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Have changing pneumococcal vaccination programmes impacted disease in Ontario?

Gillian H Lim1, Anne E Wormsbecker, Allison McGeer

  • 1Immunization and Vaccine Preventable Diseases, Public Health Ontario, Toronto, ON, Canada. gillian.lim@oahpp.ca

Vaccine
|April 20, 2013
PubMed

Insights

Ontario’s infant pneumococcal conjugate vaccine (PCV) programs showed success, reducing invasive pneumococcal disease (IPD) rates. Early impacts of PCV10 were noted in infants, but older adults still face a significant IPD burden.

Area of Science:

  • Infectious Diseases
  • Vaccinology
  • Public Health Surveillance

Background:

  • Ontario introduced infant 7-valent pneumococcal conjugate vaccine (PCV7) in 2005, later replaced by PCV10 and PCV13.
  • Adults aged 65+ have had universal access to the 23-valent polysaccharide vaccine (PPV23) since 1996.
  • PCV13 became available for adults aged 50+ in 2012, prompting an examination of vaccination program impacts on invasive pneumococcal disease (IPD).

Purpose of the Study:

  • To evaluate the effectiveness of publicly funded infant vaccination programs on invasive pneumococcal disease (IPD) incidence.
  • To assess the impact of PCV7, PCV10, and PCV13 introduction on IPD serotype distribution and rates.
  • To identify disease burden in different age groups, particularly among older adults eligible for PPV23 and PCV13.

Main Methods:

  • Analysis of laboratory data from population-based IPD surveillance in Ontario, Canada.
  • Inclusion of data from the Toronto Invasive Bacterial Disease Network and Public Health Ontario Laboratories.
  • Study period: January 1, 2008, to December 31, 2010.

Main Results:

  • Overall IPD incidence ranged from 7.4 to 9.3 per 100,000 population between 2008-2010.
  • Adults aged 65+ exhibited the highest IPD incidence (21.5-25.6/100,000), with a significant increase during the study period.
  • A 77% decrease in PCV7 serotype IPD was observed among vaccine-eligible children, with some impact also seen in non-eligible populations.

Conclusions:

  • Ontario's PCV7 program demonstrated success through serotype-specific IPD reductions, indicating herd immunity effects.
  • Early evidence suggests PCV10 introduction had a positive impact on infant IPD rates.
  • A significant burden of invasive pneumococcal disease persists among older adult populations.
Abstract

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