Impact of 13-Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Carriage Rates of Streptococcus pneumoniae in a Rural Community in the Dominican Republic.

Autor:	Dunn MG; Department of Pediatrics, Global Health Center and Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Lessa FC; Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Sánchez J; Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic., Cordero R; Centro de Salud Divina Providencia, Consuelo, Dominican Republic., Feris-Iglesias J; Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic., Cedano D; Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic., Carvalho MDG; Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Fernández J; Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic., Feemster KA; Department of Pediatrics, Global Health Center and Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2021 Sep 01; Vol. 224 (12 Suppl 2), pp. S237-S247.
DOI:	10.1093/infdis/jiab172
Abstrakt:	Background: Invasive pneumococcal disease (IPD) leads to thousands of pediatric deaths annually. Pneumococcal colonization precedes IPD. In 2013, the Dominican Republic introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into its routine infant immunization program, with doses at ages 2, 4, and 12 months. Prevalence of pneumococcal nasopharyngeal colonization was evaluated post-PCV13 introduction. Methods: A prospective cohort study of 125 children aged 2-35 months was conducted in a rural Dominican Republic community November 2016 through July 2017. Nasopharyngeal swabs and clinical and vaccination data were collected at enrollment and 4-6 months later. Serotypes included in PCV13 were defined as vaccine-type. Colonization rates and serotype distribution were compared at baseline and follow-up, and the association between colonization and vaccination status among the entire cohort was evaluated at each time point. Results: Of 125 children enrolled, 118 (94%) completed follow-up. Overall and vaccine-type pneumococcal colonization rates were 62% and 25%, respectively, at baseline and 60% and 28% at follow-up. Among children age-eligible for 3 doses, 50% and 51% were fully vaccinated at baseline and follow-up, respectively. At baseline assessment, children up-to-date for age for PCV13 were less likely to be colonized with vaccine-type pneumococci than children not up-to-date, and the same was found for fully vaccinated children (3 doses) compared to those not fully vaccinated (odds ratios [ORs], 0.38 [95% confidence interval {CI}, .18-.79], and 0.14 [95% CI, .04-.45], respectively). The same associations were not found at follow-up assessment. Conclusions: Three years post -PCV13 introduction, vaccine-type colonization rates remained high. Low vaccination coverage for 3 PCV13 doses may have contributed. The protective effect of PCV13 on vaccine-type carriage suggests an increase in PCV13 coverage could lead to substantial declines in pneumococcal vaccine-type carriage. (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
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