Characteristics of children with invasive pneumococcal disease eligible for the 1+1 compared with the 2+1 PCV13 infant immunisation schedule in England: a prospective national observational surveillance study.
Autor: | Abdullahi F; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK., Bertran M; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK., D'Aeth JC; Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK., Eletu S; Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK., Chan YW; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK., Andrews NJ; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK., Litt DJ; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK; Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK., Ramsay ME; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., Ladhani SN; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK; Centre for Neonatal and Paediatric Infections (CNPI), St George's University of London, London, UK. Electronic address: shamez.ladhani@ukhsa.gov.uk. |
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Jazyk: | angličtina |
Zdroj: | The Lancet. Child & adolescent health [Lancet Child Adolesc Health] 2024 Nov; Vol. 8 (11), pp. 788-797. Date of Electronic Publication: 2024 Sep 24. |
DOI: | 10.1016/S2352-4642(24)00193-7 |
Abstrakt: | Background: On Jan 1, 2020, the UK transitioned from a 2+1 to a 1+1 national infant immunisation schedule with the 13-valent pneumococcal conjugate vaccine (PCV13). We assessed whether the 1+1 PCV13 schedule had any impact on incidence, disease characteristics, or outcomes after invasive pneumococcal disease (IPD) in eligible children aged 0-3 years. Methods: The UK Health Security Agency conducts IPD surveillance and serotyping of invasive pneumococcal isolates via whole-genome sequencing in England. IPD was defined as identification of Streptococcus pneumoniae in a sterile site. We compared IPD incidence, demographics, clinical presentation, comorbidity prevalence, serotype distribution, and case-fatality rates (CFRs) in children from a single birth cohort eligible for the 1+1 schedule (born between Jan 1, 2020, and Dec 31, 2022) who developed IPD in the 2022-23 financial year (April to March) with children from three equivalent historical birth cohorts (born between Jan 1, 2015, and Dec 31, 2019) eligible for the 2+1 schedule who developed IPD during three respective pre-pandemic financial years: 2017-18, 2018-19, and 2019-20. Findings: There were a total of 702 IPD episodes in 697 children, including 158 (incidence 8·99 per 100 000 person-years) in the single 1+1 birth cohort and 544 (incidence 9·39 per 100 000 person-years) in the 2+1 birth cohorts, with no significant difference in the incidence of overall IPD (incidence rate ratio 0·96, 95% CI 0·80-1·14, p=0·63), PCV13-type IPD (1·21, 0·71-2·00, p=0·45), or pneumococcal meningitis (0·97, 0·66-1·40, p=0·88). Comorbidity prevalence, clinical presentation, and CFRs were also similar between the two cohorts, as was the percentage of cases in infants too young to be vaccinated (<2 months old) and infants aged 5-11 months who received one or two PCV13 priming doses, in the 1+1 and 2+1 cohorts respectively. Interpretation: After 3 years, the 1+1 schedule continues to provide direct and indirect protection against PCV13-type IPD in children, with no significant change in overall IPD incidence, serotype distribution, clinical presentation, or CFRs in children eligible for the 1+1 compared with the 2+1 schedule. Ongoing surveillance will be important to assess longer-term direct and indirect population protection. Funding: None. Competing Interests: Declaration of interests The UKHSA Immunisation and Vaccine Preventable Diseases Division (affiliated with FA, MB, Y-WC, NJA, DJL, MER, and SNL) has provided vaccine manufacturers with post-marketing surveillance reports on pneumococcal and meningococcal infections which the companies are required to submit to the UK Licensing authority in compliance with their Risk Management Strategy. A cost recovery charge is made for these reports. SNL performs contract research on behalf of St George's University of London and the UKHSA for pharmaceutical companies but receives no personal remuneration. The Respiratory and Vaccine Preventable Bacteria Reference Unit (affiliated with JCD, SE, and DJL) at UKHSA has received grant funding from vaccine manufacturers for investigator-led research projects on pneumococcal surveillance. (Copyright © 2024 Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.) |
Databáze: | MEDLINE |
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