococcal diseases (IPD), such as bacteremic pneumonia, bacteremia, meningitis, and sepsis, and non-IPDs, such as otitis media, nonbacteremic pneumonia, and upper respiratory tract infections. It was estimated in 2000 that, worldwide, S. pneumoniae was responsible for 826,000 deaths annually in children aged between 1 month and 5 years. A 7-valent pneumococcal conjugate vaccine (PCV7) was licensed in 2000 in the USA and in 2001 in Europe. METHODS A literature search was performed in PubMed to identify studies assessing the impact of routine childhood PCV7 vaccination on pneumococcal morbidity and mortality. Here, the impact on IPD is reported. RESULTS A total of 37 articles reporting impact data on IPD were included in this review: four from Australia, 17 from western Europe, and 16 from North America. In vaccine-eligible children in the postvaccination period, a reduction ranging from 39.9% in Spain to 99.1% in the USA in vaccine-type (VT) IPD incidence, compared with the prevaccination period, was reported in 18 studies. All but one of the 30 studies assessing the impact of PCV7 on all-type IPD reported a reduction ranging from 1.7% in Spain to 76.3% in Australia. In addition, the majority of studies reported reductions in VT and all-type IPD incidence in age groups that were not vaccine eligible. CONCLUSIONS The results from this review illustrate that PCV7 has had a significant impact on IPD across all ages through its use in pediatric immunization programs. With the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) further reductions in the incidence of IPD due to the six additional serotypes included, as well as continued protection against IPD due to PCV7 serotypes may be expected. Robust surveillance systems are essential for the evaluation of the impact of PCV13 on all-type IPD and for monitoring the evolution of non-VT IPD.
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Ansaldi F, de Florentiis D, Canepa P, Ceravolo A, Rappazzo E, Iudici R, Martini M, Botti G, Orsi A, Icardi G, Durando P. Carriage of Streptoccoccus pneumoniae in healthy adults aged 60 years or over in a population with very high and long-lasting pneumococcal conjugate vaccine coverage in children: rationale and perspectives for PCV13 implementation. Hum Vaccin Immunother 2013; 9:614-20. [PMID: 23292052 DOI: 10.4161/hv.23253] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A serial cross-sectional study of nasopharyngeal carriage among adults aged 60 y or over was conducted in winter-spring 2012 with the aim to describe circulating Streptococcus pneumoniae in an area, Liguria Administrative Region, where the vaccine was implemented for a decade and coverage in pediatric age group reached a value close to 100% for more than 5 y, determining a picture of very high vaccine immunological pressure. The serotype-specific carriage picture in adults was compared with that observed in children by means of a cross-sectional study performed one year before using the same sampling and laboratory methods. Cluster sampling enrolled 283 adults, representative of the open population. Detection of multi-serotype carriage was performed using, real-time PCR and primer specific PCRs. Carriage prevalence of participants with at least one positive sample adjusted for age, i.e., period prevalence, was 18.7%, considering the Ligurian population as standard population, showing that the pneumococcal carriage in the elderly is not a rare event as emerged in other surveys. The long-term use of PCV7 has resulted in strong decrease of vaccine types carriage among adults and children. A multivariate analysis showed that age class and contact with children attending day care covariates were strongly associated with Streptococcus pneumoniae carriage. A strong link between the picture observed in < 5-y-old children and ≥ 60-y-old adults emerged: a strong correlation of specific-serotype prevalence between adults and children and risk factor analysis supported the role played by inter-age-group transmission.
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Affiliation(s)
- Filippo Ansaldi
- I.R.C.C.S. "A.O.U. San Martino-IST"; Genoa, Italy; Department of Health Sciences; University of Genoa; Genoa, Italy
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Jiang Y, Gauthier A, Annemans L, van der Linden M, Nicolas-Spony L, Bresse X. Cost-effectiveness of vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany. Expert Rev Pharmacoecon Outcomes Res 2012; 12:645-60. [PMID: 23025422 DOI: 10.1586/erp.12.54] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The introduction of routine infant vaccination against pneumococcal disease has resulted in a decreased overall invasive pneumococcal disease incidence in adults but also a change in invasive pneumococcal disease serotypes. This study aimed to assess the cost-effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany in this context. A population-based Markov model was developed. A cohort of adults currently eligible for vaccination was followed until death. Adult vaccination with PPV23 was associated with an incremental cost-effectiveness ratio of €17,065/quality-adjusted life years gained from the third-party payer's perspective. Univariate sensitivity analyses showed that the incremental cost-effectiveness ratio was below €50,000/quality-adjusted life years gained in most test scenarios. The model suggests that adult PPV23 vaccination is cost effective in Germany, due to its broad serotype coverage. This is despite epidemiological changes in Streptococcus pneumoniae serotypes caused by wider use of pneumococcal conjugate vaccines during childhood.
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Jiang Y, Gauthier A, Annemans L, van der Linden M, Nicolas-Spony L, Bresse X. A public health and budget impact analysis of vaccinating at-risk adults and the elderly against pneumococcal diseases in Germany. Expert Rev Pharmacoecon Outcomes Res 2012; 12:631-43. [PMID: 23025421 DOI: 10.1586/erp.12.55] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
To assess the comparative public health and budget impact over 5 years of several pneumococcal vaccination strategies (23-valent pneumococcal polysaccharide vaccine [PPV23] and/or 13-valent pneumococcal conjugate vaccine [PCV13]) in Germany, within the context of changing invasive pneumococcal disease (IPD) incidence over time. A multi-cohort, population-based Markov model was developed. Uncertainty around vaccine effectiveness, costs and IPD incidence change was handled through scenario analyses. Between 2012 and 2016, the introduction of PCV13 in adults, compared with the use of PPV23, would be associated with a net estimated budget increase of €59.7 million (+6.7%) to €151.6 million (+13.7%). Impact on IPD incidence ranged from -113 cases (-0.8%) to +298 cases (+2.8%). Introducing PCV13 in adults is expected to significantly affect healthcare budgets. Adult vaccination with PPV23 remains the optimal vaccination strategy from public health and budget perspectives.
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Spijkerman J, Prevaes SMPJ, van Gils EJM, Veenhoven RH, Bruin JP, Bogaert D, Wijmenga-Monsuur AJ, van den Dobbelsteen GPJM, Sanders EAM. Long-term effects of pneumococcal conjugate vaccine on nasopharyngeal carriage of S. pneumoniae, S. aureus, H. influenzae and M. catarrhalis. PLoS One 2012; 7:e39730. [PMID: 22761879 PMCID: PMC3382588 DOI: 10.1371/journal.pone.0039730] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 05/25/2012] [Indexed: 12/23/2022] Open
Abstract
Background Shifts in pneumococcal serotypes following introduction of 7-valent pneumococcal conjugate vaccine (PCV-7) may alter the presence of other bacterial pathogens co-inhabiting the same nasopharyngeal niche. Methodology/Principal Findings Nasopharyngeal prevalence rates of S. pneumoniae, S. aureus, H. influenzae and M. catarrhalis were investigated before, 3 and 4.5 years after introduction of PCV-7 in the national immunisation program in children at 11 and 24 months of age, and parents of 24-month-old children (n≈330/group) using conventional culture methods. Despite a virtual disappearance of PCV-7 serotypes over time, similar overall pneumococcal rates were observed in all age groups, except for a significant reduction in the 11-month-old group (adjusted Odds Ratio after 4.5 years 0.48, 95% Confidence Interval 0.34–0.67). Before, 3 and 4.5 years after PCV-7 implementation, prevalence rates of S. aureus were 5%, 9% and 14% at 11 months of age (3.59, 1.90–6.79) and 20%, 32% and 34% in parents (1.96, 1.36–2.83), but remained similar at 24 months of age, respectively. Prevalence rates of H. influenzae were 46%, 65% and 65% at 11 months (2.22, 1.58–3.13), 52%, 73% and 76% at 24 months of age (2.68, 1.88–3.82) and 23%, 30% and 40% in parents (2.26, 1.58–3.33), respectively. No consistent changes in M. catarrhalis carriage rates were observed over time. Conclusions/Significance In addition to large shifts in pneumococcal serotypes, persistently higher nasopharyngeal prevalence rates of S. aureus and H. influenzae were observed among young children and their parents after PCV-7 implementation. These findings may have implications for disease incidence and antibiotic treatment in the post-PCV era.
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Affiliation(s)
- Judith Spijkerman
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
- Research Center Linnaeus Institute, Spaarne Hospital, Hoofddorp, The Netherlands
| | - Sabine M. P. J. Prevaes
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
- Research Center Linnaeus Institute, Spaarne Hospital, Hoofddorp, The Netherlands
| | - Elske J. M. van Gils
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
- Research Center Linnaeus Institute, Spaarne Hospital, Hoofddorp, The Netherlands
| | - Reinier H. Veenhoven
- Research Center Linnaeus Institute, Spaarne Hospital, Hoofddorp, The Netherlands
| | - Jacob P. Bruin
- Regional Laboratory of Public Health, Haarlem, The Netherlands
| | - Debby Bogaert
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
| | | | | | - Elisabeth A. M. Sanders
- Department of Pediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands
- * E-mail:
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Principi N, Esposito S. Use of the 13-valent pneumococcal conjugate vaccine in infants and young children. Expert Opin Biol Ther 2012; 12:641-8. [PMID: 22397739 DOI: 10.1517/14712598.2012.670217] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The inclusion of the heptavalent pneumococcal conjugate vaccine (PCV7) in the immunization schedule of infants and young children has greatly reduced the incidence of invasive and non-invasive diseases due to Streptococcus pneumoniae. However, as PCV7 has some limitations, new vaccines containing more pneumococcal serotypes have been developed. Only two of these have so far reached the market: a 10-valent preparation containing the PCV7 serotypes plus serotypes 1, 5 and 7F (PCV10), and a 13-valent vaccine containing the PCV7 serotypes plus serotypes 1, 3, 5, 6A, 7F and 19A (PCV13). AREAS COVERED The main aim of this review is to discuss the reasons that have led to the formulation of PCV13, its immunogenicity, safety and tolerability and the recommendations concerning its use in children. EXPERT OPINION There is no doubt that a pneumococcal conjugate vaccine with the composition of PCV13 has significantly increased the possibility of preventing pneumococcal disease. Its immunogenicity, safety and tolerability seem to be optimal, as does its cost-effectiveness. However, despite these favorable premises, it cannot be considered the final preparation for the prevention of pneumococcal disease, and it is likely that a new vaccine capable of covering all pneumococcal serotypes will be needed in the future.
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Affiliation(s)
- Nicola Principi
- Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
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Ansaldi F, de Florentiis D, Canepa P, Zancolli M, Martini M, Orsi A, Durando P, Icardi G. Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy. Vaccine 2012; 30:2288-94. [DOI: 10.1016/j.vaccine.2012.01.067] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 12/14/2011] [Accepted: 01/22/2012] [Indexed: 11/27/2022]
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Chen Y, Deng W, Wang SM, Mo QM, Jia H, Wang Q, Li SG, Li X, Yao BD, Liu CJ, Zhan YQ, Ji C, Lopez AL, Wang XY. Burden of pneumonia and meningitis caused by Streptococcus pneumoniae in China among children under 5 years of age: a systematic literature review. PLoS One 2011; 6:e27333. [PMID: 22110628 PMCID: PMC3217934 DOI: 10.1371/journal.pone.0027333] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 10/14/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND METHODS To understand the burden and epidemiology of Streptococcus pneumoniae disease among children between 1 and 59 months of age in China, we conducted a review of literature published between 1980 and 2008 applying standardized algorithms. Because of the absence of population-based surveillance for pneumococcal disease (PD), we identified all-cause pneumonia, bacteremia and meningitis burden, syndromes most commonly associated with S. pneumoniae, and applied the proportion of disease attributable to S. pneumoniae from studies that determined the etiology of these three syndromes to calculate PD burden. Because of the microbiologic difficulties in identifying S. pneumoniae-attributable pneumonia which likely underestimates the pneumonia burden, we also used the proportion obtained from vaccine efficacy trials. RESULTS Between 1980 and 2008, there were 12,815 cases/100,000/year of all-cause pneumonia among children between 1 month and 59 months, with 526 deaths/100,000 annually. There were 14 meningitis cases/100,000/year. We estimate that as of 2000, there were 260,768 (113,000 to 582,382) and 902 (114-4,463) cases of pneumococcal pneumonia and meningitis, respectively with 10,703 (4,638-23,904) and 75 (9-370) pneumococcal pneumonia and meningitis deaths, respectively. Pneumococcal pneumonia cases and deaths were more than two-fold higher, 695,382 (173,845-1,216,918) and 28,542 (7,136-49,949), respectively, when parameters from efficacy trials were used. Serotypes 19F, 19A and 14 were the most common serotypes obtained from pneumonia/meningitis patients. Currently available vaccines are expected to cover 79.5% to 88.4% of the prevalent serotypes. With high antibiotic resistance, introducing pneumococcal vaccines to the routine immunization program should be considered in China. Population-based studies are warranted.
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Affiliation(s)
- Ying Chen
- Institutes of Biomedical Sciences, Fudan University, Shanghai, People's Republic of China
| | - Wei Deng
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Song-Mei Wang
- Laboratory of Medical Molecular Biology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Qi-Mei Mo
- Institutes of Biomedical Sciences, Fudan University, Shanghai, People's Republic of China
| | - Huan Jia
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Qun Wang
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Song-Guang Li
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Xiang Li
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Bao-Dong Yao
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Cheng-Jun Liu
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Yi-Qiang Zhan
- Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Chen Ji
- Pfizer Inc., New York, New York, United States of America
| | | | - Xuan-Yi Wang
- Institutes of Biomedical Sciences, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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Zangeneh TT, Baracco G, Al-Tawfiq JA. Impact of conjugate pneumococcal vaccines on the changing epidemiology of pneumococcal infections. Expert Rev Vaccines 2011; 10:345-53. [PMID: 21434802 DOI: 10.1586/erv.11.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Streptococcus pneumoniae-related infections have a major global impact on healthcare, especially in the developing world, and are considered the number one vaccine-preventable cause of death in children. There are more than 90 pneumococcal serotypes and 46 serogroups. The first capsular polysaccharide pneumococcal vaccine was licensed in the USA in 1977 for individuals older than 2 years of age at high risk for pneumococcal disease. Two decades later, the first 7-valent pneumococcal polysaccharide-protein conjugate vaccine completed the required clinical trials and was introduced as part of the national immunization program of various countries. New-generation vaccines that include emerging serotypes, while maintaining protection against the 7-valent pneumococcal serotypes, have recently been approved. With the addition of these serotypes, the majority of potential pneumococcal serotypes causing invasive disease in most parts of the world could be covered.
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Affiliation(s)
- Tirdad T Zangeneh
- Division of Infectious Diseases, University of Miami Miller School of Medicine and the Miami Veterans Affairs Healthcare System, Miami, FL, USA
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Spijkerman J, van Gils EJM, Veenhoven RH, Hak E, Yzerman EPF, van der Ende A, Wijmenga-Monsuur AJ, van den Dobbelsteen GPJM, Sanders EAM. Carriage of Streptococcus pneumoniae 3 years after start of vaccination program, the Netherlands. Emerg Infect Dis 2011. [PMID: 21470445 PMCID: PMC3377405 DOI: 10.3201/eid1704101115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
To evaluate the effectiveness of the 7-valent pneumococcal conjugate vaccine (PCV7) program, we conducted a cross-sectional observational study on nasopharyngeal carriage of Streptococcus pneumoniae 3 years after implementation of the program in the Netherlands. We compared pneumococcal serotypes in 329 prebooster 11-month-old children, 330 fully vaccinated 24-month-old children, and 324 parents with age-matched pre-PCV7 (unvaccinated) controls (ages 12 and 24 months, n = 319 and n = 321, respectively) and 296 of their parents. PCV7 serotype prevalences before and after PCV7 implementation, respectively, were 38% and 8% among 11-month-old children, 36% and 4% among 24-month-old children, and 8% and 1% among parents. Non-PCV7 serotype prevalences were 29% and 39% among 11-month-old children, 30% and 45% among 24-month-old children, and 8% and 15% among parents, respectively; serotypes 11A and 19A were most frequently isolated. PCV7 serotypes were largely replaced by non-PCV7 serotypes. Disappearance of PCV7 serotypes in parents suggests strong transmission reduction through vaccination.
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Novaes HMD, Sartori AMC, Soárez PCD. Hospitalization rates for pneumococcal disease in Brazil, 2004 - 2006. Rev Saude Publica 2011; 45:539-47. [DOI: 10.1590/s0034-89102011005000028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2010] [Accepted: 12/08/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To estimate hospitalization rates for pneumococcal disease based on the Brazilian Hospital Information System (SIH). METHODS: Descriptive study based on the Hospital Information System of Brazilian National Health System data from January 2004 to December 2006: number of hospitalizations and deaths for pneumococcal meningitis, pneumococcal sepsis, pneumococcal pneumonia and Streptococcus pneumoniae as the cause of diseases reported in Brazil. Data from the 2003 Brazilian National Household Survey were used to estimate events in the private sector. Pneumococcal meningitis cases and deaths reported to the Notifiable Diseases Information System during the study period were also analyzed. RESULTS: Pneumococcal disease accounted for 34,217 hospitalizations in the Brazilian National Health System (0.1% of all hospitalizations in the public sector). Pneumococcal pneumonia accounted for 64.8% of these hospitalizations. The age distribution of the estimated hospitalization rates for pneumococcal disease showed a "U"-shape curve with the highest rates seen in children under one (110 to 136.9 per 100,000 children annually). The highest hospital case-fatality rates were seen among the elderly, and for sepsis and meningitis. CONCLUSIONS: PD is a major public health problem in Brazil. The analysis based on the SIH can provide an important input to pneumococcal disease surveillance and the impact assessment of immunization programs.
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Serotypes of Streptococcus pneumoniae isolates from children with invasive pneumococcal disease in Turkey: baseline evaluation of the introduction of the pneumococcal conjugate vaccine nationwide. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1028-30. [PMID: 21508171 DOI: 10.1128/cvi.00526-10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Before use of the pneumococcal conjugate vaccine PCV7 became widespread in Turkey, 202 invasive pneumococcus isolates were analyzed. The most common serotypes were 19F and 6B. In children ≤2 years of age, the potential coverage rate of PCV7 was 69.5%. The most frequent non-PCV7 serotypes were 19A, 3, 1, 6A, and 8.
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Paradiso PR. Advances in Pneumococcal Disease Prevention: 13-Valent Pneumococcal Conjugate Vaccine for Infants and Children. Clin Infect Dis 2011; 52:1241-7. [DOI: 10.1093/cid/cir142] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Spijkerman J, van Gils EJ, Veenhoven RH, Hak E, Yzerman F, van der Ende A, Wijmenga-Monsuur AJ, van den Dobbelsteen GP, Sanders EA. Carriage ofStreptococcus pneumoniae3 Years after Start of Vaccination Program, the Netherlands. Emerg Infect Dis 2011; 17:584-91. [DOI: 10.3201/eid1704.101115] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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McIntosh EDG, Reinert RR. Global prevailing and emerging pediatric pneumococcal serotypes. Expert Rev Vaccines 2011; 10:109-29. [PMID: 21162625 DOI: 10.1586/erv.10.145] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Streptococcus pneumoniae is the leading cause of vaccine-preventable deaths among children younger than 5 years of age worldwide. The 7-valent pneumococcal conjugate vaccine (PCV7) is currently licensed in more than 90 countries and has contributed to significant declines in the incidence of invasive pneumococcal disease (IPD). Recent studies report an increased incidence of IPD caused by non-PCV7 vaccine serotypes (NVTs). Seroepidemiology of IPD caused by NVTs following the introduction of PCV7 is of interest, and this article provides a comprehensive global summary of the prevailing and emerging serotypes causing IPD in children. Currently, globally emerging or persistent NVTs include serotypes 1, 3, 5, 6A, 7F and 19A. Serotypes included in the recently licensed 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13) account for pneumococcal disease burdens in most developed countries of 65-85% and 80-90%, respectively. The seroprevalence of NVTs after widespread use of PCV10 and PCV13 requires ongoing monitoring.
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Affiliation(s)
- E David G McIntosh
- Novartis Vaccines, Hullenbergweg 83-85, Amsterdam 1101CL, The Netherlands.
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Reinert RR, Paradiso P, Fritzell B. Advances in pneumococcal vaccines: the 13-valent pneumococcal conjugate vaccine received market authorization in Europe. Expert Rev Vaccines 2010; 9:229-36. [PMID: 20218848 DOI: 10.1586/erv.10.6] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Effect of heptavalent pneumococcal conjugate vaccination on invasive pneumococcal disease in preterm born infants. BMC Infect Dis 2010; 10:12. [PMID: 20085656 PMCID: PMC2823613 DOI: 10.1186/1471-2334-10-12] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 01/19/2010] [Indexed: 11/24/2022] Open
Abstract
Background Evidence for protection of preterm born infants from invasive pneumococcal disease (IPD) by 7-valent pneumococcal conjugate vaccination (PCV7) is relatively sparse. Data from randomized trials is based on relatively small numbers of preterm born children. Methods We report data from active prospective surveillance of IPD in children in Germany. The cohorts of preterm born children in 2000 and 2007 and the respective whole birth cohorts are compared regarding occurrence of IPD. Results After introduction of PCV7 we observed a reduction in the rate of IPD in preterm born infants comparing the 2000 and 2007 birth cohort. The rate of IPD among the whole birth cohorts was reduced from 15.0 to 8.5 notifications per 100,000 (P < .001). The impact among the preterm birth cohort was comparable: A reduction in notification rate from 26.1 to 16.7 per 100,000 comparing the 2000 with the 2007 preterm birth cohort (P = .39). Preterm born infants with IPD were either unvaccinated or vaccinated delayed or incomplete. Conclusions This adds to evidence that PCV7 also protects preterm born infants effectively from IPD. Preterm born infants should receive pneumococcal vaccination according to their chronological age.
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