Impact of 13-Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Carriage Rates of Streptococcus pneumoniae in a Rural Community in the Dominican Republic
| Autor: | Jacqueline Sánchez, Fernanda C. Lessa, Maria G Dunn, Kristen A. Feemster, Ramona Cordero, Maria da Gloria Carvalho, Jesús Feris-Iglesias, Josefina Fernández, Doraliza Cedano |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Rural Population medicine.medical_specialty Serogroup medicine.disease_cause Pneumococcal Infections Pneumococcal conjugate vaccine Pneumococcal Vaccines Vaccine Impact Nasopharynx Internal medicine Streptococcus pneumoniae medicine Humans Immunology and Allergy Colonization Prospective Studies nasopharyngeal colonization Prospective cohort study Caribbean Vaccines Conjugate business.industry Dominican Republic Infant Odds ratio pneumococcal conjugate vaccine Vaccination AcademicSubjects/MED00290 pediatric Infectious Diseases Carriage Carrier State Cohort Female business medicine.drug |
| Zdroj: | The Journal of Infectious Diseases |
| ISSN: | 1537-6613 0022-1899 |
| DOI: | 10.1093/infdis/jiab172 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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