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Effect of pneumococcal conjugate vaccine on pneumococcal meningitis

Heather E Hsu1, Kathleen A Shutt, Matthew R Moore

  • 1University of Pittsburgh, Pittsburgh, PA 15261, USA.

The New England Journal of Medicine
|January 16, 2009
PubMed

Insights

The pediatric heptavalent pneumococcal conjugate vaccine (PCV7) significantly reduced pneumococcal meningitis rates in children and adults. However, an increase in non-PCV7 serotype meningitis, including antibiotic-resistant strains, is a growing concern.

Area of Science:

  • Epidemiology
  • Vaccinology
  • Infectious Diseases

Background:

  • Invasive pneumococcal disease incidence decreased post-pediatric heptavalent pneumococcal conjugate vaccine (PCV7) introduction in 2000.
  • The specific impact of PCV7 on pneumococcal meningitis trends remained unclear.

Purpose of the Study:

  • To analyze trends in pneumococcal meningitis incidence from 1998 to 2005 in the United States.
  • To evaluate the effect of PCV7 on different pneumococcal serotypes causing meningitis.

Main Methods:

  • Utilized active, population-based surveillance data from eight US sites.
  • Classified isolates into PCV7, PCV7-related, and non-PCV7 serotypes.
  • Assessed changes in meningitis incidence against 1998-1999 baseline values.

Main Results:

  • Overall pneumococcal meningitis incidence declined by 30.1% (1.13 to 0.79 per 100,000).
  • Significant decreases observed in individuals younger than 2 years (64.0%) and older than 65 (54.0%).
  • PCV7-serotype meningitis dropped by 73.3%, while non-PCV7 serotype meningitis increased by 60.5%, notably serotype 19A.

Conclusions:

  • PCV7 has substantially reduced overall pneumococcal meningitis rates.
  • A concerning rise in meningitis due to non-PCV7 serotypes, some antibiotic-resistant, necessitates ongoing surveillance and potential vaccine updates.
Abstract

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