Pneumococcal serotypes before and after introduction of conjugate vaccines, United States, 1999-2011(1.)

Sandra S Richter1, Kristopher P Heilmann, Cassie L Dohrn

  • 1Cleveland Clinic, Cleveland, Ohio 44195, USA. richtes@ccf.org

Insights

The 7-valent pneumococcal conjugate vaccine significantly reduced disease-causing serotypes. The 13-valent pneumococcal vaccine (PCV13) introduction halted serotype 19A increases, offering broader protection against remaining pneumococcal disease serotypes.

Area of Science:

  • Microbiology
  • Immunology
  • Public Health

Background:

  • Pneumococcal conjugate vaccines (PCVs) have been instrumental in reducing invasive pneumococcal disease.
  • Serotype replacement and the emergence of non-vaccine serotypes are ongoing concerns following vaccination campaigns.

Purpose of the Study:

  • To analyze trends in pneumococcal serotypes causing invasive and noninvasive disease in the US.
  • To evaluate the impact of the 7-valent PCV and the introduction of the 13-valent PCV (PCV13) on serotype prevalence.

Main Methods:

  • Comparison of serotyping data from >43 US centers across multiple time periods: pre-PCV (1999-2000), post-PCV7 (2004-2005), and post-PCV13 (2008-2009, 2010-2011).
  • Analysis of prevalence changes for vaccine-type and non-vaccine-type *Streptococcus pneumoniae* serotypes.

Main Results:

  • Prevalence of 7-valent PCV serotypes drastically decreased from 64% (invasive) and 50% (noninvasive) in 1999-2000 to 3.8% and 4.2% in 2010-2011.
  • Introduction of PCV13 in 2010 coincided with a halt in the increase of serotype 19A.
  • Non-vaccine serotype 35B was the only major serotype to increase between 2008-2009 and 2010-2011.

Conclusions:

  • The 7-valent PCV has been highly effective in reducing the prevalence of its targeted serotypes.
  • PCV13 has demonstrated an impact by curbing the rise of serotype 19A and has the potential to cover a significant proportion (39%) of remaining disease-causing isolates.

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