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Comparative impact of pneumococcal conjugate vaccines on pneumococcal meningitis according to underlying conditions

Robert Cohen1, Emmanuelle Varon2, Stéphane Béchet3

  • 1Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; GPIP, Pediatric Infectious Disease Group, France; ACTIV, Pediatric Clinical and Therapeutical Association of the Val de Marne, Saint-Maur des Fossés, France; Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France.

Vaccine
|September 6, 2016
PubMed

Insights

Pneumococcal meningitis (PM) cases decreased after PCV13 vaccination, but the proportion of children with underlying conditions increased. Serotype distribution shifted, highlighting the need to identify these vulnerable children for effective vaccination strategies.

Area of Science:

  • Pediatric infectious diseases
  • Vaccinology
  • Epidemiology

Background:

  • Underlying conditions increase the risk of pneumococcal meningitis (PM) in children.
  • Pneumococcal conjugate vaccines (PCVs) target children with underlying conditions, but data on their effectiveness is limited.
  • Understanding PM epidemiology in vulnerable pediatric populations is crucial for vaccine strategy.

Purpose of the Study:

  • To analyze the impact of PCV7 and PCV13 on pediatric pneumococcal meningitis (PM) in France from 2001-2014.
  • To assess the role of underlying conditions in pediatric PM cases.
  • To evaluate changes in pneumococcal serotype distribution post-PCV13 implementation.

Main Methods:

  • Hospital-based active surveillance in 227 pediatric wards across France.
  • Inclusion criteria for PM standardized.
  • Data analyzed across pre-PCV7, post-PCV7, and post-PCV13 periods.

Main Results:

  • 1582 PM cases identified between 2001-2014; 62.5% in children under 2 years.
  • Underlying conditions were present in 16.1% of cases, higher in older children (30.8%) vs. young children (7.3%).
  • Post-PCV13, PM cases decreased 44.0%, primarily in children without underlying conditions. The proportion of PM cases in children with underlying conditions increased by 79.1%.

Conclusions:

  • Pneumococcal meningitis (PM) profile shifted, with a higher proportion of cases in children with underlying conditions.
  • Serotype distribution changed significantly post-PCV13, with a notable increase in non-vaccine serotypes.
  • Identifying underlying conditions in pediatric PM patients is critical for optimizing vaccination strategies in the PCV13 era.
Abstract

Keywords:
ChildrenImpactPneumococcal conjugate vaccinePneumococcal meningitisUnderlying conditions

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