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Invasive pneumococcal disease in infants younger than 90 days before and after introduction of PCV7
Liset Olarte1, Krow Ampofo, Chris Stockmann
1Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Insights
The heptavalent pneumococcal conjugate vaccine (PCV7) reduced PCV7 serotype invasive pneumococcal disease (IPD) in young Utah infants, but overall IPD incidence remained unchanged. Serotype 7F became the leading cause of IPD and meningitis in this age group post-vaccination.
Area of Science:
- Pediatrics
- Vaccinology
- Epidemiology
Background:
- The introduction of the heptavalent pneumococcal conjugate vaccine (PCV7) has significantly altered the landscape of invasive pneumococcal disease (IPD).
- This study focuses on the impact of PCV7 on IPD incidence in a vulnerable population: Utah infants aged 1 to 90 days, who are too young for full immunization.
Purpose of the Study:
- To evaluate the epidemiological changes in invasive pneumococcal disease (IPD) among infants aged 1 to 90 days in Utah following the introduction of the heptavalent pneumococcal conjugate vaccine (PCV7).
- To analyze the shifts in serotype distribution and clinical presentations of IPD in this age group before and after PCV7 implementation.
Main Methods:
- A retrospective analysis of culture-confirmed invasive pneumococcal disease (IPD) cases in children under 18 years old in Utah from 1997 to 2010.
- Specific focus on demographic, clinical, and serotype data for infants aged 1 to 90 days, comparing the pre-vaccine (1997-2000) and post-vaccine (2001-2010) periods.
Main Results:
- Invasive pneumococcal disease (IPD) in infants aged 1 to 90 days accounted for 7% of all pediatric IPD cases, with incidence rates remaining stable at approximately 5.0 per 100,000 live births.
- IPD caused by PCV7 serotypes significantly decreased by 74%, while non-vaccine serotype IPD increased by 57%.
- Serotype 7F emerged as the predominant serotype in infants post-PCV7 introduction, being responsible for 50% of meningitis cases.
Conclusions:
- While the heptavalent pneumococcal conjugate vaccine (PCV7) effectively reduced IPD caused by its targeted serotypes in young infants, the overall incidence of IPD in this age group remained unchanged.
- The study highlights a significant shift in serotype prevalence, with serotype 7F becoming the leading cause of IPD and meningitis among infants aged 1 to 90 days in Utah after PCV7 introduction.
Background:
Introduction of the heptavalent pneumococcal conjugate vaccine (PCV7) changed the epidemiology of invasive pneumococcal disease (IPD). We evaluated the changes that occurred after PCV7 introduction among Utah infants aged 1 to 90 days, too young to be fully immunized.
Methods:
We identified children <18 years with culture-confirmed IPD from 1997-2010. We analyzed demographic, clinical, and serotype data for infants aged 1-90 days. The pre- and post-vaccine introduction periods spanned 1997-2000 and 2001-2010, respectively.
Results:
Of 513 children with IPD, 36 were 1 to 90 days and accounted for 7% of IPD cases in both the pre- and post-vaccine introduction period. The pre-vaccine IPD incidence rate was 5.0 per 100 000 live births, and was unchanged in the post-vaccine introduction period. IPD caused by PCV7 serotypes decreased by 74% (from 2.2 to 0.58 per 100 000), whereas non-vaccine serotype IPD increased by 57% (from 2.8 to 4.4 per 100 000). Sixteen infants (44%) required intensive care, and 3 (8%) died. Bacteremia without focus (56%) and meningitis (44%) were the predominant syndromes in the pre- and post-vaccine introduction periods, respectively. In the post-vaccine introduction period, serotype 7F was the most common serotype among infants and was responsible for 50% of meningitis.
Conclusions:
The incidence of IPD in Utah infants aged 1 to 90 days caused by PCV7 serotypes decreased after PCV7 introduction, but overall incidence was unchanged. In the post-vaccine introduction period, serotype 7F predominated in this age group and was associated with meningitis.
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