Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pmed.1001517
Title: Serotype-Specific Changes in Invasive Pneumococcal Disease after Pneumococcal Conjugate Vaccine Introduction: A Pooled Analysis of Multiple Surveillance Sites
Authors: Feikin D.R.
Kagucia E.W.
Loo J.D.
Link-Gelles R.
Puhan M.A.
Cherian T.
Levine O.S.
Whitney C.G.
O'Brien K.L.
Moore M.R.
Feikin D.R.
Link-Gelles R.
Cherian T.
Adegbola R.A.
Agocs M.
Ampofo K.
Andrews N.
Barton T.
Benito J.
Broome C.V.
Bruce M.G.
Bulkow L.R.
Byington C.L.
Camou T.
Cook H.
Cotter S.
Dagan R.
de Wals P.
Deceuninck G.
Denham B.
Edwards G.
Eskola J.
Fitzgerald M.
Galanakis E.
Garcia-Gabarrot G.
Garcia-Garcia J.J.
Gene A.
Gomez B.
Heffernan H.
Hennessy T.W.
Heuberger S.
Hilty M.
Ingels H.
Jayasinghe S.
Kagucia E.W.
Kellner J.D.
Klein N.P.
Kormann-Klement A.
Kozakova J.
Krause V.
Kriz P.
Lambertsen L.
Lepoutre A.
Levine O.S.
Lipsitch M.
Loo J.D.
Lopez-Vega M.
Lovgren M.
Maraki S.
Mason E.O.
McIntyre P.B.
Menzies R.
Messina A.
Miller E.
Mintegi S.
Moore M.R.
Motlova J.
Moulton L.H.
Mühlemann K.
Muñoz-Almagro C.
O'Brien K.L.
Murdoch D.R.
Park D.E.
Puhan M.A.
Reingold A.L.
Sa-Leao R.
Sanyal A.
Smith P.G.
Spanjaard L.
Techasaensiri C.
Thompson R.E.
Thoon K.C. 
Tyrrell G.J.
Valentiner-Branth P.
van der Ende A.
Vanderkooi O.G.
van der Linden M.P.G.
Varon E.
Verhaegen J.
Vestrheim D.F.
Vickers I.
von Gottberg A.
von Kries R.
Waight P.
Weatherholtz R.
Weiss S.
Whitney C.G.
Yee A.
Zaidi A.K.M.
Keywords: Pneumococcus vaccine
adolescent
adult
aged
article
checklist
child
disease surveillance
geographic distribution
hospitalization
human
immunogenicity
incidence
income
major clinical study
meningitis
meta analysis
pneumococcal infection
prevalence
serotype
vaccination
Adolescent
Adult
Aged
Child, Preschool
Databases as Topic
Health Planning Guidelines
Humans
Meningitis, Pneumococcal
Meta-Analysis as Topic
Pneumococcal Infections
Pneumococcal Vaccines
Population Surveillance
Serotyping
Young Adult
Issue Date: 2013
Citation: Feikin D.R., Kagucia E.W., Loo J.D., Link-Gelles R., Puhan M.A., Cherian T., Levine O.S., Whitney C.G., O'Brien K.L., Moore M.R., Feikin D.R., Link-Gelles R., Cherian T., Adegbola R.A., Agocs M., Ampofo K., Andrews N., Barton T., Benito J., Broome C.V., Bruce M.G., Bulkow L.R., Byington C.L., Camou T., Cook H., Cotter S., Dagan R., de Wals P., Deceuninck G., Denham B., Edwards G., Eskola J., Fitzgerald M., Galanakis E., Garcia-Gabarrot G., Garcia-Garcia J.J., Gene A., Gomez B., Heffernan H., Hennessy T.W., Heuberger S., Hilty M., Ingels H., Jayasinghe S., Kagucia E.W., Kellner J.D., Klein N.P., Kormann-Klement A., Kozakova J., Krause V., Kriz P., Lambertsen L., Lepoutre A., Levine O.S., Lipsitch M., Loo J.D., Lopez-Vega M., Lovgren M., Maraki S., Mason E.O., McIntyre P.B., Menzies R., Messina A., Miller E., Mintegi S., Moore M.R., Motlova J., Moulton L.H., Mühlemann K., Muñoz-Almagro C., O'Brien K.L., Murdoch D.R., Park D.E., Puhan M.A., Reingold A.L., Sa-Leao R., Sanyal A., Smith P.G., Spanjaard L., Techasaensiri C., Thompson R.E., Thoon K.C., Tyrrell G.J., Valentiner-Branth P., van der Ende A., Vanderkooi O.G., van der Linden M.P.G., Varon E., Verhaegen J., Vestrheim D.F., Vickers I., von Gottberg A., von Kries R., Waight P., Weatherholtz R., Weiss S., Whitney C.G., Yee A., Zaidi A.K.M. (2013). Serotype-Specific Changes in Invasive Pneumococcal Disease after Pneumococcal Conjugate Vaccine Introduction: A Pooled Analysis of Multiple Surveillance Sites. PLoS Medicine 10 (9) : e1001517. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pmed.1001517
Abstract: Background:Vaccine-serotype (VT) invasive pneumococcal disease (IPD) rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into national immunization programs. Increases in non-vaccine-serotype (NVT) IPD rates occurred in some sites, presumably representing serotype replacement. We used a standardized approach to describe serotype-specific IPD changes among multiple sites after PCV7 introduction.Methods and Findings:Of 32 IPD surveillance datasets received, we identified 21 eligible databases with rate data ?2 years before and ?1 year after PCV7 introduction. Expected annual rates of IPD absent PCV7 introduction were estimated by extrapolation using either Poisson regression modeling of pre-PCV7 rates or averaging pre-PCV7 rates. To estimate whether changes in rates had occurred following PCV7 introduction, we calculated site specific rate ratios by dividing observed by expected IPD rates for each post-PCV7 year. We calculated summary rate ratios (RRs) using random effects meta-analysis. For children <5 years old, overall IPD decreased by year 1 post-PCV7 (RR 0·55, 95% CI 0·46-0·65) and remained relatively stable through year 7 (RR 0·49, 95% CI 0·35-0·68). Point estimates for VT IPD decreased annually through year 7 (RR 0·03, 95% CI 0·01-0·10), while NVT IPD increased (year 7 RR 2·81, 95% CI 2·12-3·71). Among adults, decreases in overall IPD also occurred but were smaller and more variable by site than among children. At year 7 after introduction, significant reductions were observed (18-49 year-olds [RR 0·52, 95% CI 0·29-0·91], 50-64 year-olds [RR 0·84, 95% CI 0·77-0·93], and ?65 year-olds [RR 0·74, 95% CI 0·58-0·95]).Conclusions:Consistent and significant decreases in both overall and VT IPD in children occurred quickly and were sustained for 7 years after PCV7 introduction, supporting use of PCVs. Increases in NVT IPD occurred in most sites, with variable magnitude. These findings may not represent the experience in low-income countries or the effects after introduction of higher valency PCVs. High-quality, population-based surveillance of serotype-specific IPD rates is needed to monitor vaccine impact as more countries, including low-income countries, introduce PCVs and as higher valency PCVs are used.Please see later in the article for the Editors' Summary.
Source Title: PLoS Medicine
URI: https://scholarbank.nus.edu.sg/handle/10635/161618
ISSN: 15491277
DOI: 10.1371/journal.pmed.1001517
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