Figure - uploaded by Rodrigo Puentes
Content may be subject to copyright.
Serotype 1 invasive pneumococcal disease all-site weighted average incidence rate ratios comparing the annual post-PCV10/13 incidence rate to the average pre-PCV10/13 incidence rate by age group.
Source publication
Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and ai...
Contexts in source publication
Context 1
... weighted average ST1 IPD IRRs comparing the pre-PCV10/13 period to each post-PCV10/13 year are shown in Table 2 All ages' analysis (in black) is not an average of each age-specific estimate in each year but rather a re-analysis of the total cases from all ages reporting at each site. ...Context 2
... This work was only possible through the contributions of many other individuals and organizations. The list of names of key individuals is provided in the Table A2. We thank all individuals involved in the surveillance activities at the sites contributing to the PSERENADE project for trusting us with their data and for the assistance along the way to ensure this work provides value. ...Similar publications
Background:
Monitoring changes in pharyngeal carriage of pneumococcus in children following 13-valent pneumococcal conjugate vaccine (PCV13) introduction in the UK in 2010 informs understanding of patterns of invasive pneumococcal disease (IPD) incidence.
Methods:
Nasopharyngeal swabs from healthy children vaccinated with PCV13 according to sche...
Specific antibody deficiency against pneumococcal serotypes was detected in a patient with recurrent episodes of fever. A 21-year-old man presented with a two-month history of recurrent episodes of fever and shaking chills. He was diagnosed with recurrent episodes of pneumonia caused by Streptococcus pneumoniae serotype 19A and treated with amoxici...
After introducing the 13-valent pneumococcal conjugate vaccine (PCV13) for children, a change in the prevalence of different Streptococcus pneumoniae serotypes that cause invasive pneumococcal diseases (IPDs) has been observed. The prevalence of vaccine serotypes has decreased and that of non-vaccine serotypes has increased. Currently, serogroup 24...
Background
Nasopharyngeal (NP) colonization with Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) is common in children and may evolve as the source of invasive infections. In Korea, the pneumococcal conjugate vaccines (PCVs) had been introduced >10 years, allowing us to study the effect of the vaccine in preventing carriage....
Invasive pneumococcal disease remains one of the leading causes of morbidity and mortality worldwide. In Russia, 13- valent pneumococcal conjugate vaccine (PCV13) was introduced into the childhood immunization programme nationwide in 2014. As part of the Global Pneumococcal Sequencing Project (GPS), we used genome data to characterize 179 pneumococ...
Citations
... 26 Several studies suggest modest direct protection was observed after immunization with PCV13 against IPD because of serotype 3, but no reduction in colonization and persistent circulation in the community. 27,28 In addition to breakthrough infections with VSTs, our study identified the increased circulation of non-PCV13 serotypes over the past 2 decades. Of importance, we observed disease because of serotypes 15A, 15BC, 23B, and 35B, which are not included in PCV13 (Fig 3b), suggesting potential serotype replacement. ...
OBJECTIVES
We sought to describe the evolving epidemiology of invasive pneumococcal disease (IPD) among children in Massachusetts, United States, over the last 2 decades during which sequential 7-valent pneumococcal conjugate vaccines (PCV7) and 13-valent PCVs (PCV13) were implemented.
METHODS
Cases of IPD in children aged <18 years were detected between 2002 and 2021 through an enhanced population-based, statewide surveillance system. Streptococcus pneumoniae isolates from normally sterile sites were serotyped and evaluated for antimicrobial susceptibility. IPD incidence rates and rate ratios with 95% confidence intervals (CIs) were calculated.
RESULTS
We identified 1347 IPD cases. Incidence of IPD in children aged <18 years declined 72% over 2 decades between 2002 and 2021 (incidence rate ratios 0.28, 95% CI 0.18–0.45). IPD rates continued to decline after replacement of PCV7 with PCV13 (incidence rate ratios 0.25, 95% CI 0.16–0.39, late PCV7 era [2010] versus late PCV13 era [2021]). During the coronavirus disease 2019 pandemic years, 2020 to 2021, the rate of IPD among children aged <18 years reached 1.6 per 100 000, the lowest incidence observed over the 20 years. In PCV13 era, approximately one-third of the IPD cases in children aged >5 years had at least 1 underlying condition (98, 30.3%). Serotypes 19A and 7F contributed 342 (48.9%) of all cases before implementation of PCV13 (2002–2010). Serotype 3 (31, 8.6%), and non-PCV13 serotypes 15B/C (39, 10.8%), 33F (29, 8.0%), 23B (21, 0.8%), and 35B (17, 4.7%) were responsible for 37.8% of cases in PCV13 era (2011–2021). Penicillin nonsusceptibility continued to decline (9.8% vs 5.3% in pre-/late PCV13 era, P = .003), however has become more common among non-PCV13 serotypes compared with vaccine serotypes (14.8% vs 1.4%, P < .001).
CONCLUSIONS
Robust ongoing surveillance networks are critical for identifying emerging serotypes and development of next-generation vaccine formulations.
... To provide information on the allergenic and pathogenic potentials of different factors, future studies must consider metagenomic methods to analyze the microbial composition of PM in urban metropolitan areas. The COVID-19 viral pandemic infection caused by the SARS-CoV-2 has produced several outbreaks worldwide, which have had a high rate of viral variants and subvariants, which in synergy with other viral or bacterial diseases, and under the pressure of environmental, socioeconomic, and demographic stressors, are significantly related to lethality and transmissibility [128][129][130]. ...
The long-distance spreading and transport of airborne particulate matter (PM) of biogenic or chemical compounds, which are thought to be possible carriers of SARS-CoV-2 virions, can have a negative impact on the incidence and severity of COVID-19 viral disease. Considering the total Aerosol Optical Depth at 550 nm (AOD) as an atmospheric aerosol loading variable, inhalable fine PM with a diameter ≤2.5 µm (PM2.5) or coarse PM with a diameter ≤10 µm (PM10) during 26 February 2020–31 March 2022, and COVID-19’s five waves in Romania, the current study investigates the impact of outdoor PM on the COVID-19 pandemic in Bucharest city. Through descriptive statistics analysis applied to average daily time series in situ and satellite data of PM2.5, PM10, and climate parameters, this study found decreased trends of PM2.5 and PM10 concentrations of 24.58% and 18.9%, respectively compared to the pre-pandemic period (2015–2019). Exposure to high levels of PM2.5 and PM10 particles was positively correlated with COVID-19 incidence and mortality. The derived average PM2.5/PM10 ratios during the entire pandemic period are relatively low (<0.44), indicating a dominance of coarse traffic-related particles’ fraction. Significant reductions of the averaged AOD levels over Bucharest were recorded during the first and third waves of COVID-19 pandemic and their associated lockdowns (~28.2% and ~16.4%, respectively) compared to pre-pandemic period (2015–2019) average AOD levels. The findings of this research are important for decision-makers implementing COVID-19 safety controls and health measures during viral infections.
... 4 Background Ten-and thirteen-valent pneumococcal conjugate vaccines (PCVs) (namely Synflorix-10 and Prevnar-13, respectively) have now been introduced into most national childhood immunisation programmes, 1 substantially reducing the burden of pneumococcal disease. [2][3][4][5][6][7][8] The impact of PCVs is partly driven by the vaccine effectiveness against disease among vaccinated persons but also by its impact against carriage. 9-11 PCVs limit vaccine serotype acquisition and density thereby reducing community transmission and inducing herd immunity, 12,13 which drives a substantial part of the overall impact of PCV programmes. ...
Background
Monitoring pneumococcal carriage prevalence and serotype distribution is critical to understanding pneumococcal transmission dynamics and vaccine impact, particularly where routine disease surveillance is limited. This study aimed to describe and interpret heterogeneity in serotype-specific carriage globally before widespread use of pneumococcal conjugate vaccines (PCVs).
Methods
A systematic literature review was undertaken to summarise all pneumococcal carriage studies across continents and age groups before PCV introduction. Serotype distributions were assessed via Bayesian nested meta-regression and hierarchical clustering.
Findings
In total 237 studies from 74 countries were included, comprising 492 age-specific datasets that contained 47,769 serotyped isolates.The modelled carriage prevalence differed substantially across regions, ranging in <5y from 35% (95%CrI 34%-35%) in Europe to 69% (95%CrI 69-70%) in Africa. Serotypes 19F, 6B, 6A, 23F, and 14 were the five most prevalent in children <5 years. The modelled proportion of Synflorix-10 (PCV10) serotypes carried by <5y ranged from 45% (95% CrI: 44% to 46%) in Asia to 59% (58% to 60%) in Europe, and that of Prevenar-13 (PCV13) from 60% (59% to 61%) in Asia to 76% (75% to 77%) in Europe. The diversity of carried serotypes increased with age, and so did the prevalence of vaccine-type serotypes. However, variation in serotype distribution did not cluster by age, ethnicity, region, or overall carriage prevalence.
Interpretation
Globally, pre-PCV pneumococcal carriage was dominated by a few serotypes. Serotype distribution variability was not easily attributable to a single discriminatory factor.
Funding
The review was funded by a grant to OlPdW from the World Health Organisation (grant number: SPHQ14-APW-2639) and by a Fellowship to SF jointly funded by the Wellcome Trust and the Royal Society (grant number: 208812/Z/17/Z).
... Time since PCV introduction is too short for maximal impact: It takes a minimum of 5 years since PCV introduction for all children <5 years of age to have a chance to be immunized, and it can take 5-7 years after vaccination to achieve a stabilized serotype distribution [5,6]. The serotype distribution changes before this time because VTs are gradually being eliminated owing to direct and indirect (herd immunity) effects, and non-VT disease may increase (replacement disease) as carriage of non-VT serotypes replaces VT carriage. ...
... This is important especially for measles, mumps and rubella (MMR) and pneumococcal vaccinations since these infections have high transmission rates in unvaccinated populations, and a wide range of potentially serious effects in those infected including pneumonia, meningitis and death. [2][3][4][5][6][7] Through 2020/2021 there have been three waves of the COVID-19 pandemic in the UK with varying levels of social distancing, school closure and lockdowns in place. 8 9 A systematic review of 17 observational studies during 2020 to assess the impact of the pandemic on childhood vaccination coverage found that there was a decline in the total number of vaccines administered and consequent reduction in coverage, with many children missing out on their vaccine doses. ...
Objectives
To describe rates and variation in uptake of pneumococcal and measles, mumps and rubella (MMR) vaccines in children and associated change in vaccine-preventable diseases (VPDs) across the first and second waves of the COVID-19 pandemic.
Methods
Retrospective database study of all children aged <19 registered with a general practice in the Oxford Royal College of General Practitioners Research and Surveillance Centre English national sentinel surveillance network between 2 November 2015 and 18 July 2021.
Results
Coverage of booster dose of pneumococcal vaccine decreased from 94.5% (95% CI 94.3% to 94.7%) at its height on International Organization for Standardization (ISO) week 47 (2020) to 93.6% (95% CI 93.4% to 93.8%) by the end of the study. Coverage of second dose of MMR decreased from 85.0% (95% CI 84.7% to 85.3%) at its height on ISO week 37 (2020) to 84.1% (95% CI 83.8% to 84.4%) by the end of the study. The break point in trends for MMR was at ISO week 34 (2020) (95% CI weeks 32–37 (2020)), while for pneumococcal vaccine the break point was later at ISO week 3 (2021) (95% CI week 53 (2020) to week 8 (2021)). Vaccination coverage for children of white ethnicity was less likely to decrease than other ethnicities. Rates of consultation for VPDs fell and remained low since August 2020.
Conclusion
Childhood vaccination rates started to fall ahead of the onset of the second wave; this fall is accentuating ethnic, socioeconomic and geographical disparities in vaccine uptake and risks widening health disparities. Social distancing and school closures may have contributed to lower rates of associated VPDs, but there may be increased risk as these measures are removed.
... Since the introduction of PCV vaccines into infant immunisation programmes in 2010, there has been a substantial global reduction in S1 outbreaks and IPD in both immunised children and unvaccinated older children and adults. Consistent with earlier data on PCV effectiveness in low disease burden settings [103], recent data describe a 95% reduction in disease incidence in settings presenting high S1 disease burden, six years following the introduction of PCV10 or PCV13 [104][105][106] . S1 epidemics persist in some settings despite high vaccine uptake, for example, an increase of S1 IPD was documented five years after the introduction of PCV13 in Malawi [58]. ...
Streptococcus pneumoniae (the 'pneumococcus') is a significant cause of morbidity and mortality worldwide, causing life-threatening diseases such as pneumonia, bacteraemia, and meningitis, with an annual death burden of over one million. Discovered over a century ago, pneumococcal serotype 1 (S1) is a significant cause of these life-threatening diseases. Our understanding of the epidemiology and biology of pneumococcal S1 has significantly improved over the past two decades, informing the development of preventative and surveillance strategies. However, many questions remain unanswered. Here, we review the current state of knowledge of pneumococcal S1, with a special emphasis on clinical epidemiology, genomics, and disease mechanisms.
... Some serotypes, such as 1 and 7F, associated to high invasive disease potential, are carried for short periods and they seem to affect to relatively healthy adults [16,22,23]. Low case-fatality rate of serotype 1 has been described previously [16], with near elimination of IPD in all ages [24], showing a decreased risk of dying [18]. Although serotype 7F had been described in some studies as quite lethal in children [7], it is usually considered as a low case-fatality rate [16] and is associated with a small risk of death [18]. ...
The aim of this study was to investigate the serotype-associated fatality rate in cases of invasive pneumococcal disease (IPD) in the Spanish region of Madrid between 2007 and 2020. Serotyping was performed by Pneumotest Latex and the Quellung reaction using commercial antisera. Case-fatality rate was estimated as the ratio between the number of deaths at hospital discharge and the number of cases attributable to each serotype. To evaluate the association measures, the odds ratios with a 95% confidence interval were calculated. Twenty five pneumococcal serotypes were associated to mortality and comprised 87.8% of the total number of isolates characterized. Serotypes 8, 3, 19A, 1, 7F, 22F, 12F, and 11A were the most prevalent (≥3% each). Serotypes 31, 11A, and 19F were significantly associated to high case-fatality rates (>20% each). The lower significantly associated case-fatality rate (<10% each) was found in serotypes 5, 1, 12B, 7F, 12F, 8, 33, and 10A. The serotypes with higher mortality levels (≥0.04 per 100,000 population) were 11A (fatality 24.0%), 3 (fatality 18.7%), 19A (fatality 12.5%), and 8 (fatality 7.2%). Serotype 3 was worrisome because it is associated with important fatality levels combined with very high incidence and mortality rates. Serotype 11A also showed a high fatality with marked incidence and mortality levels. Some few frequent serotypes as 31, 19F, and 15A despite its high fatality had low levels of mortality. By contrast other serotypes as 8 showing low fatality had high mortality ranges because it shows a wide extended distribution. Finally, common serotypes, such as 1 and 5, presented small mortality length, due to their low case-fatality rates.
... A series of papers from the impressive PSERENADE project [11][12][13] demonstrated the substantial global impact of multivalent pneumococcal conjugate vaccines on invasive pneumococcal disease, including meningitis, after their introduction into infant immunisation programmes. Six or more years after introduction, they found a 95% reduction in serotype 1 disease in all age groups. ...
Bacterial meningitis has serious health, economic, and social consequences with a high risk of death and lifelong disability [...].
Objectives:
To compare the incidence and severity of invasive pneumococcal diseases (IPDs), pneumococcal pneumonia and all-cause pneumonia during the COVID-19 pandemic period with universal masking and social distancing with that of previous 5 years.
Design:
Retrospective observational study on incidence of IPDs, pneumococcal pneumonia and all-cause pneumonia between January 2015-December 2019 and March 2020-March 2021. January-February 2020 was excluded from analysis as it was treated as a transitional period between normal time and pandemic.
Setting:
Episode-based data by retrieval of hospitalisation records from the Hospital Authority's territory-wide electronic medical record database in Hong Kong.
Participants:
Hospitalised patients with IPD (n=742), pneumococcal pneumonia (n=2163) and all-cause pneumonia (including COVID-19 pneumonia, n=453 999) aged 18 years or above. Control diagnoses were included to assess confounding from health-seeking behaviours.
Primary and secondary outcomes:
Primary outcome is the incidence of diseases between two periods. Secondary outcomes include disease severity surrogated by length of stay and mortality.
Results:
Monthly average number of IPD, pneumococcal pneumonia and all-cause pneumonia hospitalisation significantly decreased by 88.9% (95% CI 79.8% to 98.0%, p<0.0005), 72.5% (95% CI 65.9% to 79.1%, p<0.0005) and 17.5% (95% CI 16.8% to 18.2%, p<0.0005), respectively. Changes in trend from January 2015-December 2019 to March 2020-March 2021 were -70% (95% CI -87% to -35%, p=0.0025), -43% (95% CI -59% to -19%, p=0.0014) and -11% (95% CI -13% to -10%, p<0.0005), respectively. Length of stay for IPD and pneumococcal pneumonia episodes were insignificantly different in the two periods. No reductions in hospitalisations for control diagnoses were observed.
Conclusions:
Incidence of IPD, pneumococcal pneumonia and all-cause pneumonia decreased during the COVID-19 pandemic. This was observed with universal masking and social distancing. We postulated this is related to reduced transmission of respiratory viruses and bacteria.
Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining pneumococcal meningitis in countries using PCV10/13 for least 5–7 years with primary series uptake above 70%. The distribution was estimated using a multinomial Dirichlet regression model, stratified by PCV product and age. In PCV10-using sites (N = 8; cases = 1141), PCV10 types caused 5% of cases <5 years of age and 15% among ≥5 years; the top serotypes were 19A, 6C, and 3, together causing 42% of cases <5 years and 37% ≥5 years. In PCV13-using sites (N = 32; cases = 4503), PCV13 types caused 14% in <5 and 26% in ≥5 years; 4% and 13%, respectively, were serotype 3. Among the top serotypes are five (15BC, 8, 12F, 10A, and 22F) included in higher-valency PCVs under evaluation. Other top serotypes (24F, 23B, and 23A) are not in any known investigational product. In countries with mature vaccination programs, the proportion of pneumococcal meningitis caused by vaccine-in-use serotypes is lower (≤26% across all ages) than pre-PCV (≥70% in children). Higher-valency PCVs under evaluation target over half of remaining pneumococcal meningitis cases, but questions remain regarding generalizability to the African meningitis belt where additional data are needed.
