7-Valent Pneumococcal Conjugate Vaccination in England and Wales: Is It Still Beneficial Despite High Levels of Serotype Replacement?
Open Access
- 14 October 2011
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 6 (10), e26190
- https://doi.org/10.1371/journal.pone.0026190
Abstract
The UK introduced the 7-valent pneumococcal conjugate vaccine (PCV7) into the national vaccination program in September 2006. Previous modelling assumed that the likely impact of PCV7 on invasive pneumococcal disease (IPD) would be similar to the US experience with PCV7. However, recent surveillance data show a more rapid replacement of PCV7 IPD cases by non-PCV7 IPD cases than was seen in the US. A previous model of pneumococcal vaccination was re-parameterised using data on vaccine coverage and IPD from England and Wales between 2006 and 2009. Disease incidence was adjusted for the increasing trend in reported IPD cases prior to vaccination. Using this data we estimated that individuals carrying PCV7 serotypes have much higher protection (96%;95% CI 72%-100%) against acquisition of NVT carriage than the 15% previously estimated from US data, which leads to greater replacement. However, even with this level of replacement, the annual number of IPD cases may be 560 (95% CI, -100 to 1230) lower ten years after vaccine introduction compared to what it may have been without vaccination. A particularly marked fall of 39% in children under 15 years by 2015/6 is predicted. Our model suggests that PCV7 vaccination could result in a decrease in overall invasive pneumococcal disease, particularly in children, even in an environment of rapid replacement with non-PCV7 serotypes within 5 years of vaccine introduction at high coverage.Keywords
This publication has 25 references indexed in Scilit:
- Serotype replacement in disease after pneumococcal vaccinationThe Lancet, 2011
- Social Contacts and Mixing Patterns Relevant to the Spread of Infectious DiseasesPLoS Medicine, 2008
- Pneumococcal Carriage in United Kingdom Families: Estimating Serotype-specific Transmission Parameters from Longitudinal DataAmerican Journal of Epidemiology, 2007
- A longitudinal household study of Streptococcus pneumoniae nasopharyngeal carriage in a UK settingEpidemiology and Infection, 2005
- Cost-effectiveness analysis of pneumococcal conjugate vaccination in England and WalesVaccine, 2004
- Effect of a nonavalent conjugate vaccine on carriage of antibiotic-resistant Streptococcus pneumoniae in day-care centersThe Pediatric Infectious Disease Journal, 2003
- Bacterial Vaccines and Serotype Replacement: Lessons fromHaemophilus influenzaeand Prospects forStreptococcus pneumoniaeEmerging Infectious Diseases, 1999
- Estimating the transmission parameters of pneumococcal carriage in householdsEpidemiology and Infection, 1999
- Multiple colonization of the upper respiratory tract of Papua New Guinea children with Haemophilus influenzae and Streptococcus pneumoniae.1989
- Vaccination against rubella and measles: quantitative investigations of different policiesEpidemiology and Infection, 1983