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Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease in children in the USA: a matched case-control study [1]
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Date: 2016-05-01
Streptococcus pneumoniae, or pneumococcus, is a major cause of morbidity and mortality globally. In 2000, a seven-valent pneumococcal conjugate vaccine (PCV7 [Prevnar]; Wyeth, Collegeville, PA, USA) was introduced into the routine infant immunisation programme in the USA, using a schedule of doses at 2, 4, 6, and 12–15 months of age.1 Rates of invasive pneumococcal disease caused by PCV7 serotypes declined dramatically (>90% by 2007) after introduction.2, 3 After a few years, disease caused by serotype 19A, which was not included in PCV7, increased and became the most important cause of pneumococcal disease.2, 4 Invasive pneumococcal disease caused by other non-vaccine serotypes has increased in many countries. Although important, this phenomenon of serotype replacement has not overshadowed the overall benefits of conjugate vaccine introduction; rates of all invasive pneumococcal disease in the post-PCV7 period have remained well below pre-PCV7 rates in the USA.5
In 2010, a 13-valent conjugate vaccine (PCV13 [Prevnar-13]; Pfizer, New York, NY, USA) replaced PCV7 in the USA infant immunisation schedule. PCV13 included serotypes causing replacement disease in the USA and was licensed on the basis of a randomised trial with immunogenicity endpoints only.6 In addition to the routine schedule, children who started the schedule with PCV7 were recommended to complete the schedule with PCV13, and children aged up to 59 months inclusive who had completed the schedule with PCV7 were recommended to receive a single dose of PCV13.7 We used active, population-based surveillance for invasive pneumococcal disease in the USA to conduct a case-control study of PCV13 effectiveness.8 Our primary objective was to estimate the effectiveness of PCV13 in preventing invasive pneumococcal disease caused by any of the 13 serotypes included in the vaccine among children aged 2–59 months.9
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[1] Url:
https://www.sciencedirect.com/science/article/abs/pii/S2213260016000527?via%3Dihub
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