Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the USA: analysis of multisite, population-based surveillance

• Type of Material: Article
• Authors: Matthew R. Moore, Centers for Disease Control and Prevention; Ruth Link-Gelles, Centers for Disease Control and Prevention; William Schaffner, Vanderbilt University; Ruth Lynfield, Minnesota Department of Health; Catherine Lexau, Minnesota Department of Health; Nancy M. Bennett, University of Rochester; Susan Petit, Connecticut Department of Public Health; Shelley M. Zansky, New York State Department of Health; Lee H. Harrison, Johns Hopkins Bloomberg Sch Publ Hlth; Arthur Reingold, California Emerging Infections Program; Lisa Miller, Colorado Department of Public Health and Environment; Karen Scherzinger, University of New Mexico; Ann Thomas, Oregon Public Health Division; Monica Farley, Emory University; Elizabeth R. Zell, Centers for Disease Control and Prevention; Thomas H. Taylor, Centers for Disease Control and Prevention; Tracy Pondo, Centers for Disease Control and Prevention; Loren Rodgers, Centers for Disease Control and Prevention; Lesley McGee, Centers for Disease Control and Prevention; Bernard Beall, Centers for Disease Control and Prevention; James H. Jorgensen, University of Texas Health Science Center; Cynthia G. Whitney, Centers for Disease Control and Prevention
• Language: English
• Date: 2015-03-01
• Publisher: Elsevier: Lancet
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Elsevier Ltd.
• Final Published Version (URL): http://dx.doi.org/10.1016/S1473-3099(14)71081-3
• Title of Journal or Parent Work: Lancet Infectious Diseases
• ISSN: 1473-3099
• Volume: 15
• Issue: 3
• Start Page: 301
• End Page: 309
• Grant/Funding Information: Centers for Disease Control and Prevention
• Keywords: Life Sciences & Biomedicine; IMMUNOCOMPROMISING CONDITIONS RECOMMENDATIONS; IMMUNIZATION PRACTICES ACIP; IMPACT; ADVISORY-COMMITTEE; COHORT; UNITED-STATES; POLYSACCHARIDE VACCINE; Science & Technology; Infectious Diseases; SEROTYPES

Abstract

Background: In 2000, seven-valent pneumococcal conjugate vaccine (PCV7) was introduced in the USA and resulted in dramatic reductions in invasive pneumococcal disease (IPD) and moderate increases in non-PCV7 type IPD. In 2010, PCV13 replaced PCV7 in the US immunisation schedule. We aimed to assess the effect of use of PCV13 in children on IPD in children and adults in the USA. Methods: We used laboratory-based and population-based data on incidence of IPD from the Active Bacterial Core surveillance (part of the Centers for Disease Control and Prevention's Emerging Infections Program) in a time-series model to compare rates of IPD before and after the introduction of PCV13. Cases of IPD between July 1, 2004, and June 30, 2013, were classified as being caused by the PCV13 serotypes against which PCV7 has no effect (PCV13 minus PCV7). In a time-series model, we used an expected outcomes approach to compare the reported incidence of IPD to that which would have been expected if PCV13 had not replaced PCV7. Findings: Compared with incidence expected among children younger than 5 years if PCV7 alone had been continued, incidence of IPD overall declined by 64% (95% interval estimate [95% IE] 59-68) and IPD caused by PCV13 minus PCV7 serotypes declined by 93% (91-94), by July, 2012, to June, 2013. Among adults, incidence of IPD overall also declined by 12-32% and IPD caused by PCV13 minus PCV7 type IPD declined by 58-72%, depending on age. We estimated that over 30 000 cases of IPD and 3000 deaths were averted in the first 3 years after the introduction of PCV13. Interpretation: PCV13 reduced IPD across all age groups when used routinely in children in the USA. These findings provide reassurance that, similar to PCV7, PCVs with additional serotypes can also prevent transmission to unvaccinated populations.