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Effectiveness of three pneumococcal conjugate vaccines to prevent invasive pneumococcal disease in Quebec, Canada
Geneviève Deceuninck1, Gaston De Serres2, Nicole Boulianne3
1Quebec University Hospital Research Centre, Quebec City, Canada.
Insights
Pneumococcal conjugate vaccines (PCV) demonstrated high effectiveness in preventing invasive pneumococcal disease (IPD) in Quebec children. PCV10 and PCV13 showed comparable protection, with PCV10 offering significant cross-protection against the 19A strain.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health Surveillance
Background:
- Quebec implemented a pneumococcal conjugate vaccine (PCV) program in December 2004, initially using PCV-7, then PCV10, and later PCV13.
- The program recommended a 2+1 dose schedule for infants, achieving over 90% vaccination coverage.
Purpose of the Study:
- To evaluate the effectiveness of sequentially used pneumococcal conjugate vaccines (PCV-7, PCV-10, PCV-13) in preventing invasive pneumococcal disease (IPD) in young children.
- To assess cross-protection against the 19A serotype and compare different PCV schedules.
Main Methods:
- A case-control study involving children aged 2-59 months diagnosed with IPD between 2005 and 2013 in Quebec.
- Vaccine effectiveness (VE) was calculated using multivariate logistic regression, comparing IPD cases to randomly selected controls from the provincial health insurance registry.
Main Results:
- High vaccine effectiveness (VE) was observed for vaccine-type IPD: 90% for PCV-7, 97% for PCV-10, and 86% for PCV-13 (with at least one dose).
- Significant cross-protection against 19A IPD was noted for PCV-10 (71%) and PCV-13 (74%).
- VE against PCV-13 type IPD was comparable across PCV-10, PCV-13, and mixed schedules (85-89%) with two or more doses.
Conclusions:
- All three PCV vaccines provided strong protection against vaccine-type IPD.
- PCV-10 demonstrated notable cross-protection against the 19A serotype.
- No significant difference in effectiveness was found between PCV-10, PCV-13, or a mixed PCV-10/PCV-13 schedule.
Background:
In Quebec, a pneumococcal conjugate vaccine (PCV) program was implemented in December 2004. The recommended schedule is 2+1 doses for low-risk infants. PCV-7 was first used (including catch-up for children <5 years of age), replaced by PCV10 in June 2009, and by PCV13 in January 2011 (no catch-up in both instances). From the beginning, >90% of children received the recommended number of doses.
Objective:
To assess the effectiveness of the three PCVs sequentially used to prevent invasive infectious disease (IPD).
Methods:
IPD cases in children 2-59 months during the years 2005-2013 were eligible. Controls were randomly identified in the provincial health insurance registry. Parents were interviewed and immunization records reviewed. Vaccine effectiveness (VE) was computed using multivariate logistic regression models.
Results:
Out of 889 IPD cases reported, full participation was obtained for 516 cases (58%) and for 1767 controls. Against vaccine-type IPD, VE (≥1 dose) was 90% (82-95%) for PCV7, 97% (84-99%) for PCV10 and 86% (62-95%) for PCV13. Against 19A IPD, VE was, respectively, 42% (-9% to 69%), 71% (24-89%), and 74% (11-92%). VE (≥2 doses) against PCV13-type IPD was 85% for PCV10 (66-94%), 85% for PCV13 (55-94%), and 89% (58-97%) for a mixed PCV10+PCV13 schedule.
Conclusions:
All three PCV vaccines showed high level of protection against IPD caused by serotypes included in their formulation and there was a high level of cross-protection against 19A for PCV10. No substantial difference was seen between PCV10, PCV13, or a mixed PCV10+PCV13 schedule.
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