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Invasive pneumococcal disease after routine pneumococcal conjugate vaccination in children, England and Wales

Shamez N Ladhani1, Mary P E Slack, Nick J Andrews

  • 1Immunisation Department, Health Protection Agency Colindale, London, UK. shamez.ladhani@hpa.org.uk

Emerging Infectious Diseases
|December 25, 2012
PubMed

Insights

Invasive pneumococcal disease (IPD) in children post-vaccine introduction shows comorbidities are more common in non-PCV13 serotypes, increasing fatality. This highlights the need for broader vaccine coverage against pneumococcal bacteria.

Area of Science:

  • Pediatric infectious diseases
  • Vaccinology
  • Epidemiology

Background:

  • The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in England and Wales.
  • Invasive pneumococcal disease (IPD) surveillance is crucial for monitoring vaccine impact and disease trends.

Purpose of the Study:

  • To assess risk factors, clinical presentation, and outcomes of IPD in children aged 3-59 months after PCV7 introduction.
  • To analyze the relationship between comorbidities, vaccine serotypes, and IPD outcomes.

Main Methods:

  • Retrospective analysis of 1,342 IPD episodes in 1,332 children from September 2006 to March 2010.
  • Comparison of comorbidity prevalence and case fatality rates across different pneumococcal serotype groups (PCV7, PCV10, PCV13, PPV23, non-PPV23).

Main Results:

  • 14.9% of children with IPD had comorbidities.
  • Comorbidities were less common in PCV7 and PCV10 serotypes but increased in PCV13, PPV23, and non-PPV23 serotypes.
  • The overall case-fatality rate was 4.4%, higher for meningitis (11.0%) and children with comorbidities (9.1%).

Conclusions:

  • Comorbidities are more prevalent in children with IPD caused by non-PCV13 serotypes.
  • The presence of comorbidities is associated with increased case fatality in pediatric IPD.
  • Findings underscore the importance of vaccines covering a broader range of pneumococcal serotypes.

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