Global impact of 10- and 13-valent pneumococcal conjugate vaccines on pneumococcal meningitis in all ages: The PSERENADE project.
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Yang Yangyupei, Knoll Maria Deloria, Herbert Carly, Bennett Julia C, Feikin Daniel R, Garcia Quesada Maria, Hetrich Marissa K, Zeger Scott L, Kagucia Eunice W, Xiao Melody, Cohen Adam L, van der Linden Mark, du Plessis Mignon, Yildirim Inci, Winje Brita A, Varon Emmanuelle, Valenzuela Maria Teresa, Valentiner-Branth Palle, Steens Anneke, Scott J Anthony, Savrasova Larisa, Sanz Juan Carlos, Khan Aalisha Sahu, Oishi Kazunori, Nzoyikorera Néhémie, Nuorti J Pekka, Mereckiene Jolita, McMahon Kimberley, McGeer Allison, Mackenzie Grant A, MacDonald Laura, Ladhani Shamez N, Kristinsson Karl G, Kleynhans Jackie, Kellner James D, Jayasinghe Sanjay, Ho Pak-Leung, Hilty Markus, Hammitt Laura L, Guevara Marcela, Gilkison Charlotte, Gierke Ryan, Desmet Stefanie, De Wals Philippe, Dagan Ron, Colzani Edoardo, Ciruela Pilar, Chuluunbat Urtnasan, Chan Guanhao, Camilli Romina, Bruce Michael G, Brandileone Maria-Cristina C, Ampofo Krow, O'Brien Katherine L, Hayford Kyla, PSERENADE Team
Аннотация
METHODS: The number of cases with serotyped pneumococci detected in cerebrospinal fluid and population denominators were obtained from surveillance sites globally. Site-specific meningitis incidence rate ratios (IRRs) comparing pre-PCV incidence to each year post-PCV10/13 were estimated by age (<5, 5-17 and ≥18 years) using Bayesian multi-level mixed effects Poisson regression, accounting for pre-PCV trends. All-site weighted average IRRs were estimated using linear mixed-effects regression stratified by age, product (PCV10 or PCV13) and prior PCV7 impact (none, moderate, or substantial). Changes in pneumococcal meningitis incidence were estimated overall and for product-specific vaccine-types and non-PCV13-types.
RESULTS: Analyses included 10,168 cases <5 y from PCV13 sites and 2849 from PCV10 sites, 3711 and 1549 for 5-17 y and 29,187 and 5653 for ≥18 y from 42 surveillance sites (30 PCV13, 12 PCV10, 2 PCV10/13) in 30 countries, primarily high-income (84%). Six years after PCV10/PCV13 introduction, pneumococcal meningitis declined 48-74% across products and PCV7 impact strata for children <5 y, 35-62% for 5-17 y and 0-36% for ≥18 y. Impact against PCV10-types at PCV10 sites, and PCV13-types at PCV13 sites was high for all age groups (<5 y: 96-100%; 5-17 y: 77-85%; ≥18 y: 73-85%). After switching from PCV7 to PCV10/13, increases in non-PCV13-types were generally low to none for all age groups.
CONCLUSION: Pneumococcal meningitis declined in all age groups following PCV10/PCV13 introduction. Plateaus in non-PCV13-type meningitis suggest less replacement than for all IPD. Data from meningitis belt and high-burden settings were limited.