Dynamics of Invasive Pneumococcal Disease in Israel in Children and Adults in the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Era: A Nationwide Prospective Surveillance

被引：25

作者：

Ben-Shimol, Shalom ^{[1
,2
]}

Regev-Yochay, Gili ^{[3
,4
]}

Givon-Lavi, Noga ^{[1
,2
]}

van der Beek, Bart Adriaan ^{[1
]}

Brosh-Nissimov, Tal ^{[1
,5
]}

Peretz, Avi ^{[6
,7
]}

Megged, Orli ^{[8
,9
]}

Dagan, Ron ^{[1
]}

机构：

[1] Ben Gurion Univ Negev, Fac Hlth Sci, Beer Sheva, Israel

[2] Soroka Univ, Pediat Infect Dis Unit, Med Ctr, Itchak Hager Ave, Beer Sheva, Israel

[3] Sheba Med Ctr, Infect Prevent & Control Unit, Ramat Gan, Israel

[4] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel

[5] Assuta Ashdod Univ Hosp, Ashdod, Israel

[6] Baruch Padeh Med Ctr, Clin Microbiol Lab, Poriya, Tiberias, Israel

[7] Bar Ilan Univ, Azrieli Fac Med, Safed, Israel

[8] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel

[9] Shaare Zedek Med Ctr, Pediat Dept, Pediat Infect Dis Unit, Jerusalem, Israel

来源：

CLINICAL INFECTIOUS DISEASES | 2022年 / 74卷 / 09期

关键词：

indirect protection; invasive pneumococcal disease; Israel epidemiology; pneumococcal conjugate vaccines; SEQUENTIAL INTRODUCTION; STREPTOCOCCUS-PNEUMONIAE; IMMUNIZATION PLAN; EARLY IMPACT; SEROTYPES; ENGLAND; BURDEN;

D O I：

10.1093/cid/ciab645

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Ten-year surveillance post-PCV7/PCV13 implementation showed a steep reduction in invasive pneumococcal disease in children and adults, stabilizing after 4 years. The main PCV13 pneumococcal serotypes were 3, 19A, and 14; serotypes 8 and 12F were the leading nonvaccine serotypes. Background. Following 13-valent pneumococcal conjugate vaccine (PCV13) implementation in infants worldwide, overall and vaccine-type invasive pneumococcal disease (IPD) rates declined in children, with variable indirect impact on adults. Methods. A population-based, prospective, nationwide active surveillance of IPD in Israel, 2004-2019 (for adults >= 18 years, 2009-2019). The 7-valent PCV (PCV7)/PCV13 were implemented in Israel in July 2009/November 2010, respectively, with >90% uptake in children <2 years. The 23-valent pneumococcal polysaccharide vaccine (PPV-23) uptake among those >65 years was similar to 75%. For pre-PCV episodes with missing serotype, extrapolations were applied. Overall, PCV13 serotypes (VT13) and non-VT13 (NVT) incidence rate ratios (IRRs) comparing pre-PCV (2004-2008), early-PCV (2009-2011), and late-PCV13 (2016-2019) periods were calculated for different age groups. Results. Overall, 8614 IPD cases were recorded. IPD rates declined by 67% in children <5 and 5-17 years, comparing late-PCV13 versus pre-PCV periods (IRR [95% CI]: .33 [.27-.40] and .33 [.21-.50], respectively). For adults, comparing late-PCV13 with early-PCV periods, rates significantly declined by 53% in those aged 18-44, while rates did not decline significantly in other age groups. VT13 rates significantly declined in all ages, with decline rates ranging between 94% in children <5 years and 60% in adults >= 85 years. NVT rates significantly increased in <5-, 50-64-, and >= 65-year age groups. In the late-PCV13 period, serotypes 3, 14, and 19A remained the predominant VT13, while serotypes 8 and 12F emerged as predominant NVTs. Conclusions. Continuous monitoring of circulating serotypes in all ages demonstrated direct and indirect PCV effects, which are essential for the development of new vaccination strategies.

引用

页码：1639 / 1649

页数：11

共 24 条

[1] Characteristics of Invasive Pneumococcal Disease Caused by Emerging Serotypes After the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in England: A Prospective Observational Cohort Study, 2014-2018 [J].