Impact of 13-Valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease Among Adults With HIV-United States, 2008-2018

• Authors: Miwako Kobayashi, Centers for Disease Control and Prevention, Atlanta; Almea Matanock, Centers for Disease Control and Prevention, Atlanta; Wei Xing, Centers for Disease Control and Prevention; William K Adih, Centers for Disease Control and Prevention; Jianmin Li, Centers for Disease Control and Prevention; Ryan Gierke, Centers for Disease Control and Prevention; Olivia Almendares, Centers for Disease Control and Prevention; Arthur Reingold, University of California Berkeley; Nisha Alden, Colorado Department of Public Health and Environment, Denve; Susan Petit, Connecticut Department of Public Health; Monica Farley, Emory University; Lee H Harrison, Johns Hopkins Bloomberg School of Public Health; Corinne Holtzman, Minnesota Department of Health, St. Paul, MN; Joan Baumbach, New Mexico Department of Health, Santa Fe, NM; Ann Thomas, Oregon Department of Human Services, Portland, OR; William Schaffner, Vanderbilt University; Lesley McGee, Centers for Disease Control and Prevention, Atlanta; Tamara Pilishvili, Centers for Disease Control and Prevention, Atlanta
• Journal Title: JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
• Volume: Volume 90, Number 1
• Publisher: LIPPINCOTT WILLIAMS & WILKINS | 2022-05-01, Pages 6-14
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/QAI.0000000000002916
• Subjects: Health Sciences, Public Health; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Immunology; Infectious Diseases; 13-valent pneumococcal conjugate vaccine; invasive pneumococcal disease; indirect effects; direct effects; HIV infection; STREPTOCOCCUS-PNEUMONIAE INFECTIONS; POLYSACCHARIDE VACCINE; ANTIRETROVIRAL THERAPY; ADVISORY-COMMITTEE; RACIAL DISPARITIES; RISK-FACTORS; ERA; RECOMMENDATIONS; PREVENTION; RESPONSES

Abstract

Background:People with HIV (PWH) are at increased risk for invasive pneumococcal disease (IPD). Thirteen-valent pneumococcal conjugate vaccine (PCV13) was recommended for use in US children in 2010 and for PWH aged 19 years or older in 2012. We evaluated the population-level impact of PCV13 on IPD among PWH and non-PWH aged 19 years or older.Methods:We identified IPD cases from 2008 to 2018 through the Active Bacterial Core surveillance platform. We estimated IPD incidence using the National HIV Surveillance System and US Census Bureau data. We measured percent changes in IPD incidence from 2008 to 2009 to 2017-2018 by HIV status, age group, and vaccine serotype group, including serotypes in recently licensed 15-valent (PCV15) and 20-valent (PCV20) PCVs.Results:In 2008-2009 and 2017-2018, 8.4% (552/6548) and 8.0% (416/5169) of adult IPD cases were among PWH, respectively. Compared with non-PWH, a larger proportion of IPD cases among PWH were in adults aged 19-64 years (94.7%-97.4% vs. 56.0%-60.1%) and non-Hispanic Black people (62.5%-73.0% vs. 16.7%-19.2%). Overall and PCV13-type IPD incidence in PWH declined by 40.3% (95% confidence interval: -47.7 to -32.3) and 72.5% (95% confidence interval: -78.8 to -65.6), respectively. In 2017-2018, IPD incidence was 16.8 (overall) and 12.6 (PCV13 type) times higher in PWH compared with non-PWH; PCV13, PCV15/non-PCV13, and PCV20/non-PCV15 serotypes comprised 21.5%, 11.2%, and 16.5% of IPD in PWH, respectively.Conclusions:Despite reductions post-PCV13 introduction, IPD incidence among PWH remained substantially higher than among non-PWH. Higher-valent PCVs provide opportunities to reduce remaining IPD burden in PWH.