Dynamics of Invasive Pneumococcal Disease in Israel in Children and Adults in the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Era: A Nationwide Prospective Surveillance.

Abstract

BACKGROUND:

Following 13-valent pneumococcal conjugate vaccine (PCV13) implementation in infants worldwide, overall and vaccine-type invasive pneumococcal disease (IPD) rates declined in children, with variable indirect impact on adults.

METHODS:

A population-based, prospective, nationwide active surveillance of IPD in Israel, 2004-2019 (for adults ≥18 years, 2009-2019). The 7-valent PCV (PCV7)/PCV13 were implemented in Israel in July 2009/November 2010, respectively, with >90% uptake in children <2 years. The 23-valent pneumococcal polysaccharide vaccine (PPV-23) uptake among those >65 years was ~75%. For pre-PCV episodes with missing serotype, extrapolations were applied. Overall, PCV13 serotypes (VT13) and non-VT13 (NVT) incidence rate ratios (IRRs) comparing pre-PCV (2004-2008), early-PCV (2009-2011), and late-PCV13 (2016-2019) periods were calculated for different age groups.

RESULTS:

Overall, 8614 IPD cases were recorded. IPD rates declined by 67% in children <5 and 5-17 years, comparing late-PCV13 versus pre-PCV periods (IRR [95% CI]: .33 [.27-.40] and .33 [.21-.50], respectively). For adults, comparing late-PCV13 with early-PCV periods, rates significantly declined by 53% in those aged 18-44, while rates did not decline significantly in other age groups. VT13 rates significantly declined in all ages, with decline rates ranging between 94% in children <5 years and 60% in adults ≥85 years. NVT rates significantly increased in <5-, 50-64-, and ≥65-year age groups. In the late-PCV13 period, serotypes 3, 14, and 19A remained the predominant VT13, while serotypes 8 and 12F emerged as predominant NVTs.

CONCLUSIONS:

Continuous monitoring of circulating serotypes in all ages demonstrated direct and indirect PCV effects, which are essential for the development of new vaccination strategies.

• Authors: Shalom Ben-Shimol, Gili Regev-Yochay, Noga Givon-Lavi, Bart Adriaan van der Beek, Tal Brosh-Nissimov, Avi Peretz, Orli Megged, Ron Dagan, Israeli Pediatric Bacteremia and Meningitis Group (IPBMG), Israeli Adult Invasive Pneumococcal Disease (IAIPD) Group
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 74 Issue 9 Pg. 1639-1649 (05 03 2022) ISSN: 1537-6591 [Electronic] United States
• PMID: 34293091 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Heptavalent Pneumococcal Conjugate Vaccine
• Pneumococcal Vaccines
• Vaccines, Conjugate

Topics

• Adult
• Child
• Child, Preschool
• Heptavalent Pneumococcal Conjugate Vaccine
• Humans
• Incidence
• Infant
• Israel (epidemiology)
• Pneumococcal Infections (epidemiology, prevention & control)
• Pneumococcal Vaccines
• Prospective Studies
• Serogroup
• Vaccines, Conjugate