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Published on: February 23, 2014
Effect of Pneumococcal Conjugate Vaccine on Pneumonia Incidence Rates among Children 2-59 Months of Age, Mongolia,
Insights
The 13-valent pneumococcal conjugate vaccine (PCV13) reduced pneumonia incidence in Mongolian children. Catch-up campaigns further enhanced these protective effects against pneumococcal pneumonia.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health Surveillance
Background:
- Pneumonia remains a leading cause of child mortality globally.
- The 13-valent pneumococcal conjugate vaccine (PCV13) targets common causes of pneumococcal pneumonia.
- Evaluating vaccine impact in real-world settings is crucial for public health policy.
Purpose of the Study:
- To assess the impact of PCV13 introduction on pneumonia incidence in Mongolian children aged 2-59 months.
- To determine the influence of catch-up vaccination campaigns on PCV13 effectiveness.
- To analyze changes in pneumococcal carriage prevalence post-PCV13 introduction.
Main Methods:
- Prospective hospital-based surveillance over a 6-year period (2016-2021).
- Analysis of pneumonia incidence rates, including specific endpoints like very severe and probable pneumococcal pneumonia.
- Comparison of pneumonia trends in districts with and without PCV13 catch-up campaigns.
- Assessment of pneumococcal carriage prevalence before and after PCV13 introduction.
Main Results:
- Overall adjusted incidence rate ratios indicated a significant decline in primary endpoint pneumonia, very severe pneumonia, and probable pneumococcal pneumonia until June 2021.
- Pneumonia incidence decreased in districts implementing PCV13 with catch-up campaigns, but not in the district without catch-up.
- Vaccine-type pneumococcal carriage prevalence decreased by 44%, while non-vaccine-type carriage increased by 49% after PCV13 introduction.
- The observed effects remained consistent when excluding or including the COVID-19 pandemic period.
Conclusions:
- PCV13 introduction in Mongolia led to a significant reduction in specific pneumonia endpoints among young children.
- Catch-up vaccination campaigns conferred additional benefits, amplifying the positive impact of PCV13.
- The findings support the effectiveness of PCV13 in reducing childhood pneumonia and highlight the value of comprehensive immunization strategies.
Abstract:
Starting in June 2016, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced into the routine immunization program of Mongolia by using a 2+1 dosing schedule, phased by district. We used prospective hospital surveillance to evaluate the vaccine's effect on pneumonia incidence rates among children 2-59 months of age over a 6-year period. Of 17,607 children with pneumonia, overall adjusted incidence rate ratios showed decreased primary endpoint pneumonia, very severe pneumonia, and probable pneumococcal pneumonia until June 2021. Results excluding and including the COVID-19 pandemic period were similar. Pneumonia declined in 3 districts that introduced PCV13 with catch-up campaigns but not in the 1 district that did not. After PCV13 introduction, vaccine-type pneumococcal carriage prevalence decreased by 44% and nonvaccine-type carriage increased by 49%. After PCV13 introduction in Mongolia, the incidence of more specific pneumonia endpoints declined in children 2-59 months of age; additional benefits were conferred by catch-up campaigns.
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