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Invasive pneumococcal diseases in children and adults before and after introduction of the 10-valent pneumococcal conjugate vaccine into the Austrian national immunization program.
Richter, Lukas; Schmid, Daniela; Kanitz, Elisabeth Eva; Zwazl, Ines; Pöllabauer, Eva; Jasinska, Joanna; Burgmann, Heinz; Kundi, Michael; Wiedermann, Ursula.
Afiliación
  • Richter L; Department of Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, Austria.
  • Schmid D; Department of Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, Austria.
  • Kanitz EE; Department of Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety, Vienna, Austria.
  • Zwazl I; Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
  • Pöllabauer E; Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
  • Jasinska J; Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
  • Burgmann H; General Hospital, AKH, Vienna, Austria.
  • Kundi M; Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria.
  • Wiedermann U; Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
PLoS One ; 14(1): e0210081, 2019.
Article en En | MEDLINE | ID: mdl-30629620
ABSTRACT

BACKGROUND:

In February 2012 the ten-valent pneumococcal conjugate vaccine (PCV10) with a 2+1 doses schedule (3, 5, 12 or 14 months of age) without catch-up vaccination was introduced in Austria. We assessed direct and indirect vaccine effects on invasive pneumococcal disease (IPD) by a population-based intervention study.

METHODS:

The study period was divided into pre- (2009-2011) and post-period (2013-2017, February), regarding 2012 as transition year. Outcomes were defined as PCV10 ST-IPD, the PCV10-related ST 6A and 19A IPD and non-PCV10 excluding ST 6A-/19A-IPD (NVT-IPD). We used national surveillance data and compared average monthly incidence rate (IR) between pre- and post-period among <5, 5-49 and ≥50 years old. Additionally, for the 5-49 and ≥50 years old, and the 50-59 and ≥60 years old, we analyzed monthly incidence data of the pre-, post-period, and estimated trend and level changes by using a segmented time-series regression.

RESULTS:

The PCV-10 IPD was reduced by 58% (95% CI 30%; 74%) and 67% (95% CI 32%; 84%) among <5 and ≥50 years old; the reduction in ≥60 years was 71% (95% CI 36%; 88%). There were no significant changes in the pre-post-rate or incidence trend of NVT-IPD in the <5 and ≥50 years old. ST-specific analyses revealed no ST 6A- and ST 19A IPD decline in any age-group, and a ST 8 IPD increase among ≥50 years old (IR ratio 3.5; 95% CI 1.7; 7.2). We found no vaccine effects among 5-49 years old.

CONCLUSIONS:

Our study adds to the evidence on direct and indirect protection of a childhood PCV10 vaccine program. Elderlies seem to benefit the most. Findings did not support PCV 10 cross-protection, but indicate replacement at least for ST 8 among the ≥50 years old. Follow-up analyses of IPD surveillance data are needed to fully characterize the magnitude of serotype replacement and further vaccine-attributable IPD reduction with time.
Asunto(s)

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Infecciones Neumocócicas / Evaluación de Programas y Proyectos de Salud / Programas de Inmunización / Vacunas Neumococicas Tipo de estudio: Evaluation_studies / Incidence_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Austria

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Infecciones Neumocócicas / Evaluación de Programas y Proyectos de Salud / Programas de Inmunización / Vacunas Neumococicas Tipo de estudio: Evaluation_studies / Incidence_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Austria