Effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-type invasive pneumococcal disease in older adults
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)...
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| creator | Hsiao, Amber Lewis, Ned Hansen, John Timbol, Julius Suaya, Jose A. Alexander-Parrish, Ronika Grant, Lindsay R. Gessner, Bradford D. Klein, Nicola P. |
| description | 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.
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 VEAdjusted as (1-ORAdjusted) × 100 %.
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 VEAdjusted of 61.5 % (95 % CI: 36.2, 76.7; p |
| doi_str_mv | 10.1016/j.vaccine.2024.126543 |
| format | Article |
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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 VEAdjusted as (1-ORAdjusted) × 100 %.
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 VEAdjusted 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.
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.
•Pneumococcal conjugate vaccine (PCV) use in the US has reduced vaccine serotype invasive pneumococcal disease (IPD).•Despite declines in the incidence of most 13-valent PCV-serotype cases, IPD cases due to serotype 3 have persisted.•This study found that PCV13 vaccination reduced the incidence of vaccine-type IPD in adults aged ≥65 years by 61.5 %.</description><identifier>ISSN: 0264-410X</identifier><identifier>ISSN: 1873-2518</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2024.126543</identifier><identifier>PMID: 39637487</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adults ; Age ; Aged ; Aged, 80 and over ; California ; California - epidemiology ; Cardiovascular disease ; Chronic illnesses ; Chronic obstructive pulmonary disease ; Cohort analysis ; Conjugates ; Diabetes ; Effectiveness ; Female ; health services ; Humans ; Immunization ; Incidence ; Influenza ; influenza vaccines ; Invasive pneumococcal disease ; Male ; monitoring ; nationalities and ethnic groups ; Observational studies ; odds ratio ; Older people ; Pediatrics ; Pneumococcal Infections - epidemiology ; Pneumococcal Infections - immunology ; Pneumococcal Infections - prevention & control ; Pneumococcal Vaccines - administration & dosage ; Pneumococcal Vaccines - immunology ; Pneumonia ; Polysaccharides ; Population ; Population studies ; regression analysis ; risk ; Risk factors ; Serogroup ; Serotypes ; Service areas ; Streptococcus infections ; Streptococcus pneumoniae ; Streptococcus pneumoniae - classification ; Streptococcus pneumoniae - immunology ; Surveillance ; vaccination ; Vaccination - statistics & numerical data ; Vaccine effectiveness ; Vaccine efficacy ; Vaccine Efficacy - statistics & numerical data ; Vaccines ; Vaccines, Conjugate - administration & dosage ; Vaccines, Conjugate - immunology</subject><ispartof>Vaccine, 2025-01, Vol.44, p.126543, Article 126543</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><rights>2024. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c351t-933f4c98afa827d9c25eaf52489e2e290838eea911aa4a898267bdb642b2da8e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0264410X24012258$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39637487$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsiao, Amber</creatorcontrib><creatorcontrib>Lewis, Ned</creatorcontrib><creatorcontrib>Hansen, John</creatorcontrib><creatorcontrib>Timbol, Julius</creatorcontrib><creatorcontrib>Suaya, Jose A.</creatorcontrib><creatorcontrib>Alexander-Parrish, Ronika</creatorcontrib><creatorcontrib>Grant, Lindsay R.</creatorcontrib><creatorcontrib>Gessner, Bradford D.</creatorcontrib><creatorcontrib>Klein, Nicola P.</creatorcontrib><title>Effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-type invasive pneumococcal disease in older adults</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>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.
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 VEAdjusted as (1-ORAdjusted) × 100 %.
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 VEAdjusted 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.
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.
•Pneumococcal conjugate vaccine (PCV) use in the US has reduced vaccine serotype invasive pneumococcal disease (IPD).•Despite declines in the incidence of most 13-valent PCV-serotype cases, IPD cases due to serotype 3 have persisted.•This study found that PCV13 vaccination reduced the incidence of vaccine-type IPD in adults aged ≥65 years by 61.5 %.</description><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>California</subject><subject>California - epidemiology</subject><subject>Cardiovascular disease</subject><subject>Chronic illnesses</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort analysis</subject><subject>Conjugates</subject><subject>Diabetes</subject><subject>Effectiveness</subject><subject>Female</subject><subject>health services</subject><subject>Humans</subject><subject>Immunization</subject><subject>Incidence</subject><subject>Influenza</subject><subject>influenza vaccines</subject><subject>Invasive pneumococcal disease</subject><subject>Male</subject><subject>monitoring</subject><subject>nationalities and ethnic groups</subject><subject>Observational studies</subject><subject>odds ratio</subject><subject>Older people</subject><subject>Pediatrics</subject><subject>Pneumococcal Infections - epidemiology</subject><subject>Pneumococcal Infections - immunology</subject><subject>Pneumococcal Infections - prevention & control</subject><subject>Pneumococcal Vaccines - administration & dosage</subject><subject>Pneumococcal Vaccines - immunology</subject><subject>Pneumonia</subject><subject>Polysaccharides</subject><subject>Population</subject><subject>Population studies</subject><subject>regression analysis</subject><subject>risk</subject><subject>Risk factors</subject><subject>Serogroup</subject><subject>Serotypes</subject><subject>Service areas</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumoniae</subject><subject>Streptococcus pneumoniae - classification</subject><subject>Streptococcus pneumoniae - immunology</subject><subject>Surveillance</subject><subject>vaccination</subject><subject>Vaccination - statistics & numerical data</subject><subject>Vaccine effectiveness</subject><subject>Vaccine efficacy</subject><subject>Vaccine Efficacy - statistics & numerical data</subject><subject>Vaccines</subject><subject>Vaccines, Conjugate - administration & dosage</subject><subject>Vaccines, Conjugate - immunology</subject><issn>0264-410X</issn><issn>1873-2518</issn><issn>1873-2518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU-LFDEQxYMo7uzqR1ACXrz0mP-dnESWdRUWvCh4CzVJ9ZKmJxk73Q0Lfnh7mFlBL3oqQv3eK_IeIa8423LGzbt-u0AIKeNWMKG2XBit5BOy4baVjdDcPiUbJoxqFGffL8hlrT1jTEvunpML6YxslW035OdN12GY0oIZa6Wlo1w2CwyYJ3rIOO9LKCHAQEPJ_XwPE9LzXQr3kHKdHt_N9HBAmvICdXX7UxxTRajHLS1DxJFCnIepviDPOhgqvjzPK_Lt483X60_N3Zfbz9cf7pogNZ8aJ2WngrPQgRVtdEFohE4LZR0KFI5ZaRHBcQ6gwDorTLuLO6PETkSwKK_I25PvYSw_ZqyT36cacBggY5mrl1wrIVvXmv9AldFyDVus6Ju_0L7MY14_cqS0kVYwuVL6RIWx1Dpi5w9j2sP44DnzxyZ9788J-mOT_tTkqnt9dp93e4y_VY_VrcD7E4BrckvC0deQMAeMaVwb9bGkf5z4Ba8Fsuk</recordid><startdate>20250112</startdate><enddate>20250112</enddate><creator>Hsiao, Amber</creator><creator>Lewis, Ned</creator><creator>Hansen, John</creator><creator>Timbol, Julius</creator><creator>Suaya, Jose A.</creator><creator>Alexander-Parrish, Ronika</creator><creator>Grant, Lindsay R.</creator><creator>Gessner, Bradford D.</creator><creator>Klein, Nicola P.</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T5</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope></search><sort><creationdate>20250112</creationdate><title>Effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-type invasive pneumococcal disease in older adults</title><author>Hsiao, Amber ; Lewis, Ned ; Hansen, John ; Timbol, Julius ; Suaya, Jose A. ; Alexander-Parrish, Ronika ; Grant, Lindsay R. ; Gessner, Bradford D. ; Klein, Nicola P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-933f4c98afa827d9c25eaf52489e2e290838eea911aa4a898267bdb642b2da8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Adults</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>California</topic><topic>California - epidemiology</topic><topic>Cardiovascular disease</topic><topic>Chronic illnesses</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Cohort analysis</topic><topic>Conjugates</topic><topic>Diabetes</topic><topic>Effectiveness</topic><topic>Female</topic><topic>health services</topic><topic>Humans</topic><topic>Immunization</topic><topic>Incidence</topic><topic>Influenza</topic><topic>influenza vaccines</topic><topic>Invasive pneumococcal disease</topic><topic>Male</topic><topic>monitoring</topic><topic>nationalities and ethnic groups</topic><topic>Observational studies</topic><topic>odds ratio</topic><topic>Older people</topic><topic>Pediatrics</topic><topic>Pneumococcal Infections - epidemiology</topic><topic>Pneumococcal Infections - immunology</topic><topic>Pneumococcal Infections - prevention & control</topic><topic>Pneumococcal Vaccines - administration & dosage</topic><topic>Pneumococcal Vaccines - immunology</topic><topic>Pneumonia</topic><topic>Polysaccharides</topic><topic>Population</topic><topic>Population studies</topic><topic>regression analysis</topic><topic>risk</topic><topic>Risk factors</topic><topic>Serogroup</topic><topic>Serotypes</topic><topic>Service areas</topic><topic>Streptococcus infections</topic><topic>Streptococcus pneumoniae</topic><topic>Streptococcus pneumoniae - classification</topic><topic>Streptococcus pneumoniae - immunology</topic><topic>Surveillance</topic><topic>vaccination</topic><topic>Vaccination - statistics & numerical data</topic><topic>Vaccine effectiveness</topic><topic>Vaccine efficacy</topic><topic>Vaccine Efficacy - statistics & numerical data</topic><topic>Vaccines</topic><topic>Vaccines, Conjugate - administration & dosage</topic><topic>Vaccines, Conjugate - immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hsiao, Amber</creatorcontrib><creatorcontrib>Lewis, Ned</creatorcontrib><creatorcontrib>Hansen, John</creatorcontrib><creatorcontrib>Timbol, Julius</creatorcontrib><creatorcontrib>Suaya, Jose A.</creatorcontrib><creatorcontrib>Alexander-Parrish, Ronika</creatorcontrib><creatorcontrib>Grant, Lindsay R.</creatorcontrib><creatorcontrib>Gessner, Bradford D.</creatorcontrib><creatorcontrib>Klein, Nicola P.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><jtitle>Vaccine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hsiao, Amber</au><au>Lewis, Ned</au><au>Hansen, John</au><au>Timbol, Julius</au><au>Suaya, Jose A.</au><au>Alexander-Parrish, Ronika</au><au>Grant, Lindsay R.</au><au>Gessner, Bradford D.</au><au>Klein, Nicola P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-type invasive pneumococcal disease in older adults</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2025-01-12</date><risdate>2025</risdate><volume>44</volume><spage>126543</spage><pages>126543-</pages><artnum>126543</artnum><issn>0264-410X</issn><issn>1873-2518</issn><eissn>1873-2518</eissn><abstract>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.
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 VEAdjusted as (1-ORAdjusted) × 100 %.
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 VEAdjusted 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.
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.
•Pneumococcal conjugate vaccine (PCV) use in the US has reduced vaccine serotype invasive pneumococcal disease (IPD).•Despite declines in the incidence of most 13-valent PCV-serotype cases, IPD cases due to serotype 3 have persisted.•This study found that PCV13 vaccination reduced the incidence of vaccine-type IPD in adults aged ≥65 years by 61.5 %.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39637487</pmid><doi>10.1016/j.vaccine.2024.126543</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adults Age Aged Aged, 80 and over California California - epidemiology Cardiovascular disease Chronic illnesses Chronic obstructive pulmonary disease Cohort analysis Conjugates Diabetes Effectiveness Female health services Humans Immunization Incidence Influenza influenza vaccines Invasive pneumococcal disease Male monitoring nationalities and ethnic groups Observational studies odds ratio Older people Pediatrics Pneumococcal Infections - epidemiology Pneumococcal Infections - immunology Pneumococcal Infections - prevention & control Pneumococcal Vaccines - administration & dosage Pneumococcal Vaccines - immunology Pneumonia Polysaccharides Population Population studies regression analysis risk Risk factors Serogroup Serotypes Service areas Streptococcus infections Streptococcus pneumoniae Streptococcus pneumoniae - classification Streptococcus pneumoniae - immunology Surveillance vaccination Vaccination - statistics & numerical data Vaccine effectiveness Vaccine efficacy Vaccine Efficacy - statistics & numerical data Vaccines Vaccines, Conjugate - administration & dosage Vaccines, Conjugate - immunology |
| title | Effectiveness of 13-valent pneumococcal conjugate vaccine against vaccine-type invasive pneumococcal disease in older adults |
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