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Efficacy of 7-valent pneumococcal conjugate vaccination in Germany: An analysis using the indirect cohort method
Simon Rückinger1, Mark van der Linden, Ralf René Reinert
1Ludwig-Maximilians-University of Munich, Institute of Social Pediatrics and Adolescent Medicine, Division of Epidemiology, Heiglhofstr. 63, 81377 München, Germany. simon.rueckinger@med.uni-muenchen.de
Insights
Reduced pneumococcal conjugate vaccination schedules, even with one dose, provide significant protection against invasive pneumococcal disease (IPD). This study confirms PCV7 efficacy in Germany, where delayed vaccination is common.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- 7-valent pneumococcal conjugate vaccine (PCV7) efficacy is established with 4-dose schedules in young children.
- Reduced vaccination schedules and even single doses show protection against invasive pneumococcal disease (IPD).
- Delayed and incomplete vaccination is a significant challenge in Germany.
Purpose of the Study:
- To assess the efficacy of PCV7 using a real-world German dataset.
- To evaluate the effectiveness of reduced PCV7 vaccination schedules.
- To provide evidence supporting vaccination strategies in settings with delayed immunizations.
Main Methods:
- Employed an indirect cohort design (Broome method) using active surveillance data for IPD cases.
- Compared IPD cases caused by vaccine-serotype strains versus non-vaccine-serotype strains.
- Analyzed efficacy based on the number of PCV7 doses received and timing within the first seven months of life.
Main Results:
- Efficacy of at least one PCV7 dose against IPD was estimated at 88.3% (95% CI: 64.0-96.6).
- Efficacy estimates for one, two, and three doses within the first seven months were 78.1%, 89.8%, and 94.6%, respectively.
- The study indicates good protection from reduced PCV7 schedules, including two-dose primary series, even with delayed vaccinations.
Conclusions:
- Reduced PCV7 vaccination schedules offer substantial protection against IPD.
- The findings support the use of less intensive vaccination schedules in populations with delayed or incomplete uptake.
- PCV7 demonstrates effectiveness in preventing IPD in a setting with common vaccination delays.
Abstract:
Efficacy of 7-valent pneumococcal conjugate vaccination has been shown in randomized controlled trials using 4 dose vaccination schedules in children under 2 years of age. A case-control study from the US showed considerable protection from IPD for reduced vaccination schedules and even some protection from only one dose. In Germany, delayed and incomplete vaccination is a major issue. We assessed efficacy of PCV7 using data on cases of IPD from active surveillance and applying the indirect cohort design proposed by Broome, comparing cases of IPD with a vaccine serotype with cases with a non-vaccine serotype. Efficacy of at least one dose of PCV7 was estimated to be 88.3% (95% CI: 64.0-96.6). Estimates of efficacy for one, two, and three doses in the first 7 months of life were 78.1% (3.4-96.1), 89.8% (20.6-100.0), and 94.6% (69.7-99.5) respectively. Our study adds to evidence of good protection from IPD by reduced vaccination schedules with PCV7, e.g. with two doses as primary series, in a setting where a high proportion of children receives vaccination delayed.
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