Increasing incidence of invasive pneumococcal disease and pneumonia despite improved vaccination uptake: surveillance in Hull and East Yorkshire, UK, 2002-2009
ABSTRACT Introduction of pneumococcal polysaccharide (PPV23) and conjugate vaccine (PCV7) programmes were expected to change the epidemiology of invasive pneumococcal disease (IPD) and pneumonia in the UK. We describe the epidemiology of IPD and hospitalization with pneumonia using high-quality surveillance data over an 8-year period, 2002-2009. Although PPV23 uptake increased from 49% to 70% and PCV7 uptake reached 98% by 2009, the overall incidence of IPD increased from 11.8/100 000 to 16.4/100 000 (P=0.13), and the incidence of hospitalization with pneumonia increased from 143/100 000 to 207/100 000 (P<0.001). Although a reduction in the proportion of IPD caused by PCV7 serotypes was observed, concurrent increases in PPV23 and non-vaccine serotype IPD contributed to an increased IPD burden overall. Marked inequalities in the geographical distribution of disease were observed. Existing vaccination programmes have, so far, not been sufficient to address an increasing burden of pneumococcal disease in our locality.
SourceAvailable from: Paolo Castiglia[Show abstract] [Hide abstract]
ABSTRACT: The global burden of pneumococcal diseases is high, with young children and adults ≥50 years of age at highest risk of infection. Two types of vaccine are available for the prevention of pneumococcal diseases caused by specific Streptococcus pneumoniae serotypes: the pneumococcal polysaccharide vaccine (PPV23) and the pneumococcal conjugate vaccine (PCV7, PCV10, and PCV13). Despite pneumococcal immunization programs in adults and children, the burden in adults has remained high. Most European countries have national or local/regional vaccination recommendations. The objective of this review was to provide an overview of the government recommendations for pneumococcal vaccination outside routine childhood vaccination programs for 16 Western European countries as of August 2014. We found that recommendations for pneumococcal immunization across Europe are complex and vary greatly among countries in terms of age groups and risk groups recommended for vaccination, as well as which vaccine should be administered. Clarifying or simplifying these recommendations and improving their dissemination could help to increase pneumococcal vaccine uptake and decrease the high burden of pneumococcal diseases in adults, both through a direct effect of the vaccine and via a herd effect in unvaccinated individuals. Electronic supplementary material The online version of this article (doi:10.1007/s12325-014-0157-1) contains supplementary material, which is available to authorized users.Advances in Therapy 10/2014; 31(10). DOI:10.1007/s12325-014-0157-1 · 2.44 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Background. The 7-valent pneumococcal conjugate (PCV7) vaccine's impact on invasive pneumococcal disease (IPD) is well described, but few reports exist on the additional impact of the 13-valent vaccine (PCV13).Methods. We calculated IPD incidence across all ages in a surveillance project following implementation of PCV7 (September 2006) and PCV13 (April 2010) in children under two years (11 hospitals; 4935 cases).Results. Overall incidence decreased from 10/100,000 persons/year in 1996-1997 to 8/100,000 in 2007-2008 and 7/100,000 in 2012-2013. Declines were greater in under twos (from 37/100,000 to 29/100,000 and 14/100,000 respectively). PCV7-serotype IPD decreased in all ages after its introduction (p<0.001), whereas IPD with the additional six PCV13 (PCV13(6)) serotypes and non-vaccine types (NVT) increased in over twos (both p<0.001). PCV13(6)-serotype IPD declined significantly after PCV13 introduction in all ages (p<0.01), and NVT IPD declined significantly in over twos (p=0.003). In 2011-13, overall PCV7, PCV13(6) serotypes and NVT IPD incidence was 0.3, 2.8 and 4.4/100,000; 0.9; and 2.4 and 10.8/100,000 in under twos.Conclusions. Vaccine serotype IPD incidence of 1-3/100,000 in target (<2 years) and non-target groups demonstrates the success of PCV7 and PCV13 vaccines. Substantially higher incidence with NVT IPD indicates importance of ongoing surveillance and extension of vaccine polyvalency.The Journal of Infectious Diseases 04/2014; DOI:10.1093/infdis/jiu213 · 5.78 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: SUMMARY Analysis of the Dutch national invasive pneumococcal disease (IPD) surveillance data by sex reveals an increase in the incidence of serotype-1 disease in young female adults in The Netherlands after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in the national immunization schedule. This has led to an overall increase in IPD in women aged 20-45 years, which was not observed in men of the same age. No other differences in serotype shifts possibly induced by the introduction of PCV7 were observed between the sexes in this age group. Serotype 1 is a naturally fluctuating serotype in Europe and it has been associated with disease in young healthy adults before. It remains uncertain whether or not there is an association between the observed increase in serotype-1 disease in young female adults and the implementation of PCV7 in The Netherlands.Epidemiology and Infection 11/2013; 142(9):1-4. DOI:10.1017/S0950268813002860 · 2.49 Impact Factor