dc.contributor |
Universitat de Barcelona |
dc.contributor.author |
Feikin, Daniel R. |
dc.contributor.author |
Kagucia, Eunice W. |
dc.contributor.author |
Loo, Jennifer D. |
dc.contributor.author |
Link-Gelles, Ruth |
dc.contributor.author |
Puhan, Milo A. |
dc.contributor.author |
Cherian, Thomas |
dc.contributor.author |
Levine, Orin S. |
dc.contributor.author |
Whitney,Cynthia G. |
dc.contributor.author |
O'Brien, Katherine L. |
dc.contributor.author |
Moore, Matthew R. |
dc.contributor.author |
García García, Juan José |
dc.contributor.author |
Serotype Replacement Study Group |
dc.date |
2019-04-23T13:28:27Z |
dc.date |
2019-04-23T13:28:27Z |
dc.date |
2013-09-24 |
dc.date |
2019-04-23T13:28:27Z |
dc.identifier.citation |
1549-1277 |
dc.identifier.citation |
664606 |
dc.identifier.uri |
http://hdl.handle.net/2445/132333 |
dc.format |
28 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
Public Library of Science (PLoS) |
dc.relation |
Reproducció del document publicat a: https://doi.org/10.1371/journal.pmed.1001517 |
dc.relation |
PLoS Medicine, 2013, vol. 10, num. 9, p. e1001517 |
dc.relation |
https://doi.org/10.1371/journal.pmed.1001517 |
dc.rights |
cc-by (c) Feikin, Daniel R. et al., 2013 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es |
dc.subject |
Pneumococs |
dc.subject |
Vacunes |
dc.subject |
Immunologia |
dc.subject |
Infants |
dc.subject |
Streptococcus pneumonia |
dc.subject |
Vaccines |
dc.subject |
Immunology |
dc.subject |
Children |
dc.title |
Serotype-specific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites. |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
BACKGROUND: Vaccine-serotype (VT) invasive pneumococcal disease (IPD) rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into national immunization programs. Increases in non-vaccine-serotype (NVT) IPD rates occurred in some sites, presumably representing serotype replacement. We used a standardized approach to describe serotype-specific IPD changes among multiple sites after PCV7 introduction. METHODS AND FINDINGS: Of 32 IPD surveillance datasets received, we identified 21 eligible databases with rate data ≥ 2 years before and ≥ 1 year after PCV7 introduction. Expected annual rates of IPD absent PCV7 introduction were estimated by extrapolation using either Poisson regression modeling of pre-PCV7 rates or averaging pre-PCV7 rates. To estimate whether changes in rates had occurred following PCV7 introduction, we calculated site specific rate ratios by dividing observed by expected IPD rates for each post-PCV7 year. We calculated summary rate ratios (RRs) using random effects meta-analysis. For children <5 years old, overall IPD decreased by year 1 post-PCV7 (RR 0.55, 95% CI 0.46-0.65) and remained relatively stable through year 7 (RR 0.49, 95% CI 0.35-0.68). Point estimates for VT IPD decreased annually through year 7 (RR 0.03, 95% CI 0.01-0.10), while NVT IPD increased (year 7 RR 2.81, 95% CI 2.12-3.71). Among adults, decreases in overall IPD also occurred but were smaller and more variable by site than among children. At year 7 after introduction, significant reductions were observed (18-49 year-olds [RR 0.52, 95% CI 0.29-0.91], 50-64 year-olds [RR 0.84, 95% CI 0.77-0.93], and ≥ 65 year-olds [RR 0.74, 95% CI 0.58-0.95]). CONCLUSIONS: Consistent and significant decreases in both overall and VT IPD in children occurred quickly and were sustained for 7 years after PCV7 introduction, supporting use of PCVs. Increases in NVT IPD occurred in most sites, with variable magnitude. These findings may not represent the experience in low-income countries or the effects after introduction of higher valency PCVs. High-quality, population-based surveillance of serotype-specific IPD rates is needed to monitor vaccine impact as more countries, including low-income countries, introduce PCVs and as higher valency PCVs are used. Please see later in the article for the Editors' Summary. |