TY - JOUR
T1 - Real world impact of 13vPCV in preventing invasive pneumococcal pneumonia in Australian children
T2 - A national study
AU - Homaira, Nusrat
AU - Strachan, Roxanne
AU - Quinn, Helen
AU - Beggs, Sean
AU - Bhuiyan, Mejbah
AU - Bowen, Asha
AU - Fawcett, Laura K.
AU - Gilbert, Gwendolyn L.
AU - Lambert, Stephen B.
AU - Macartney, Kristine
AU - Marshall, Helen S.
AU - Martin MD, Andrew C.
AU - McCallum, Gabrielle
AU - McCullagh, Angela
AU - McDonald, Tim
AU - Selvadurai, Hiran
AU - McIntyre, Peter
AU - Oftadeh, Shahin
AU - Ranganathan PhD, Sarath
AU - Saunders, Thomas
AU - Suresh, Sadasivam
AU - Wainwright, Claire
AU - Wilson, Angela
AU - Wong, Melanie
AU - Jaffe, Adam
AU - Snelling, Tom
PY - 2023/1/4
Y1 - 2023/1/4
N2 - Background: We aimed to assess the direct protective effect of 13 valent pneumococcal conjugate vaccine (13vPCV) against invasive pneumococcal pneumonia (IPP; including pneumonia and empyema) in children using a nation-wide case-control study across 11 paediatric tertiary hospitals in Australia. Methods: Children < 18 years old admitted with pneumonia were eligible for enrolment. IPP was defined as Streptococcus pneumoniae (SP) cultured or detected by polymerase chain reaction (PCR) from blood or pleural fluid. Causative SP serotype (ST) was determined from blood or pleural fluid SP isolates by molecular methods in PCR positive specimens or else inferred from nasopharyngeal isolates. For each IPP case, 20 population controls matched by age and socio-economic status were sampled from the Australian Immunisation Register. Conditional logistic regression was used to estimate the adjusted odds ratio (aOR) of being fully vaccinated with 13vPCV (≥3 doses versus < 3 doses) among IPP cases compared to controls, adjusted for sex and Indigenous status. Results: From February 2015 to September 2018, we enrolled 1,168 children with pneumonia; 779 were 13vPCV-eligible and were individually matched to 15,580 controls. SP was confirmed in 195 IPP cases, 181 of whom had empyema. ST3 and ST19A were identified in 52% (102/195) and 11% (21/195) of IPP cases respectively. The aOR of being fully vaccinated with 13vPCV was 0.8 (95% CI 0.6–1.0) among IPP cases compared to matched controls. Conclusion: We failed to identify a strong direct protective effect of 13vPCV against IPP among Australian children, where disease was largely driven by ST3.
AB - Background: We aimed to assess the direct protective effect of 13 valent pneumococcal conjugate vaccine (13vPCV) against invasive pneumococcal pneumonia (IPP; including pneumonia and empyema) in children using a nation-wide case-control study across 11 paediatric tertiary hospitals in Australia. Methods: Children < 18 years old admitted with pneumonia were eligible for enrolment. IPP was defined as Streptococcus pneumoniae (SP) cultured or detected by polymerase chain reaction (PCR) from blood or pleural fluid. Causative SP serotype (ST) was determined from blood or pleural fluid SP isolates by molecular methods in PCR positive specimens or else inferred from nasopharyngeal isolates. For each IPP case, 20 population controls matched by age and socio-economic status were sampled from the Australian Immunisation Register. Conditional logistic regression was used to estimate the adjusted odds ratio (aOR) of being fully vaccinated with 13vPCV (≥3 doses versus < 3 doses) among IPP cases compared to controls, adjusted for sex and Indigenous status. Results: From February 2015 to September 2018, we enrolled 1,168 children with pneumonia; 779 were 13vPCV-eligible and were individually matched to 15,580 controls. SP was confirmed in 195 IPP cases, 181 of whom had empyema. ST3 and ST19A were identified in 52% (102/195) and 11% (21/195) of IPP cases respectively. The aOR of being fully vaccinated with 13vPCV was 0.8 (95% CI 0.6–1.0) among IPP cases compared to matched controls. Conclusion: We failed to identify a strong direct protective effect of 13vPCV against IPP among Australian children, where disease was largely driven by ST3.
KW - 13vPCV effectiveness
KW - Children
KW - Invasive pneumococcal pneumonia
UR - http://www.scopus.com/inward/record.url?scp=85142163522&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2022.11.006
DO - 10.1016/j.vaccine.2022.11.006
M3 - Article
C2 - 36400662
AN - SCOPUS:85142163522
SN - 0264-410X
VL - 41
SP - 85
EP - 91
JO - Vaccine
JF - Vaccine
IS - 1
ER -
