Limited indirect effects of an infant pneumococcal vaccination program in an aging population
A general recommendation for adult pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) for adults 60 and older has been in place in Germany since 1998, but uptake has been low. Just over a decade after the implementation of an infant pneumococcal conjugate vaccine recommendation,...
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| description | A general recommendation for adult pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) for adults 60 and older has been in place in Germany since 1998, but uptake has been low. Just over a decade after the implementation of an infant pneumococcal conjugate vaccine recommendation, we examined indirect protection effects on adult invasive pneumococcal disease (IPD) in Germany.
Reported IPD cases decreased in children under two years of age from 11.09 per 100,000 in 2003-2006 to 5.94 per 100,000 in 2017/18, while in adult age groups, reported IPD cases rose across the board, most dramatically in adults 60 years of age and over, from 1.64 to 10.08 cases per 100,000. PCV13-type IPD represents 31% of all cases in this age group, the lion's share of which is due to the rapid increase of serotype 3 IPD, which, by itself, has reached 2.11 reported cases per 100,000 and makes up 21% of all IPD cases in this age group. The two vaccine formulations currently in development (PCV15 and PCV20) would increase current (PCV13) coverage by 8.5% points and 28.0% points in children, while in adults coverage would increase by 10.4% points and 21.9% points, respectively.
While original models predicted that indirect effects of childhood vaccination would suffice for adults, it seems that the herd protection effect has reached its limit, with vaccine serotypes 4, 19F, and 19A IPD persisting in adults after initial reductions, and serotype 3 IPD not showing any herd protection effect at all. |
| doi_str_mv | 10.1371/journal.pone.0220453 |
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Reported IPD cases decreased in children under two years of age from 11.09 per 100,000 in 2003-2006 to 5.94 per 100,000 in 2017/18, while in adult age groups, reported IPD cases rose across the board, most dramatically in adults 60 years of age and over, from 1.64 to 10.08 cases per 100,000. PCV13-type IPD represents 31% of all cases in this age group, the lion's share of which is due to the rapid increase of serotype 3 IPD, which, by itself, has reached 2.11 reported cases per 100,000 and makes up 21% of all IPD cases in this age group. The two vaccine formulations currently in development (PCV15 and PCV20) would increase current (PCV13) coverage by 8.5% points and 28.0% points in children, while in adults coverage would increase by 10.4% points and 21.9% points, respectively.
While original models predicted that indirect effects of childhood vaccination would suffice for adults, it seems that the herd protection effect has reached its limit, with vaccine serotypes 4, 19F, and 19A IPD persisting in adults after initial reductions, and serotype 3 IPD not showing any herd protection effect at all.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0220453</identifier><identifier>PMID: 31369597</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Adults ; Age ; Age Factors ; Aged ; Aging ; Biology and Life Sciences ; Child ; Child, Preschool ; Children ; Cost analysis ; Drug therapy ; Female ; Formulations ; Germany - epidemiology ; Hospitals ; Humans ; Immunity, Herd ; Immunization Programs - statistics & numerical data ; Immunotherapy ; Infant ; Male ; Medicine and Health Sciences ; Middle Aged ; Older people ; People and places ; Pneumococcal infections ; Pneumococcal Infections - epidemiology ; Pneumococcal Infections - prevention & control ; Pneumococcal vaccines ; Pneumococcal Vaccines - therapeutic use ; Pneumonia ; Polysaccharides ; Serotypes ; Streptococcus infections ; Streptococcus pneumoniae ; Vaccination ; Vaccination Coverage - statistics & numerical data ; Vaccines ; Young Adult</subject><ispartof>PloS one, 2019-08, Vol.14 (8), p.e0220453-e0220453</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 van der Linden et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 van der Linden et al 2019 van der Linden et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-bdf4faa6b768fbaf92b03932833b6b96ff0721034a565bab0a6a32eafa301b893</citedby><cites>FETCH-LOGICAL-c692t-bdf4faa6b768fbaf92b03932833b6b96ff0721034a565bab0a6a32eafa301b893</cites><orcidid>0000-0002-6574-4313 ; 0000-0002-3146-2182</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675109/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675109/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31369597$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Melo-Cristino, Jose</contributor><creatorcontrib>van der Linden, Mark</creatorcontrib><creatorcontrib>Imöhl, Matthias</creatorcontrib><creatorcontrib>Perniciaro, Stephanie</creatorcontrib><title>Limited indirect effects of an infant pneumococcal vaccination program in an aging population</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>A general recommendation for adult pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) for adults 60 and older has been in place in Germany since 1998, but uptake has been low. Just over a decade after the implementation of an infant pneumococcal conjugate vaccine recommendation, we examined indirect protection effects on adult invasive pneumococcal disease (IPD) in Germany.
Reported IPD cases decreased in children under two years of age from 11.09 per 100,000 in 2003-2006 to 5.94 per 100,000 in 2017/18, while in adult age groups, reported IPD cases rose across the board, most dramatically in adults 60 years of age and over, from 1.64 to 10.08 cases per 100,000. PCV13-type IPD represents 31% of all cases in this age group, the lion's share of which is due to the rapid increase of serotype 3 IPD, which, by itself, has reached 2.11 reported cases per 100,000 and makes up 21% of all IPD cases in this age group. The two vaccine formulations currently in development (PCV15 and PCV20) would increase current (PCV13) coverage by 8.5% points and 28.0% points in children, while in adults coverage would increase by 10.4% points and 21.9% points, respectively.
While original models predicted that indirect effects of childhood vaccination would suffice for adults, it seems that the herd protection effect has reached its limit, with vaccine serotypes 4, 19F, and 19A IPD persisting in adults after initial reductions, and serotype 3 IPD not showing any herd protection effect at all.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aging</subject><subject>Biology and Life Sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cost analysis</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Formulations</subject><subject>Germany - epidemiology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunity, Herd</subject><subject>Immunization Programs - statistics & numerical data</subject><subject>Immunotherapy</subject><subject>Infant</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>People and places</subject><subject>Pneumococcal infections</subject><subject>Pneumococcal Infections - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Linden, Mark</au><au>Imöhl, Matthias</au><au>Perniciaro, Stephanie</au><au>Melo-Cristino, Jose</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limited indirect effects of an infant pneumococcal vaccination program in an aging population</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>14</volume><issue>8</issue><spage>e0220453</spage><epage>e0220453</epage><pages>e0220453-e0220453</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>A general recommendation for adult pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) for adults 60 and older has been in place in Germany since 1998, but uptake has been low. Just over a decade after the implementation of an infant pneumococcal conjugate vaccine recommendation, we examined indirect protection effects on adult invasive pneumococcal disease (IPD) in Germany.
Reported IPD cases decreased in children under two years of age from 11.09 per 100,000 in 2003-2006 to 5.94 per 100,000 in 2017/18, while in adult age groups, reported IPD cases rose across the board, most dramatically in adults 60 years of age and over, from 1.64 to 10.08 cases per 100,000. PCV13-type IPD represents 31% of all cases in this age group, the lion's share of which is due to the rapid increase of serotype 3 IPD, which, by itself, has reached 2.11 reported cases per 100,000 and makes up 21% of all IPD cases in this age group. The two vaccine formulations currently in development (PCV15 and PCV20) would increase current (PCV13) coverage by 8.5% points and 28.0% points in children, while in adults coverage would increase by 10.4% points and 21.9% points, respectively.
While original models predicted that indirect effects of childhood vaccination would suffice for adults, it seems that the herd protection effect has reached its limit, with vaccine serotypes 4, 19F, and 19A IPD persisting in adults after initial reductions, and serotype 3 IPD not showing any herd protection effect at all.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31369597</pmid><doi>10.1371/journal.pone.0220453</doi><tpages>e0220453</tpages><orcidid>https://orcid.org/0000-0002-6574-4313</orcidid><orcidid>https://orcid.org/0000-0002-3146-2182</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Adults Age Age Factors Aged Aging Biology and Life Sciences Child Child, Preschool Children Cost analysis Drug therapy Female Formulations Germany - epidemiology Hospitals Humans Immunity, Herd Immunization Programs - statistics & numerical data Immunotherapy Infant Male Medicine and Health Sciences Middle Aged Older people People and places Pneumococcal infections Pneumococcal Infections - epidemiology Pneumococcal Infections - prevention & control Pneumococcal vaccines Pneumococcal Vaccines - therapeutic use Pneumonia Polysaccharides Serotypes Streptococcus infections Streptococcus pneumoniae Vaccination Vaccination Coverage - statistics & numerical data Vaccines Young Adult |
| title | Limited indirect effects of an infant pneumococcal vaccination program in an aging population |
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