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Invasive pneumococcal disease in Indigenous people in north Queensland: an update, 2005-2007
Jeffrey N Hanna1, Jan L Humphreys, Denise M Murphy
1Tropical Population Health Network, Queensland Health, Cairns, QLD, Australia. jeffrey_hanna@health.qld.gov.au
The Medical Journal of Australia
|July 8, 2008
Summary
The 7-valent pneumococcal conjugate vaccine (7vPCV) significantly reduced invasive pneumococcal disease (IPD) in Indigenous children and adults in North Queensland. However, an increase in non-7vPCV serotype IPD in adults warrants further investigation and newer vaccines.
Area of Science:
- Public Health
- Infectious Diseases
- Vaccinology
Background:
- Invasive pneumococcal disease (IPD) remains a significant public health concern, particularly in Indigenous populations.
- The introduction of pneumococcal conjugate vaccines (PCVs) has aimed to reduce the burden of IPD globally.
- Understanding vaccine impact and serotype replacement is crucial for ongoing disease control strategies.
Purpose of the Study:
- To evaluate the impact of the 7-valent pneumococcal conjugate vaccine (7vPCV) on IPD incidence in Indigenous people in North Queensland.
- To assess trends in IPD caused by vaccine-type and non-vaccine-type serotypes following 7vPCV introduction.
- To investigate indirect protective effects (herd immunity) and the emergence of non-vaccine-type IPD.
Main Methods:
- A retrospective study comparing IPD incidence over three 3-year periods: pre-vaccine (1999-2001) and two post-vaccine periods (2002-2004, 2005-2007).
- Analysis focused on Indigenous children and adults, examining IPD caused by 7vPCV and non-7vPCV serotypes.
- Statistical trend analysis was used to evaluate changes in incidence over time.
Main Results:
- A 60% overall decline in IPD was observed from 1999-2001 to 2005-2007, with near elimination of 7vPCV serotype IPD in young Indigenous children.
- While IPD incidence in Indigenous adults remained stable, a 75% reduction in 7vPCV serotype IPD occurred, indicating herd immunity.
- Conversely, IPD caused by non-7vPCV serotypes more than tripled in Indigenous adults, suggesting serotype replacement.
Conclusions:
- The 7vPCV vaccination program provided indirect protection to Indigenous adults in North Queensland via herd immunity.
- The benefit of 7vPCV in adults was partially offset by a significant increase in non-7vPCV serotype IPD.
- Future vaccination strategies utilizing newer PCVs are recommended to address the remaining burden of IPD in this population.
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