TY - JOUR
T1 - Differences in the impact of pneumococcal serotype replacement in individuals with and without underlying medical conditions
AU - Weinberger, Daniel M.
AU - Warren, Joshua L.
AU - Dalby, Tine
AU - Shapiro, Eugene D.
AU - Valentiner-Branth, Palle
AU - Slotved, Hans Christian
AU - Harboe, Zitta Barrella
N1 - Funding Information:
and R56AI110449 to D. M. W.). Support was also received from the Bill & Melinda Gates Foundation (award numbers OPP1176267 and OPP1114733); the National Institute on Aging (grant number P30AG021342; Scholar at the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine to D. M. W.); and the National Center for Advancing Translational Science, components of NIH and the NIH Roadmap for Medical Research (grant numbers UL1TR001863, UL1 TR000142, and KL2 TR000140).
Funding Information:
Potential conflicts of interest. D. M. W. has received consulting fees from Pfizer, Merck, GlaxoSmithKline, and Affinivax. Z. B. H. has received travel grants and consultancy fees from Pfizer and GSK. D. M. W. and Z. B. H. have received support from the Robert Austrian Research Award in Pneumococcal Vaccinology, which is supported by Pfizer. H. C. S. is participating in a Pfizer-sponsored project. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Funding Information:
Financial support. This work was funded by the National Institute of Allergy and Infectious Diseases, NIH (grant numbers R01AI123208
Funding Information:
This work was funded by the National Institute of Allergy and Infectious Diseases, NIH (grant numbers R01AI123208 and R56AI110449 to D. M. W.). Support was also received from the Bill & Melinda Gates Foundation (award numbers OPP1176267 and OPP1114733); the National Institute on Aging (grant number P30AG021342; Scholar at the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine to D. M. W.); and the National Center for Advancing Translational Science, components of NIH and the NIH Roadmap for Medical Research (grant numbers UL1TR001863, UL1 TR000142, and KL2 TR000140).
Publisher Copyright:
© The Author(s) 2018.
PY - 2019/6/18
Y1 - 2019/6/18
N2 - Background. Pneumococcal conjugate vaccines (PCVs) have had a well-documented impact on the incidence of invasive pneumococcal disease (IPD). However, declines in IPD due to vaccine-targeted serotypes have been partially offset by increases in IPD due to nonvaccine serotypes (NVTs). The goal of this study was to quantify serotype-specific changes in the incidence of IPD that occurred in different age groups, with or without certain comorbidities, following the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) in the childhood vaccination program in Denmark. Methods. We used nationwide surveillance data for IPD and a hierarchical Bayesian regression framework to estimate changes in the incidence of IPD associated with the introduction of PCV7 (2007) and PCV13 (2010) while controlling for serotype-specific epidemic cycles and unrelated secular trends. Results. Following the introduction of PCV7 and PCV13 in children, the net impact of serotype replacement varied considerably by age group and comorbidities. Differences in the magnitude of serotype replacement were due to variations in the incidence of NVTs in the different risk groups before the introduction of PCVs. The relative increases in the incidence of IPD caused by specific NVTs did not differ appreciably between risk groups in the postvaccination period. Serotype replacement offset a greater proportion of the benefit of PCVs in strata in which the NVTs comprised a larger proportion of cases prior to the introduction of the vaccines. Conclusions. These findings could help to predict the impact of next-generation PCVs in specific risk groups.
AB - Background. Pneumococcal conjugate vaccines (PCVs) have had a well-documented impact on the incidence of invasive pneumococcal disease (IPD). However, declines in IPD due to vaccine-targeted serotypes have been partially offset by increases in IPD due to nonvaccine serotypes (NVTs). The goal of this study was to quantify serotype-specific changes in the incidence of IPD that occurred in different age groups, with or without certain comorbidities, following the introduction of 7-valent pneumococcal conjugate vaccine (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) in the childhood vaccination program in Denmark. Methods. We used nationwide surveillance data for IPD and a hierarchical Bayesian regression framework to estimate changes in the incidence of IPD associated with the introduction of PCV7 (2007) and PCV13 (2010) while controlling for serotype-specific epidemic cycles and unrelated secular trends. Results. Following the introduction of PCV7 and PCV13 in children, the net impact of serotype replacement varied considerably by age group and comorbidities. Differences in the magnitude of serotype replacement were due to variations in the incidence of NVTs in the different risk groups before the introduction of PCVs. The relative increases in the incidence of IPD caused by specific NVTs did not differ appreciably between risk groups in the postvaccination period. Serotype replacement offset a greater proportion of the benefit of PCVs in strata in which the NVTs comprised a larger proportion of cases prior to the introduction of the vaccines. Conclusions. These findings could help to predict the impact of next-generation PCVs in specific risk groups.
KW - Bayesian hierarchical model
KW - Conjugate vaccines
KW - Pneumococcus
KW - Serotype replacement
UR - http://www.scopus.com/inward/record.url?scp=85068430726&partnerID=8YFLogxK
U2 - 10.1093/cid/ciy875
DO - 10.1093/cid/ciy875
M3 - Journal article
C2 - 30321313
AN - SCOPUS:85068430726
SN - 1058-4838
VL - 69
SP - 100
EP - 106
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -