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Daniel M Weinberger1, Richard Malley, Marc Lipsitch

  • 1Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA. weinbergerdm@mail.nih.gov

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La vacuna conjugada neumocócica heptavalente (PCV7) redujo la enfermedad pero aumentó los serotipos no vacunados (NVTs). El reemplazo del serotipo en la enfermedad es menor que en el transporte debido a la invasividad de la TNV y los sesgos de vigilancia.

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Área de la Ciencia:

  • Microbiología Microbiología.
  • Inmunología Inmunología.
  • Salud Pública La salud pública.

Sus antecedentes:

  • La vacuna conjugada neumocócica heptavalente (PCV7) redujo significativamente la carga de la enfermedad neumocócica.
  • Existen preocupaciones con respecto al aumento de la prevalencia de los serotipos no vacunados (NVTs) debido a la limitada cobertura de serotipos del PCV7.

Objetivo del estudio:

  • Revisar la evidencia para la sustitución del serotipo en el transporte de neumocócicos y la enfermedad después de la vacunación con PCV7.
  • Para abordar los sesgos de vigilancia que afectan a los hallazgos sobre el reemplazo del serotipo.
  • Para discutir las razones de las discrepancias entre el transporte de NVT y la prevalencia de la enfermedad.

Principales métodos:

  • Revisión de la evidencia existente sobre el reemplazo del serotipo neumocócico.
  • Análisis de los datos de transporte y vigilancia de enfermedades.
  • Evaluación de posibles sesgos en la recopilación e interpretación de datos.

Principales resultados:

  • Las TNV han aumentado sustancialmente en portadores asintomáticos, con poco cambio neto en la prevalencia general del transporte.
  • La enfermedad neumocócica causada por NVTs ha aumentado en muchas poblaciones, pero generalmente es menor que el aumento del transporte de NVT.
  • Discrepancias atribuidas a una menor invasividad de la sustitución de los serotipos y sesgos de vigilancia.

Conclusiones:

  • El reemplazo del serotipo en la enfermedad se explica en parte por la menor invasividad de la TNV y los sesgos de vigilancia.
  • La vigilancia continua es crucial para monitorear las tendencias futuras de reemplazo de serotipos en la enfermedad neumocócica.