TY - JOUR
T1 - Effects of vaccination on invasive pneumococcal disease in South Africa
AU - Von Gottberg, Anne
AU - De Gouveia, Linda
AU - Tempia, Stefano
AU - Quan, Vanessa
AU - Meiring, Susan
AU - Von Mollendorf, Claire
AU - Madhi, Shabir A.
AU - Zell, Elizabeth R.
AU - Stat, M.
AU - Verani, Jennifer R.
AU - O'Brien, Katherine L.
AU - Whitney, Cynthia G.
AU - Klugman, Keith P.
AU - Cohen, Cheryl
N1 - Funding Information:
Supported by the National Institute for Communicable Diseases of the National Health Laboratory Service, the President’s Emergency Plan for AIDS Relief, the U.S. Agency for International Development’s Antimicrobial Resistance Initiative, and the Centers for Disease Control and Prevention (cooperative agreements U62/CCU022901, 5U2GPS001328, and U60/CCU022088).
Funding Information:
Dr. von Gottberg reports receiving grant support through her institution from Pfizer; Dr. von Mollendorf, receiving honoraria for presentations from Pfizer and salary support from the Global Alliance for Vaccines and Immunization through the Program for Appropriate Technology in Health; Dr. Madhi, receiving fees from GlaxoSmithKline and Pfizer for serving on advisory boards, lecture fees from GlaxoSmithKline, Pfizer, and Sanofi Pasteur, and grant support through his institution from GlaxoSmithKline, Pfizer, and Novartis; Dr. O’Brien, receiving grant support from GlaxoSmithKline and Pfizer; and Dr. Klugman, receiving fees from Pfizer and GlaxoSmithKline for serving on advisory boards and grant support from Pfizer. No other potential conflict of interest relevant to this article was reported.
Publisher Copyright:
© 2014 Massachusetts Medical Society. All rights reserved.
PY - 2014/11/13
Y1 - 2014/11/13
N2 - In South Africa, a 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2009 with a three-dose schedule for infants at 6, 14, and 36 weeks of age; a 13-valent vaccine (PCV13) replaced PCV7 in 2011. In 2012, it was estimated that 81% of 12-month-old children had received three doses of vaccine. We assessed the effect of vaccination on invasive pneumococcal disease.Methods We conducted national, active, laboratory-based surveillance for invasive pneumococcal disease. We calculated the change in the incidence of the disease from a prevaccine (baseline) period (2005 through 2008) to postvaccine years 2011 and 2012, with a focus on high-risk age groups.Results Surveillance identified 35,192 cases of invasive pneumococcal disease. The rates among children younger than 2 years of age declined from 54.8 to 17.0 cases per 100,000 person-years from the baseline period to 2012, including a decline from 32.1 to 3.4 cases per 100,000 person-years in disease caused by PCV7 serotypes (-89%; 95% confidence interval [CI], -92 to -86). Among children not infected with the human immunodeficiency virus (HIV), the estimated incidence of invasive pneumococcal disease caused by PCV7 serotypes decreased by 85% (95% CI, -89 to -79), whereas disease caused by nonvaccine serotypes increased by 33% (95% CI, 15 to 48). Among adults 25 to 44 years of age, the rate of PCV7-serotype disease declined by 57% (95% CI, -63 to -50), from 3.7 to 1.6 cases per 100,000 personyears. CONCLUSIONS Rates of invasive pneumococcal disease among children in South Africa fell substantially by 2012. Reductions in the rates of disease caused by PCV7 serotypes among both children and adults most likely reflect the direct and indirect effects of vaccination.
AB - In South Africa, a 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2009 with a three-dose schedule for infants at 6, 14, and 36 weeks of age; a 13-valent vaccine (PCV13) replaced PCV7 in 2011. In 2012, it was estimated that 81% of 12-month-old children had received three doses of vaccine. We assessed the effect of vaccination on invasive pneumococcal disease.Methods We conducted national, active, laboratory-based surveillance for invasive pneumococcal disease. We calculated the change in the incidence of the disease from a prevaccine (baseline) period (2005 through 2008) to postvaccine years 2011 and 2012, with a focus on high-risk age groups.Results Surveillance identified 35,192 cases of invasive pneumococcal disease. The rates among children younger than 2 years of age declined from 54.8 to 17.0 cases per 100,000 person-years from the baseline period to 2012, including a decline from 32.1 to 3.4 cases per 100,000 person-years in disease caused by PCV7 serotypes (-89%; 95% confidence interval [CI], -92 to -86). Among children not infected with the human immunodeficiency virus (HIV), the estimated incidence of invasive pneumococcal disease caused by PCV7 serotypes decreased by 85% (95% CI, -89 to -79), whereas disease caused by nonvaccine serotypes increased by 33% (95% CI, 15 to 48). Among adults 25 to 44 years of age, the rate of PCV7-serotype disease declined by 57% (95% CI, -63 to -50), from 3.7 to 1.6 cases per 100,000 personyears. CONCLUSIONS Rates of invasive pneumococcal disease among children in South Africa fell substantially by 2012. Reductions in the rates of disease caused by PCV7 serotypes among both children and adults most likely reflect the direct and indirect effects of vaccination.
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U2 - 10.1056/NEJMoa1401914
DO - 10.1056/NEJMoa1401914
M3 - Article
C2 - 25386897
AN - SCOPUS:84910124401
SN - 0028-4793
VL - 371
SP - 1889
EP - 1899
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 20
ER -