Jayasinghe S; Menzies R; Chiu C; Toms C; Blyth CC; Krause VL; McIntyre P

Author(s)

Jayasinghe S

Menzies R

Chiu C

Toms C

Blyth CC

Krause VL

McIntyre P

Publication Date

2017-01-15

Abstract

Australia introduced universal 7-valent pneumococcal conjugate vaccine (PCV7) from 2005, replaced by 13-valent PCV (PCV13) in 2011, uniquely among high-income countries giving doses at 2, 4, and 6 months (3 + 0 schedule). Data on impact of a timely 3 + 0 PCV schedule with high coverage are sparse, with none for PCV13. We used national surveillance of invasive pneumococcal disease (IPD) from 2002 for baseline and appropriate later comparison periods to calculate incidence rate ratios (IRRs) by serotype and age using a Poisson model. PCV coverage was assessed from the Australian Childhood Immunisation Register. After 9 years of timely 3-dose PCV coverage of >92%, all-age IPD in Australia almost halved (IRR, 0.53; 95% confidence interval [CI], .50-.57), but differed by PCV era. Reductions in IPD due to vaccine serotypes from PCV7 (IRR, 0.20; CI, .17-.22) were about 2-fold greater than for IPD due to extra serotypes in PCV13 (13v-non7v) in a similar period (IRR, 0.58; CI, .51-.66). Post-PCV13 declines in serotype 19A IPD in persons aged <2 years (IRR, 0.23; CI, .13-.35) and ≥2 years (IRR, 0.35; CI, .28-.44) differed from other 13v-non7v IPD (IRR, 0.73; CI, .35-1.48 for those aged <2 years and IRR, 0.96; CI, .81-1.15 for those ≥2 years). Meningitis due to vaccine serotypes nearly disappeared in children eligible for 3 PCV13 doses. IPD due to non-PCV13 serotypes increased by 30% compared with 76% for non-PCV7 serotypes in equivalent period of vaccine use. Reductions in vaccine-type IPD post-PCV13 were inferior to Australian experience with PCV7 and reports from high-income countries giving a PCV booster dose. Applicability of findings to other settings would depend on age of IPD onset, serotype profile, and timeliness of vaccination.

Citation

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2017-01-15; 64(2): 175-183

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/27986682/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/5297

Subject

Australia

PCV13

PCV7

invasive pneumococcal disease

vaccine impact.

MESH subject

Adolescent

Adult

Aged

Aged, 80 and over

Australia

Child

Child, Preschool

Female

Heptavalent Pneumococcal Conjugate Vaccine

History, 21st Century

Humans

Incidence

Infant

Male

Middle Aged

Outcome Assessment (Health Care)

Pneumococcal Infections

Pneumococcal Vaccines

Population Surveillance

Serogroup

Streptococcus pneumoniae

Vaccination

Vaccines, Conjugate

Young Adult

Immunization Schedule

Title

Long-term Impact of a "3 + 0" Schedule for 7- and 13-Valent Pneumococcal Conjugate Vaccines on Invasive Pneumococcal Disease in Australia, 2002-2014.

Type of document

Historical Article

Journal Article

Entity Type

Publication

Author(s)	Jayasinghe S Menzies R Chiu C Toms C Blyth CC Krause VL McIntyre P
Publication Date	2017-01-15
Abstract	Australia introduced universal 7-valent pneumococcal conjugate vaccine (PCV7) from 2005, replaced by 13-valent PCV (PCV13) in 2011, uniquely among high-income countries giving doses at 2, 4, and 6 months (3 + 0 schedule). Data on impact of a timely 3 + 0 PCV schedule with high coverage are sparse, with none for PCV13. We used national surveillance of invasive pneumococcal disease (IPD) from 2002 for baseline and appropriate later comparison periods to calculate incidence rate ratios (IRRs) by serotype and age using a Poisson model. PCV coverage was assessed from the Australian Childhood Immunisation Register. After 9 years of timely 3-dose PCV coverage of >92%, all-age IPD in Australia almost halved (IRR, 0.53; 95% confidence interval [CI], .50-.57), but differed by PCV era. Reductions in IPD due to vaccine serotypes from PCV7 (IRR, 0.20; CI, .17-.22) were about 2-fold greater than for IPD due to extra serotypes in PCV13 (13v-non7v) in a similar period (IRR, 0.58; CI, .51-.66). Post-PCV13 declines in serotype 19A IPD in persons aged <2 years (IRR, 0.23; CI, .13-.35) and ≥2 years (IRR, 0.35; CI, .28-.44) differed from other 13v-non7v IPD (IRR, 0.73; CI, .35-1.48 for those aged <2 years and IRR, 0.96; CI, .81-1.15 for those ≥2 years). Meningitis due to vaccine serotypes nearly disappeared in children eligible for 3 PCV13 doses. IPD due to non-PCV13 serotypes increased by 30% compared with 76% for non-PCV7 serotypes in equivalent period of vaccine use. Reductions in vaccine-type IPD post-PCV13 were inferior to Australian experience with PCV7 and reports from high-income countries giving a PCV booster dose. Applicability of findings to other settings would depend on age of IPD onset, serotype profile, and timeliness of vaccination.
Citation	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2017-01-15; 64(2): 175-183
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/27986682/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/5297
Subject	Australia PCV13 PCV7 invasive pneumococcal disease vaccine impact.
MESH subject	Adolescent Adult Aged Aged, 80 and over Australia Child Child, Preschool Female Heptavalent Pneumococcal Conjugate Vaccine History, 21st Century Humans Incidence Infant Male Middle Aged Outcome Assessment (Health Care) Pneumococcal Infections Pneumococcal Vaccines Population Surveillance Serogroup Streptococcus pneumoniae Vaccination Vaccines, Conjugate Young Adult Immunization Schedule
Title	Long-term Impact of a "3 + 0" Schedule for 7- and 13-Valent Pneumococcal Conjugate Vaccines on Invasive Pneumococcal Disease in Australia, 2002-2014.
Type of document	Historical Article Journal Article
Entity Type	Publication

Long-term Impact of a "3 + 0" Schedule for 7- and 13-Valent Pneumococcal Conjugate Vaccines on Invasive Pneumococcal Disease in Australia, 2002-2014.

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