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Title: Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination.
Author: Hanquet, Germaine
Krizova, Pavla
Valentiner-Branth, Palle
Ladhani, Shamez N.
Nuorti, J. Pekka
Lepoutre, Agnes
Mereckiene, Jolita
Knol, Mirjam
Winje, Brita A.
Ciruela, Pilar
Ordobas, Maria
Guevara, Marcela
McDonald, Eisin
Morfeldt, Eva
Kozakova, Jana
Slotved, Hans-Christian
Fry, Norman K.
Rinta-Kokko, Hanna
Varon, Emmanuelle
Corcoran, Mary
Van der Ende, Arie
Vestrheim, Didrik F.
Muñoz-Almagro, Carmen
Latasa, Pello
Castilla, Jesús
Smith, Andrew
Henriques-Normark, Birgitta
Whittaker, Robert
Pastore Celentano, Lucia
Savulescu, Camelia
SpIDnet/I-MOVE+ Pneumo Group
Keywords: Malalties bacterianes
Vacuna antipneumocòccica
Bacterial diseases
Pneumococcal vaccine
Issue Date: May-2019
Publisher: BMJ Publishing Group
Abstract: Background: pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies. Methods: for each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100. Results: after five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively. Conclusion: overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.
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It is part of: Thorax, 2019, vol. 74, num. 5, p. 211767
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ISSN: 0040-6376
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)

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