Effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-type invasive pneumococcal disease in older adults

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-01-12 DOI:10.1016/j.vaccine.2024.126543

Amber Hsiao , Ned Lewis , John Hansen , Julius Timbol , Jose A. Suaya , Ronika Alexander-Parrish , Lindsay R. Grant , Bradford D. Gessner , Nicola P. Klein

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Abstract

Background

In 2014, the Advisory Committee on Immunization Practices recommended routine use of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults age ≥ 65 years. Incidence of most PCV13-serotype cases declined, however serotype 3 cases have persisted. We estimated PCV13 vaccine effectiveness (VE) against PCV13-serotypes and serotype 3 invasive pneumococcal disease (IPD) among Kaiser Permanente Northern California (KPNC) adults.

Methods

This observational study included adults ≥65 years between September 1, 2014-December 31, 2020. We used active laboratory-based surveillance to identify and serotype all Streptococcus pneumoniae isolates obtained from normally-sterile sites. We estimated the odds ratio (OR) of vaccine-type IPD using conditional logistic regression stratified by age and calendar day, adjusting for sex, age, race, ethnicity, influenza vaccine receipt, 23-valent pneumococcal polysaccharide vaccine receipt since age 65, pneumonia risk factors, healthcare utilization, and KPNC service area. We estimated VE_Adjusted as (1-OR_Adjusted) × 100 %.

Results

There were 610,576 adults ≥65 years in the study population. By the end of the study period, PCV13 coverage was nearly 80 %. There were 307 IPD cases during the study period, of which 98 (31.9 %) were serotype 3. PCV13 was associated with a VE_Adjusted of 61.5 % (95 % CI: 36.2, 76.7; p < 0.001) against PCV13-serotype IPD and 46.3 % (95 % CI: −2.4, 77.9; p = 0.06) against serotype 3 IPD.

Conclusions

PCV13 vaccination protected adults ≥65 years against IPD due to PCV13 serotypes. Continued surveillance will be critical in the ≥65-year-old population to assess the impact of higher valent PCVs on IPD serotype distribution, including individual serotypes such as serotype 3.

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13价肺炎球菌结合疫苗对老年人疫苗型侵袭性肺炎球菌病的有效性

背景：2014年，免疫实践咨询委员会推荐≥65岁成人常规使用13价肺炎球菌结合疫苗（PCV13）。大多数pcv13血清型病例发病率下降，但血清3型病例持续存在。我们在Kaiser Permanente Northern California （KPNC）成人中评估了PCV13疫苗对PCV13血清型和血清3型侵袭性肺炎球菌病（IPD）的有效性（VE）。方法：本观察性研究纳入2014年9月1日至2020年12月31日期间≥65岁的成年人。我们采用基于实验室的主动监测，对从正常无菌地点获得的所有肺炎链球菌分离株进行鉴定和血清分型。我们使用按年龄和日历日分层的条件logistic回归来估计疫苗型IPD的优势比（OR），调整性别、年龄、种族、民族、流感疫苗接种、65岁以来23价肺炎球菌多糖疫苗接种、肺炎危险因素、医疗保健利用和KPNC服务区域。我们估计VEAdjusted为（1-ORAdjusted） × 100%。结果：研究人群中有610,576名≥65岁的成年人。在研究期结束时，PCV13的覆盖率接近80%。研究期间共发生IPD 307例，其中血清3型98例（31.9%）。PCV13与VEAdjusted的相关性为61.5% (95% CI: 36.2, 76.7；结论：接种PCV13疫苗可保护≥65岁的成年人免受PCV13血清型引起的IPD。持续监测对于≥65岁人群至关重要，以评估高价pcv对IPD血清型分布的影响，包括个体血清型，如血清型3。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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