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Direct effect of 10-valent conjugate pneumococcal vaccination on pneumococcal carriage in children Brazil.

Andrade AL, Ternes YM, Vieira MA, Moreira WG, Lamaro-Cardoso J, Kipnis A, Cardoso MR, Brandileone MC, Moura I, Pimenta FC, da Gloria Carvalho M, Saraiva FO, Toscano CM, Minamisava R - PLoS ONE (2014)

Bottom Line: PCV10 effectiveness/VE on vaccine-type carriage was calculated as 1-RR*100.After adjusted for confounders, children who had received 2p+0 or 3p+0 dosing schedule presented a significant reduction in pneumococcal vaccine-type carriage, with PCV10 VE equal to 35.9% (95%CI: 4.2-57.1; p = 0.030) and 44.0% (95%CI: 14.-63.5; p = 0.008), respectively, when compared with unvaccinated children.The continuous evaluation of carriage serotypes distribution is likely to be useful for evaluating the long-term effectiveness and impact of pneumococcal vaccination on serotypes reduction.

View Article: PubMed Central - PubMed

Affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil.

ABSTRACT

Background: 10-valent conjugate pneumococcal vaccine/PCV10 was introduced in the Brazilian National Immunization Program along the year of 2010. We assessed the direct effectiveness of PCV10 vaccination in preventing nasopharyngeal/NP pneumococcal carriage in infants.

Methods: A cross-sectional population-based household survey was conducted in Goiania Brazil, from December/2010-February/2011 targeting children aged 7-11 m and 15-18 m. Participants were selected using a systematic sampling. NP swabs, demographic data, and vaccination status were collected from 1,287 children during home visits. Main outcome and exposure of interest were PCV10 vaccine-type carriage and dosing schedules (3p+0, 2p+0, and one catch-up dose), respectively. Pneumococcal carriage was defined by a positive culture and serotyping was performed by Quellung reaction. Rate ratio/RR was calculated as the ratio between the prevalence of vaccine-types carriage in children exposed to different schedules and unvaccinated for PCV10. Adjusted RR was estimated using Poisson regression. PCV10 effectiveness/VE on vaccine-type carriage was calculated as 1-RR*100.

Results: The prevalence of pneumococcal carriage was 41.0% (95%CI: 38.4-43.7). Serotypes covered by PCV10 and PCV13 were 35.2% and 53.0%, respectively. Vaccine serotypes 6B (11.6%), 23F (7.8%), 14 (6.8%), and 19F (6.6%) were the most frequently observed. After adjusted for confounders, children who had received 2p+0 or 3p+0 dosing schedule presented a significant reduction in pneumococcal vaccine-type carriage, with PCV10 VE equal to 35.9% (95%CI: 4.2-57.1; p = 0.030) and 44.0% (95%CI: 14.-63.5; p = 0.008), respectively, when compared with unvaccinated children. For children who received one catch-up dose, no significant VE was detected (p = 0.905).

Conclusion: PCV10 was associated with high protection against vaccine-type carriage with 2p+0 and 3p+0 doses for children vaccinated before the second semester of life. The continuous evaluation of carriage serotypes distribution is likely to be useful for evaluating the long-term effectiveness and impact of pneumococcal vaccination on serotypes reduction.

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Distribution of pneumococcal serotypes carriage in children 7–18 months of age. Goiania, December/2010-February/2011.Other serotypes: 9A, 9N, 10A, 15A, 17F, 18A, 20, 21, 22F, 23A, 23B, 24F, 25A, 28A, 29, 31, 33F, 34, 35F.
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pone-0098128-g001: Distribution of pneumococcal serotypes carriage in children 7–18 months of age. Goiania, December/2010-February/2011.Other serotypes: 9A, 9N, 10A, 15A, 17F, 18A, 20, 21, 22F, 23A, 23B, 24F, 25A, 28A, 29, 31, 33F, 34, 35F.

Mentions: Overall, 35 serotypes were identified among the 494 isolates tested, with the proportions of serotypes covered by PCV10 and PCV13 estimated at 36.2% and 53.0%, respectively. As seen in Figure 1, vaccine serotypes 6B (11.6%), 23F (7.8%), 14 (6.8%) and 19F (6.6%) were the most frequently observed, whereas PCV10 non-vaccine serotypes 6A (9.8%) and 19A (6.3%) were found in slightly higher proportions compared to 6C (5.9%), 35B (4.3%), 11A (4.3%) and 15C (3.3%). Thirty-four (6.6%) pneumococcal isolates could not be retrieved for serotyping. Simultaneous colonization with at least two pneumococcal serotypes was found in 17 (3.3%) children, six of which had a NT pneumococcal strain identified. Sixty (11.4%) of the non-serotypeable isolates were negative for capsular biosynthetic loci (positive cpsA control as well as serotype-specific cps loci) corresponding to 40 serotypes or small serogroups. NT isolates (by both culture and by cmPCR) were observed in a higher proportion from children aged 15–18 months (59.4%) compared with children aged 7–11 months (40.6%) (p = 0.015). Serotypes 1, 5 and 7F were not detected.


Direct effect of 10-valent conjugate pneumococcal vaccination on pneumococcal carriage in children Brazil.

Andrade AL, Ternes YM, Vieira MA, Moreira WG, Lamaro-Cardoso J, Kipnis A, Cardoso MR, Brandileone MC, Moura I, Pimenta FC, da Gloria Carvalho M, Saraiva FO, Toscano CM, Minamisava R - PLoS ONE (2014)

Distribution of pneumococcal serotypes carriage in children 7–18 months of age. Goiania, December/2010-February/2011.Other serotypes: 9A, 9N, 10A, 15A, 17F, 18A, 20, 21, 22F, 23A, 23B, 24F, 25A, 28A, 29, 31, 33F, 34, 35F.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4043727&req=5

pone-0098128-g001: Distribution of pneumococcal serotypes carriage in children 7–18 months of age. Goiania, December/2010-February/2011.Other serotypes: 9A, 9N, 10A, 15A, 17F, 18A, 20, 21, 22F, 23A, 23B, 24F, 25A, 28A, 29, 31, 33F, 34, 35F.
Mentions: Overall, 35 serotypes were identified among the 494 isolates tested, with the proportions of serotypes covered by PCV10 and PCV13 estimated at 36.2% and 53.0%, respectively. As seen in Figure 1, vaccine serotypes 6B (11.6%), 23F (7.8%), 14 (6.8%) and 19F (6.6%) were the most frequently observed, whereas PCV10 non-vaccine serotypes 6A (9.8%) and 19A (6.3%) were found in slightly higher proportions compared to 6C (5.9%), 35B (4.3%), 11A (4.3%) and 15C (3.3%). Thirty-four (6.6%) pneumococcal isolates could not be retrieved for serotyping. Simultaneous colonization with at least two pneumococcal serotypes was found in 17 (3.3%) children, six of which had a NT pneumococcal strain identified. Sixty (11.4%) of the non-serotypeable isolates were negative for capsular biosynthetic loci (positive cpsA control as well as serotype-specific cps loci) corresponding to 40 serotypes or small serogroups. NT isolates (by both culture and by cmPCR) were observed in a higher proportion from children aged 15–18 months (59.4%) compared with children aged 7–11 months (40.6%) (p = 0.015). Serotypes 1, 5 and 7F were not detected.

Bottom Line: PCV10 effectiveness/VE on vaccine-type carriage was calculated as 1-RR*100.After adjusted for confounders, children who had received 2p+0 or 3p+0 dosing schedule presented a significant reduction in pneumococcal vaccine-type carriage, with PCV10 VE equal to 35.9% (95%CI: 4.2-57.1; p = 0.030) and 44.0% (95%CI: 14.-63.5; p = 0.008), respectively, when compared with unvaccinated children.The continuous evaluation of carriage serotypes distribution is likely to be useful for evaluating the long-term effectiveness and impact of pneumococcal vaccination on serotypes reduction.

View Article: PubMed Central - PubMed

Affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil.

ABSTRACT

Background: 10-valent conjugate pneumococcal vaccine/PCV10 was introduced in the Brazilian National Immunization Program along the year of 2010. We assessed the direct effectiveness of PCV10 vaccination in preventing nasopharyngeal/NP pneumococcal carriage in infants.

Methods: A cross-sectional population-based household survey was conducted in Goiania Brazil, from December/2010-February/2011 targeting children aged 7-11 m and 15-18 m. Participants were selected using a systematic sampling. NP swabs, demographic data, and vaccination status were collected from 1,287 children during home visits. Main outcome and exposure of interest were PCV10 vaccine-type carriage and dosing schedules (3p+0, 2p+0, and one catch-up dose), respectively. Pneumococcal carriage was defined by a positive culture and serotyping was performed by Quellung reaction. Rate ratio/RR was calculated as the ratio between the prevalence of vaccine-types carriage in children exposed to different schedules and unvaccinated for PCV10. Adjusted RR was estimated using Poisson regression. PCV10 effectiveness/VE on vaccine-type carriage was calculated as 1-RR*100.

Results: The prevalence of pneumococcal carriage was 41.0% (95%CI: 38.4-43.7). Serotypes covered by PCV10 and PCV13 were 35.2% and 53.0%, respectively. Vaccine serotypes 6B (11.6%), 23F (7.8%), 14 (6.8%), and 19F (6.6%) were the most frequently observed. After adjusted for confounders, children who had received 2p+0 or 3p+0 dosing schedule presented a significant reduction in pneumococcal vaccine-type carriage, with PCV10 VE equal to 35.9% (95%CI: 4.2-57.1; p = 0.030) and 44.0% (95%CI: 14.-63.5; p = 0.008), respectively, when compared with unvaccinated children. For children who received one catch-up dose, no significant VE was detected (p = 0.905).

Conclusion: PCV10 was associated with high protection against vaccine-type carriage with 2p+0 and 3p+0 doses for children vaccinated before the second semester of life. The continuous evaluation of carriage serotypes distribution is likely to be useful for evaluating the long-term effectiveness and impact of pneumococcal vaccination on serotypes reduction.

Show MeSH
Related in: MedlinePlus