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Routine pneumococcal vaccination of children provokes new patterns of serotypes causing invasive pneumococcal disease

Nancy B Norton1, Ronald J Stanek, Maurice A Mufson

  • 1Department of Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA. norton2@marshall.edu

The American Journal of the Medical Sciences
|July 21, 2012
PubMed

Insights

Routine infant pneumococcal vaccination (PCV7) reduced childhood invasive pneumococcal disease (IPD) but increased adult IPD. Serotype changes reduced vaccine effectiveness, increasing risks from non-vaccine serotypes in adults.

Area of Science:

  • Epidemiology
  • Vaccinology
  • Microbiology

Background:

  • The introduction of 7-valent pneumococcal conjugate vaccine (PCV7) in 2000 altered the landscape of invasive pneumococcal disease (IPD) serotypes.
  • Understanding serotype shifts post-PCV7 is crucial for adult vaccination strategies.

Purpose of the Study:

  • To analyze changes in Streptococcus pneumoniae serotypes causing IPD in a community before and after PCV7 introduction.
  • To assess the impact of PCV7 on the serotype coverage of the 23-valent pneumococcal polysaccharide vaccine (PPV23) in adults.

Main Methods:

  • Collection and serotyping (Quellung reaction) of 620 IPD strains from hospitalized adults and children over a 15-year period (1996-2010).
  • Comparison of IPD incidence and serotype distribution in pre-PCV7 and post-PCV7 periods.

Main Results:

  • Significant decrease in childhood IPD, but a significant increase in adult IPD following PCV7 introduction.
  • PCV7 serotypes declined in both age groups; however, non-PCV7 serotypes, including those covered by PPV23 and novel ones, replaced them in adults.
  • Increased incidence of IPD caused by non-susceptible serotypes not covered by PCV7 was observed.

Conclusions:

  • PCV7 effectively reduced pediatric IPD but did not impact adult IPD rates.
  • Shifting serotype prevalence post-PCV7 diminished the effectiveness of both PCV7 and PPV23, particularly in adults.
  • The rise of non-vaccine serotypes poses an increasing risk for IPD in the adult population.
Abstract

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