Related Experiment Video
Updated: Dec 28, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Pneumococcal Conjugate Vaccine Breakthrough Infections: 2001-2016
Tolulope A Adebanjo1,2, Tracy Pondo1, David Yankey2
1Epidemic Intelligence Service and.
Insights
A 3-dose pneumococcal conjugate vaccine (PCV) schedule is more effective at preventing invasive pneumococcal disease (IPD) in infants under one year old compared to a 2-dose schedule. This difference was more pronounced when fewer vaccine serotypes were circulating.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Epidemiology
Background:
- Most countries utilize a 3-dose pneumococcal conjugate vaccine (PCV) schedule for infants.
- The United States has a licensed 4-dose schedule (3 primary doses + 1 booster) for infants.
- Evaluating PCV schedules is crucial for optimizing protection against invasive pneumococcal disease (IPD).
Purpose of the Study:
- To compare the incidence of invasive pneumococcal disease (IPD) breakthrough infections in children who received 2 vs. 3 primary doses of PCV.
- To assess the impact of booster doses on IPD incidence across different primary dose schedules (2+1 vs. 3+1 and 2+0 vs. 3+0).
Main Methods:
- Utilized 2001-2016 Active Bacterial Core surveillance data.
- Identified vaccine-type IPD breakthrough infections in children younger than 5 years who received at least one dose of PCV7 or PCV13.
- Calculated schedule-specific IPD incidence rates (IRs) and compared them using rate differences (RDs) and incidence rate ratios.
Main Results:
- Higher PCV13 IPD breakthrough infection rates were observed in infants under 1 year receiving a 2+0 schedule compared to a 3+0 schedule (IR: 7.8 vs. 0.6).
- PCV7 results showed similar trends.
- The disparity in breakthrough infections between the 2+0 and 3+0 schedules was larger in 2010-2011 than in 2012-2016, correlating with decreased serotype circulation.
Conclusions:
- A 3-primary-dose PCV schedule resulted in fewer breakthrough IPD infections in the first year of life compared to a 2-primary-dose schedule.
- The difference in breakthrough infection rates between schedules diminished as vaccine serotypes became less prevalent in circulation.
Background:
Most countries use 3-dose pneumococcal conjugate vaccine (PCV) schedules; a 4-dose (3 primary and 1 booster) schedule is licensed for US infants. We evaluated the invasive pneumococcal disease (IPD) breakthrough infection incidence in children receiving 2 vs 3 primary PCV doses with and without booster doses (2 + 1 vs 3 + 1; 2 + 0 vs 3 + 0).
Methods:
We used 2001-2016 Active Bacterial Core surveillance data to identify breakthrough infections (vaccine-type IPD in children receiving ≥1 7-valent pneumococcal conjugate vaccine [PCV7] or 13-valent pneumococcal conjugate vaccine [PCV13] dose) among children aged <5 years. We estimated schedule-specific IPD incidence rates (IRs) per 100 000 person-years and compared incidence by schedule (2 + 1 vs 3 + 1; 2 + 0 vs 3 + 0) using rate differences (RDs) and incidence rate ratios.
Results:
We identified 71 PCV7 and 49 PCV13 breakthrough infections among children receiving a schedule of interest. PCV13 breakthrough infection rates were higher in children aged <1 year receiving the 2 + 0 (IR: 7.8) vs 3 + 0 (IR: 0.6) schedule (incidence rate ratio: 12.9; 95% confidence interval: 4.1-40.4); PCV7 results were similar. Differences in PCV13 breakthrough infection rates by schedule in children aged <1 year were larger in 2010-2011 (2 + 0 IR: 18.6; 3 + 0 IR: 1.4; RD: 16.6) vs 2012-2016 (2 + 0 IR: 3.6; 3 + 0 IR: 0.2; RD: 3.4). No differences between schedules were detected in children aged ≥1 year for PCV13 breakthrough infections.
Conclusions:
Fewer PCV breakthrough infections occurred in the first year of life with 3 primary doses. Differences in breakthrough infection rates by schedule decreased as vaccine serotypes decreased in circulation.
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
01:51Vaccinations
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...