Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination

被引：125

作者：

Hanquet, Germaine ^{[1
,2
]}

Krizova, Pavla ^{[3
]}

Valentiner-Branth, Palle ^{[4
]}

Ladhani, Shamez N. ^{[5
]}

Nuorti, J. Pekka ^{[6
,7
]}

Lepoutre, Agnes ^{[8
]}

Mereckiene, Jolita ^{[9
]}

Knol, Mirjam ^{[10
]}

Winje, Brita A. ^{[11
]}

Ciruela, Pilar ^{[12
,13
]}

Ordobas, Maria ^{[14
]}

Guevara, Marcela ^{[13
,15
]}

McDonald, Eisin ^{[16
]}

Morfeldt, Eva ^{[17
]}

Kozakova, Jana ^{[3
]}

Slotved, Hans-Christian ^{[4
]}

Fry, Norman K. ^{[5
]}

Rinta-Kokko, Hanna ^{[6
]}

Varon, Emmanuelle ^{[18
]}

Corcoran, Mary ^{[19
]}

van der Ende, Arie ^{[20
]}

Vestrheim, Didrik F. ^{[11
]}

Munoz-Almagro, Carmen ^{[13
,21
]}

Latasa, Pello ^{[14
]}

Castilla, Jesus ^{[13
,15
]}

Smith, Andrew ^{[22
]}

Henriques-Normark, Birgitta ^{[17
,23
,24
]}

Whittaker, Robert ^{[25
]}

Celentano, Lucia Pastore ^{[25
]}

Savulescu, Camelia ^{[1
]}

机构：

[1] EpiConcept, Paris, France

[2] Antwerp Univ, Antwerp, Belgium

[3] Natl Inst Publ Hlth, Prague, Czech Republic

[4] Statens Serum Inst, Copenhagen, Denmark

[5] Publ Hlth England, London, England

[6] Natl Inst Hlth & Welf, Helsinki, Finland

[7] Univ Tampere, Tampere, Finland

[8] Sante Publ France, St Maurice, France

[9] Hlth Protect Surveillance Ctr, Dublin, Ireland

[10] Natl Inst Publ Hlth & Environm, Bilthoven, Netherlands

[11] Norwegian Inst Publ Hlth, Oslo, Norway

[12] Publ Hlth Agcy Catalunya, Barcelona, Spain

[13] CIBER Epidemiol & Salud Publ, Madrid, Spain

[14] Gen Directorate Publ Hlth, Madrid, Spain

[15] Inst Salud Publ Navarra IdiSNA, Pamplona, Spain

[16] Hlth Protect Scotland, Natl Serv Scotland, Glasgow, Lanark, Scotland

[17] Publ Hlth Agcy Sweden, Solna, Sweden

[18] European Hosp George Pompidou, Natl Ctr Pneumococci, Paris, France

[19] Temple St Childrens Univ Hosp, Irish Pneumococcal Reference Lab, Dublin, Ireland

[20] Acad Med Ctr, Netherlands Reference Lab Bacterial Meningitis, Amsterdam, Netherlands

[21] Univ Int Catalunya, Hosp St Joan Deu, Inst Recerca Pediat, Barcelona, Spain

[22] Scottish Haemophilus Legionella Meningococcus & P, Glasgow, Lanark, Scotland

[23] Karolinska Inst, Dept Microbiol Tumor & Cell Biol, Stockholm, Sweden

[24] Karolinska Univ Hosp, Dept Clin Microbiol, Stockholm, Sweden

[25] European Ctr Dis Prevent & Control, Stockholm, Sweden

来源：

THORAX | 2019年 / 74卷 / 05期

基金：

欧盟地平线“2020”;

关键词：

STREPTOCOCCUS-PNEUMONIAE; IMPACT; ENGLAND; SEROTYPES; VACCINES; WALES; EPIDEMIOLOGY; 10-VALENT; CARRIAGE; CHILDREN;

D O I：

10.1136/thoraxjnl-2018-211767

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background Pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies. Methods For each site we calculated IPD incidence rate ratios (IRR) in people aged >= 65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 -IRR)*100. Results A fter five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively. Conclusion Overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.

引用

页码：473 / 482

页数：10

共 40 条

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