Effectiveness of the 13-valent pneumococcal conjugate vaccine in preventing invasive pneumococcal disease in children aged 7-59 months. A matched case-control study
Effectiveness of the 13-valent pneumococcal conjugate vaccine in preventing invasive pneumococcal disease in children aged 7-59 months. A matched case-control study
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DOI：
10.1371/journal.pone.0183191
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发表时间：
2017-08-14
期刊：
影响因子：
3.7
通讯作者：
Salleras, Luis
中科院分区：
文献类型：
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作者：
Dominguez, Angela;Ciruela, Pilar;Salleras, Luis
背景13价肺炎球菌结合疫苗（PCV 13）是根据7价肺炎球菌结合疫苗随机临床试验的免疫原性研究结果和保护相关性而获得许可的。我们评估了PCV 13在预防7-59个月儿童侵袭性肺炎球菌病（IPD）中的疫苗接种有效性（VE），该人群的次优疫苗接种覆盖率为55%.MethodsThe研究在巴塞罗那（西班牙）三家医院收治的IPD儿童中进行，对照组按医院、年龄、性别、住院日期和基础疾病进行匹配。从书面病历中获得疫苗接种状态信息。采用条件Logistic回归分析方法，计算调整后的VE值及其95%可信区间（CI）。当在12个月前给予≥ 2剂、在12个月时或之后给予2剂或在24个月时或之后给予1剂时，≥ 1剂PCV 13在预防由于疫苗血清型引起的IPD方面的总体VE为75.8%（95%CI，54.1-87.2）和90%（95%CI，63.9-97.2）。针对血清型1，>= 1剂的VE为89%（95%CI，42.7-97.9），针对血清型19 A的VE为86.0%（95%CI，51.2-99.7）。血清3型显示出非统计学显著的有效性（25.9%; 95%CI，-65.3至66.8）。结论在7-59个月的儿童中，>= 1剂PCV 13预防由所有PCV 13血清型引起的IPD的效果良好，除了血清3型，当单独考虑时，>= 1剂量对最常见的引起IPD的PCV 13血清型的有效性高。
BackgroundThe 13-valent pneumococcal conjugate vaccine (PCV13) was licensed based on the results of immunogenicity studies and correlates of protection derived from randomized clinical trials of the 7-valent conjugate pneumococcal vaccine. We assessed the vaccination effectiveness (VE) of the PCV13 in preventing invasive pneumococcal disease (IPD) in children aged 7-59 months in a population with suboptimal vaccination coverage of 55%.MethodsThe study was carried out in children with IPD admitted to three hospitals in Barcelona (Spain) and controls matched by hospital, age, sex, date of hospitalization and underlying disease. Information on the vaccination status was obtained from written medical records. Conditional logistic regression was made to estimate the adjusted VE and 95% confidence intervals (CI).Results169 cases and 645 controls were included. The overall VE of >= 1 doses of PCV13 in preventing IPD due to vaccine serotypes was 75.8% (95% CI, 54.1-87.2) and 90% (95% CI, 63.9-97.2) when >= 2 doses before 12 months, two doses on or after 12 months or one dose on or after 24 months, were administered. The VE of >= 1 doses was 89% (95% CI, 42.7-97.9) against serotype 1 and 86.0% (95% CI, 51.2-99.7) against serotype 19A. Serotype 3 showed a non- statistically significant effectiveness (25.9%; 95% CI, - 65.3 to 66.8).ConclusionsThe effectiveness of >= 1 doses of PCV13 in preventing IPD caused by all PCV13 serotypes in children aged 7-59 months was good and, except for serotype 3, the effectiveness of >= 1 doses against the most frequent PCV13 serotypes causing IPD was high when considered individually.