Effectiveness of the seven-valent and thirteen-valent pneumococcal conjugate vaccines in England: The indirect cohort design, 2006-2018
Effectiveness of the seven-valent and thirteen-valent pneumococcal conjugate vaccines in England: The indirect cohort design, 2006-2018
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DOI：
10.1016/j.vaccine.2019.06.071
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发表时间：
2019-07-26
期刊：
影响因子：
5.5
通讯作者：
Ladhani, Shamez N.
中科院分区：
文献类型：
--
作者：
Andrews, Nick;Kent, Alison;Ladhani, Shamez N.
背景：7价肺炎球菌结合疫苗(PCV7)于2006年引入英国儿童免疫计划，并于2010年被13价疫苗(PCV13)取代。这两种疫苗都导致疫苗血清型侵袭性肺炎球菌(IPD)的发病率迅速下降。在这里，我们评估了两种疫苗在英国的长期疫苗有效性(VE)。方法：英国公共卫生部门在英国加强了对IPD的国家监测。用疫苗血清型IPD病例和非疫苗血清型IPD对照(Broome方法)对2006年9月至2018年6月符合疫苗接种条件的儿童进行IPD的VE评估。结果：3421例IPD病例有疫苗史，其中1299例是由于额外的PCV13血清型和PCV13相关的6C型，274例是PCV7型，1848例是非PCV13血清型。对于完整的2+1方案，PCV7和PCV13对PCV7血清型的联合VE为92.0%(95%可信区间，81.7-96.7)。在2+1方案中，PCV13 VE对其他PCV13血清型+6C的VE为73.7%(31.1-89.9)，而PCV7对PCV7血清型的VE为90.0%(75.3-96.0)，但如果排除3型血清，PCV13 VE增加到84.8%(58.7-94.4)；36例符合条件的3型IPD病例全部接种了PCV13。老年病例数低，但有减少的迹象，这对有足够病例数可供分析的19A血清型尤为显著。结论：PCV在预防疫苗血清型IPD方面是有效的，但3型的发病率一直在上升。19A型IPD也持续存在，可能是由于VE略低和/或保护作用更快减弱所致。(C)2019爱思唯尔有限公司。保留所有权利。
Background: The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the UK childhood immunisation programme in 2006 and replaced with a 13-valent vaccine (PCV13) in 2010. Both vaccines led to rapid declines in vaccine-serotype invasive pneumococcal disease (IPD). Here, we assessed the long-term vaccine-effectiveness (VE) of both vaccines in England.Methods: Public Health England conducts enhanced national surveillance of IPD in England. VE against IPD was estimated using vaccine-serotype IPD cases and non-vaccine serotype IPD controls among vaccine-eligible children from September 2006 to June 2018 (the Broome method).Results: Vaccine history was available for 3421 IPD cases, including 1299 due to the additional PCV13 serotypes and the PCV13-related serotype 6C, 274 PCV7 serotypes and 1848 non-PCV13 serotypes. For the complete 2 + 1 schedule, both PCV7 and PCV13 showed high effectiveness against PCV7 serotypes with a combined VE of 92.0% (95%CI, 81.7-96.7). For the 2 + 1 schedule, PCV13 VE against the additional PCV13 serotypes plus 6C was 73.7% (31.1-89.9) compared to 90.0% (75.3 - 96.0) for PCV7 against PCV7 serotypes, although PCV13 VE increased to 84.8% (58.7-94.4) if serotype 3 was excluded; all 36 eligible serotype 3 IPD cases were fully-vaccinated with PCV13. Case numbers were low in older ages but there was evidence of waning, which was significant for serotype 19A for which there were sufficient numbers of cases for analysis.Conclusions: PCVs are highly effective in preventing vaccine-serotype IPD except for serotype 3 which has been increasing in incidence. Serotype 19A IPD has also persisted, likely due to a slightly lower VE and/or more rapid waning of protection. (C) 2019 Elsevier Ltd. All rights reserved.