Article

Increasing incidence of invasive pneumococcal disease and pneumonia despite improved vaccination uptake: surveillance in Hull and East Yorkshire, UK, 2002-2009

Hull and East Yorkshire Hospitals NHS Trust, Department of Infection and Tropical Medicine, Hull, UK.
Epidemiology and Infection (Impact Factor: 2.49). 11/2011; 140(7):1252-66. DOI: 10.1017/S0950268811001907
Source: PubMed

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.

0 Followers
 · 
73 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Since implementation of infant immunization with 7-valent pneumococcal conjugate vaccine (PCV7), increased rates of pneumococcal pneumonia have been reported among adults. Using a cohort of mother-infant pairs identified from the General Practice Research Database in the UK we found that from 2006 to 2010 the annual incidence rate of pneumococcal pneumonia among mothers increased from 61/100,000 to 81/100,000. We identified 43 cases of pneumococcal pneumonia in mothers and 430 control mother-infant pairs. The conditional odds ratio of pneumococcal pneumonia in mothers whose infants received a three-dose series of PCV7 compared to mothers whose infants received zero, one, or two doses was 4.0 (95% confidence interval [95%CI]: 1.0-15.8), and 11.0 (95%CI: 1.2-98.6) when compared with mothers whose infants received no vaccinations. The incidence of pneumococcal pneumonia may have increased in mothers following the introduction of PCV7, possibly because mothers whose infants received PCV7 are at increased risk for pneumococcal pneumonia. Though there is a chance of bias inherent to observational studies, the study findings support close monitoring of adult pneumococcal disease and potential role of adult vaccination needs to be explored.
    Vaccine 01/2013; 31(12). DOI:10.1016/j.vaccine.2013.01.018 · 3.49 Impact Factor
  • Source
    [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
  • Source
    [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