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Published on: February 23, 2014
Pneumococcal Serotype Distribution and Coverage of Existing and Pipeline Pneumococcal Vaccines
Laura M King1, Kristin L Andrejko2, Miwako Kobayashi2
1School of Public Health, University of California, Berkeley, Berkeley, California, USA.
Insights
Next-generation pneumococcal conjugate vaccines (PCVs) show increasing serotype coverage, with PCV31 offering the broadest protection against pneumococcal diseases like IPD and ARIs. These advanced vaccines can prevent millions of infections annually, informing future public health policy.
Area of Science:
- Infectious Diseases
- Vaccinology
- Public Health
Background:
- Next-generation pneumococcal conjugate vaccines (PCVs) are designed to target an increasing number of pneumococcal serotypes.
- Assessing the serotype coverage of existing and pipeline PCVs is crucial for understanding their potential impact on invasive pneumococcal disease (IPD) and acute respiratory infections (ARIs).
Purpose of the Study:
- To evaluate the proportion of IPD and ARIs caused by serotypes included in current and developing PCVs.
- To estimate the annual burden of pneumococcal disease in the U.S. that could be prevented by these vaccines.
Main Methods:
- Utilized Markov chain Monte Carlo methods to estimate serotype distribution and disease proportions for ARIs and IPD.
- Incorporated data from epidemiological studies and Active Bacterial Core Surveillance.
- Calculated preventable disease cases by multiplying incidence rates by PCV-targeted disease proportions and vaccine effectiveness.
Main Results:
- PCV serotype coverage varied significantly, with PCV31 targeting up to 68% of pediatric AOM and 87% of adult non-bacteremic pneumonia.
- PCV-targeted serotypes accounted for 42-85% of pediatric and 42-94% of adult IPD cases.
- Annual preventable disease burdens included millions of ARIs, thousands of pneumonia hospitalizations, and thousands of IPD cases.
Conclusions:
- PCV15 demonstrated the lowest coverage, while PCV31 offered the highest, across various pneumococcal conditions.
- PCV21 also showed significant potential in addressing adult pneumococcal disease burdens.
- Comparative burden estimates can guide future vaccine policy decisions.
Background:
Next-generation pneumococcal conjugate vaccines (PCVs) target an expanding array of serotype antigens. We assessed the proportions of invasive pneumococcal disease (IPD) and pneumococcal acute respiratory infections (ARIs) caused by serotypes targeted by existing and pipeline PCVs, and the annual United States pneumococcal disease burdens potentially preventable by these products.
Methods:
We estimated serotype distribution and proportions of pneumococcal ARIs (acute otitis media [AOM; children only], sinusitis, nonbacteremic pneumonia) and IPD attributable to serotypes targeted by each PCV using Markov chain Monte Carlo approaches incorporating data from epidemiological studies and Active Bacterial Core surveillance. We then estimated annual numbers of outpatient-managed ARIs, nonbacteremic pneumonia hospitalizations, and IPD cases potentially preventable by PCVs by multiplying disease incidence rates by PCV-targeted disease proportions and vaccine effectiveness estimates.
Results:
In children, PCV15, PCV20, PCV24, PCV25, and PCV31 serotypes account for 16% (95% confidence interval, 15%-17%), 31% (30%-32%), 34% (32%-35%), 43% (42%-44%), and 68% (67%-69%) of pneumococcal AOM, respectively. In adults, PCV15, PCV20, PCV21, PCV24, PCV25, and PCV31 serotypes account for 43% (38%-47%), 52% (47%-57%), 69% (64%-73%), 65% (61%-70%), 62% (57%-67%), and 87% (83%-90%) of pneumococcal nonbacteremic pneumonia. For IPD, 42%-85% of pediatric and 42%-94% of adult cases were due to PCV-targeted serotypes. PCV-preventable burdens encompassed 270 000-3 300 000 outpatient-managed ARIs, 2000-17 000 pneumonia hospitalizations, and 3000-14 000 IPD cases annually.
Conclusions:
Across pneumococcal conditions, coverage and preventable burdens were lowest for PCV15 and highest for PCV31, with PCV21 also targeting sizeable burdens of adult disease. Comparative estimates of preventable disease burden may inform future policy.
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