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Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination.

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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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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. Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination.. _Thorax_. 2019. Vol. 74, núm. 5, pàgs. 211767. [consulta: 24 de gener de 2026]. ISSN: 0040-6376. [Disponible a: https://hdl.handle.net/2445/133077]

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