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Vaccine. 2019 Oct 8;37(43):6299-6309. doi: 10.1016/j.vaccine.2019.08.073. Epub 2019 Sep 6.

Using pneumococcal carriage studies to monitor vaccine impact in low- and middle-income countries.

Author information

1
New Vaccines Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia. Electronic address: jocelyn.chan@mcri.edu.au.
2
New Vaccines Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
3
New Vaccines Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
4
National Center of Communicable Diseases (NCCD), Ministry of Health, Ulaanbaatar, Mongolia.
5
Papua New Guinea Institute of Medical Research, Infection and Immunity Unit, Goroka, Papua New Guinea; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia.
6
Ministry of Health and Medical Services, Suva, Fiji.
7
New Vaccines Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
8
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States.
9
New Vaccines Group, Murdoch Children's Research Institute, Melbourne, Australia; Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Melbourne, Australia. Electronic address: fmruss@unimelb.edu.au.

Abstract

Pneumococcal disease is a leading cause of childhood mortality, globally. The pneumococcal conjugate vaccine (PCV) has been introduced to many countries worldwide. However there are few studies evaluating PCV impacts in low- and middle-income countries (LMIC) because measuring the impact of PCV on pneumococcal disease in LMICs is challenging. We review the role of pneumococcal carriage studies for the evaluation of PCVs in LMICs and discuss optimal methods for conducting these studies. Fifteen carriage studies from 13 LMICs quantified the effects of PCV on carriage, and identified replacement carriage serotypes in the post-PCV era. Ten studies reported on the indirect effects of PCV on carriage. Results can be used to inform cost-effectiveness evaluations, guide policy decisions on dosing and product, and monitor equity in program implementation. Critically, we highlight gaps in our understanding of serotype replacement disease in LMICs and identify priorities for research to address this gap.

KEYWORDS:

Low- and middle-income countries; Nasopharyngeal carriage; Pneumococcal vaccines

PMID:
31500968
DOI:
10.1016/j.vaccine.2019.08.073
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