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Lancet Infect Dis. 2015 Mar;15(3):301-9. doi: 10.1016/S1473-3099(14)71081-3. Epub 2015 Feb 3.

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.

Author information

1
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: matt.moore@cdc.hhs.gov.
2
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
3
Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
4
Minnesota Department of Health, St Paul, MN, USA.
5
Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
6
Connecticut Department of Public Health, Hartford, CT, USA.
7
New York State Department of Health, Albany, NY, USA.
8
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
9
California Emerging Infections Program, Oakland, CA, USA; School of Public Health, Department of Epidemiology, University of California, Berkeley, CA, USA.
10
Colorado Department of Public Health and Environment, Denver, CO, USA.
11
Institute for Public Health, University of New Mexico, Emerging Infections Program, Albuquerque, NM, USA.
12
Oregon Public Health Division and Oregon Emerging Infections Program, Portland, OR, USA.
13
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA; Infection Disease Section, Medical Specialty Care Service Line, Atlanta VA Medical Center, Atlanta, GA, USA.
14
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Stat-Epi Associates, Ponte Vedra Beach, FL, USA.
15
Department of Pathology, University of Texas Health Science Center, San Antonio, TX, USA.

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.

FUNDING:

Centers for Disease Control and Prevention.

PMID:
25656600
PMCID:
PMC4876855
DOI:
10.1016/S1473-3099(14)71081-3
[Indexed for MEDLINE]
Free PMC Article

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