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Declining serotype coverage of new pneumococcal conjugate vaccines relating to the carriage of streptococcus pneumoniae in young children

Declining serotype coverage of new pneumococcal conjugate vaccines relating to the carriage of streptococcus pneumoniae in young children
Declining serotype coverage of new pneumococcal conjugate vaccines relating to the carriage of streptococcus pneumoniae in young children
Background: asymptomatic carriage of the opportunistic pathogen Streptococcus pneumoniae is known to precede the development of invasive disease. Young children are one of the major reservoirs for pneumococci and worldwide over 700,000 children under two years old die due to invasive pneumococcal disease each year. Heptavalent conjugate vaccine (PCV-7) was introduced into the UK childhood immunisation schedule in September 2006. Our objective was to assess the emergence of colonising serotypes in young children in the three years following PCV-7 implementation.

Methods: time-series prevalence survey set in the paediatric outpatients department of a large UK teaching hospital. Participants were children aged four years and under attending the outpatients department during PCV-7 introduction (October 2006–February 2007) and in the same months of the two subsequent years. The main outcome measure was prevalence of pneumococcal carriage by serotype.

Results: the rate of pneumococcal nasopharyngeal carriage remained stable during the three year period. We observed a significant 69% (95% CI, ?40% to ?118%, p < 0.0001) decrease in carriage of PCV-7 serotypes during PCV-7 implementation and a concomitant increase in the proportion of non PCV-7 serotypes. The most prevalent emerging non-vaccine serotypes were 6C, 11A, 19A and 22F. By March 2009, PCV-13 was predicted to cover only 33.3% (95% CI, 24.2–42.5%) of strains carried in the study population.

Conclusions: although the overall pneumococcal carriage rate remained stable between 2006 and 2009, we observed a significant decrease in the serotype coverage of PCV-7 and PCV-13. PCV-7 was highly successful in reducing carriage of vaccine serotypes. However, the increase in the proportion of non-vaccine serotypes found both in our study and causing invasive disease currently in the UK, underlines the importance of continued surveillance of carriage and disease
streptococcus pneumoniae, pneumococcal conjugate vaccine
4400-4404
Tocheva, Anna
f428e2af-7338-4cf3-bb12-9fe37e4fcbb0
Jefferies, Johanna M.C.
9468e292-0b41-412d-9470-944e257c7bcf
Rubery, Henry
b9e04137-7361-4243-b2fe-f43a7a758ace
Bennett, Jessica
48aae1d6-4d04-4640-b239-86a032934fbf
Afimeke, Geraldine
c6b41b12-c07b-4c89-b281-71d19eb25d9b
Garland, Joanna
7e673e59-abec-4f26-8689-c97edfe9ef22
Christodoulides, Myron
eba99148-620c-452a-a334-c1a52ba94078
Faust, Saul N.
f97df780-9f9b-418e-b349-7adf63e150c1
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
Tocheva, Anna
f428e2af-7338-4cf3-bb12-9fe37e4fcbb0
Jefferies, Johanna M.C.
9468e292-0b41-412d-9470-944e257c7bcf
Rubery, Henry
b9e04137-7361-4243-b2fe-f43a7a758ace
Bennett, Jessica
48aae1d6-4d04-4640-b239-86a032934fbf
Afimeke, Geraldine
c6b41b12-c07b-4c89-b281-71d19eb25d9b
Garland, Joanna
7e673e59-abec-4f26-8689-c97edfe9ef22
Christodoulides, Myron
eba99148-620c-452a-a334-c1a52ba94078
Faust, Saul N.
f97df780-9f9b-418e-b349-7adf63e150c1
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17

Tocheva, Anna, Jefferies, Johanna M.C., Rubery, Henry, Bennett, Jessica, Afimeke, Geraldine, Garland, Joanna, Christodoulides, Myron, Faust, Saul N. and Clarke, Stuart C. (2011) Declining serotype coverage of new pneumococcal conjugate vaccines relating to the carriage of streptococcus pneumoniae in young children. Vaccine, 29 (26), 4400-4404. (doi:10.1016/j.vaccine.2011.04.004). (PMID:21504773)

Record type: Article

Abstract

Background: asymptomatic carriage of the opportunistic pathogen Streptococcus pneumoniae is known to precede the development of invasive disease. Young children are one of the major reservoirs for pneumococci and worldwide over 700,000 children under two years old die due to invasive pneumococcal disease each year. Heptavalent conjugate vaccine (PCV-7) was introduced into the UK childhood immunisation schedule in September 2006. Our objective was to assess the emergence of colonising serotypes in young children in the three years following PCV-7 implementation.

Methods: time-series prevalence survey set in the paediatric outpatients department of a large UK teaching hospital. Participants were children aged four years and under attending the outpatients department during PCV-7 introduction (October 2006–February 2007) and in the same months of the two subsequent years. The main outcome measure was prevalence of pneumococcal carriage by serotype.

Results: the rate of pneumococcal nasopharyngeal carriage remained stable during the three year period. We observed a significant 69% (95% CI, ?40% to ?118%, p < 0.0001) decrease in carriage of PCV-7 serotypes during PCV-7 implementation and a concomitant increase in the proportion of non PCV-7 serotypes. The most prevalent emerging non-vaccine serotypes were 6C, 11A, 19A and 22F. By March 2009, PCV-13 was predicted to cover only 33.3% (95% CI, 24.2–42.5%) of strains carried in the study population.

Conclusions: although the overall pneumococcal carriage rate remained stable between 2006 and 2009, we observed a significant decrease in the serotype coverage of PCV-7 and PCV-13. PCV-7 was highly successful in reducing carriage of vaccine serotypes. However, the increase in the proportion of non-vaccine serotypes found both in our study and causing invasive disease currently in the UK, underlines the importance of continued surveillance of carriage and disease

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More information

Published date: 10 June 2011
Keywords: streptococcus pneumoniae, pneumococcal conjugate vaccine
Organisations: Infection Inflammation & Immunity

Identifiers

Local EPrints ID: 191617
URI: http://eprints.soton.ac.uk/id/eprint/191617
PURE UUID: ff8c9731-3280-4dcc-860d-5d71df9da776
ORCID for Myron Christodoulides: ORCID iD orcid.org/0000-0002-9663-4731
ORCID for Saul N. Faust: ORCID iD orcid.org/0000-0003-3410-7642
ORCID for Stuart C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548

Catalogue record

Date deposited: 23 Jun 2011 07:21
Last modified: 15 Mar 2024 03:26

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Contributors

Author: Anna Tocheva
Author: Johanna M.C. Jefferies
Author: Henry Rubery
Author: Jessica Bennett
Author: Geraldine Afimeke
Author: Joanna Garland
Author: Saul N. Faust ORCID iD

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