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Ir Med J. 2019 Mar 14;112(3):894.

Is It Time To Review The Vaccination Strategy To Protect Adults Against Invasive Pneumococcal Disease?

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The Irish Pneumococcal Reference Laboratory, Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children’s University Hospital, Temple Street, Dublin 1, Ireland.
Health Protection Surveillance Centre, Dublin, Gardiner Street, Dublin 1, Ireland.
Department of Clinical Microbiology, the Royal College of Surgeons in Ireland, RCSI Education & Research Centre, Beaumont Hospital, Beaumont, Dublin 9, Ireland.
Department of Microbiology, Temple Street Children’s University Hospital, Dublin 1, Ireland.
Department of Microbiology, Beaumont Hospital, Beaumont, Dublin 9, Ireland.


Pneumococcal conjugate vaccines (PCVs) have reduced the predominant serotypes causing invasive pneumococcal disease (IPD). We assessed the impact of the paediatric 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13) among older adults. We compared serotype-specific incidence rates from 2007/08 to 2016/17, expressed as incidence rate ratios (IRR). Introducing PCV7 and PCV13 into the childhood immunisation programme resulted in a decline in these serotypes in adults ≥65 years of age, with PCV7 serotypes decreasing by 85% (IRR=0.11, 95%CI: 0.05-0.22, p<0.0001) and PCV13 serotypes not included in PCV7 (PCV13-7), decreasing by 9% (IRR=0.68, 95%CI: 0.40-1.16, p=0.134). However, there was a significant increase in serotypes only found in the 23-valent polysaccharide vaccine, PPV23-PCV13: IRR=2.57, 95%CI: 1.68-4.03, p<0.0001, and non-vaccine types (NVTs), IRR=3.33, 95%CI: 1.75-6.84, p=0.0001. The decline of IPD associated with PCV7/13 serotypes and the increase in PPV23-PCV13 serotypes indicates clear serotype replacement. Increasing PPV23 uptake could still reduce the burden of disease for this population.

[Indexed for MEDLINE]

Conflict of interest statement

HH has recently received research funds from Astellas and Pfizer, and has received lecture and other fees from Cepheid and Astellas. MCo and MMcE have received funding support from Pfizer. Additional funding has been provided through an unrestricted research grant from Pfizer (Ireland). The funders had no role in the collection, analysis, interpretation of data or in the writing of and decision to submit the article for publication.

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