Have changing pneumococcal vaccination programmes impacted disease in Ontario?
Highlights • Impact of Ontario's pneumococcal conjugate vaccine (PCV) programme was investigated. • Invasive pneumococcal disease due to PCV7 serotypes declined in children <5 years. • There is also some suggestion of early impact among infants of the change to PCV10. • Evidence of herd immu...
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| Published in | Vaccine Vol. 31; no. 24; pp. 2680 - 2685 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Kidlington
Elsevier Ltd
31.05.2013
Elsevier Elsevier Limited |
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| Online Access | Get full text |
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| Abstract | Highlights • Impact of Ontario's pneumococcal conjugate vaccine (PCV) programme was investigated. • Invasive pneumococcal disease due to PCV7 serotypes declined in children <5 years. • There is also some suggestion of early impact among infants of the change to PCV10. • Evidence of herd immunity and serotype replacement was observed. • Our results also demonstrate the substantial burden of disease among older adults. |
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| AbstractList | Background: Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent vaccines (PCV10, PCV13) in October 2009 and November 2010, respectively. Among adults aY 65 years, a 23-valent polysaccharide vaccine (PPV23) has been universally available since 1996. In January 2012, PCV13 was approved for adults aY 50 years. This study examines the impact of publicly funded vaccination programmes on invasive pneumococcal disease (IPD). Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent vaccines (PCV10, PCV13) in October 2009 and November 2010, respectively. Among adults ≥ 65 years, a 23-valent polysaccharide vaccine (PPV23) has been universally available since 1996. In January 2012, PCV13 was approved for adults ≥ 50 years. This study examines the impact of publicly funded vaccination programmes on invasive pneumococcal disease (IPD). Laboratory data from population-based surveillance for IPD conducted at the Toronto Invasive Bacterial Disease Network and from Public Health Ontario Laboratories between January 1, 2008 and December 31, 2010 were analyzed. Between 2008 and 2010 there were 3259 cases of IPD; overall incidence was 7.4/9.3/8.3 per 100,000 in 2008/9/10, respectively. Incidence increased significantly among adults 65+ years during the period; this group had the highest incidence (21.5-25.6/100,000). The second highest incidence in 2008 and 2009 was in infants <1 year, whereas in 2010 it was in children 1-4 years. Among children <5 years, 68% and 19% of serotypes were covered by PCV13 and PCV10, respectively, between 2008 and 2010. In 2009, 6 cases with the 3 additional PCV10 serotypes were reported in infants compared with 2 in 2010. Among persons eligible for PCV7 (born≥2004), there was a 77% decrease in the rate of IPD due to PCV7 serotypes between 2008 and 2010 and a 60% decrease in PCV7 serotypes among persons not vaccine-eligible (born<2004). There was a 15% difference in serotype coverage between PCV13 and the 23-valent polysaccharide vaccine in adults≥50 years. During Ontario's PCV7 programme, serotype-specific decreases in IPD were observed, suggesting vaccine programme success, including herd immunity. Our results also suggest some early impact among infants from PCV10 introduction. A substantial burden of disease was also observed among older adults. BACKGROUNDPublicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent vaccines (PCV10, PCV13) in October 2009 and November 2010, respectively. Among adults ≥ 65 years, a 23-valent polysaccharide vaccine (PPV23) has been universally available since 1996. In January 2012, PCV13 was approved for adults ≥ 50 years. This study examines the impact of publicly funded vaccination programmes on invasive pneumococcal disease (IPD).METHODSLaboratory data from population-based surveillance for IPD conducted at the Toronto Invasive Bacterial Disease Network and from Public Health Ontario Laboratories between January 1, 2008 and December 31, 2010 were analyzed.RESULTSBetween 2008 and 2010 there were 3259 cases of IPD; overall incidence was 7.4/9.3/8.3 per 100,000 in 2008/9/10, respectively. Incidence increased significantly among adults 65+ years during the period; this group had the highest incidence (21.5-25.6/100,000). The second highest incidence in 2008 and 2009 was in infants <1 year, whereas in 2010 it was in children 1-4 years. Among children <5 years, 68% and 19% of serotypes were covered by PCV13 and PCV10, respectively, between 2008 and 2010. In 2009, 6 cases with the 3 additional PCV10 serotypes were reported in infants compared with 2 in 2010. Among persons eligible for PCV7 (born≥2004), there was a 77% decrease in the rate of IPD due to PCV7 serotypes between 2008 and 2010 and a 60% decrease in PCV7 serotypes among persons not vaccine-eligible (born<2004). There was a 15% difference in serotype coverage between PCV13 and the 23-valent polysaccharide vaccine in adults≥50 years.CONCLUSIONSDuring Ontario's PCV7 programme, serotype-specific decreases in IPD were observed, suggesting vaccine programme success, including herd immunity. Our results also suggest some early impact among infants from PCV10 introduction. A substantial burden of disease was also observed among older adults. •Impact of Ontario's pneumococcal conjugate vaccine (PCV) programme was investigated.•Invasive pneumococcal disease due to PCV7 serotypes declined in children <5 years.•There is also some suggestion of early impact among infants of the change to PCV10.•Evidence of herd immunity and serotype replacement was observed.•Our results also demonstrate the substantial burden of disease among older adults. Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent vaccines (PCV10, PCV13) in October 2009 and November 2010, respectively. Among adults≥65 years, a 23-valent polysaccharide vaccine (PPV23) has been universally available since 1996. In January 2012, PCV13 was approved for adults ≥50 years. This study examines the impact of publicly funded vaccination programmes on invasive pneumococcal disease (IPD). Laboratory data from population-based surveillance for IPD conducted at the Toronto Invasive Bacterial Disease Network and from Public Health Ontario Laboratories between January 1, 2008 and December 31, 2010 were analyzed. Between 2008 and 2010 there were 3259 cases of IPD; overall incidence was 7.4/9.3/8.3 per 100,000 in 2008/9/10, respectively. Incidence increased significantly among adults 65+ years during the period; this group had the highest incidence (21.5–25.6/100,000). The second highest incidence in 2008 and 2009 was in infants <1 year, whereas in 2010 it was in children 1–4 years. Among children <5 years, 68% and 19% of serotypes were covered by PCV13 and PCV10, respectively, between 2008 and 2010. In 2009, 6 cases with the 3 additional PCV10 serotypes were reported in infants compared with 2 in 2010. Among persons eligible for PCV7 (born≥2004), there was a 77% decrease in the rate of IPD due to PCV7 serotypes between 2008 and 2010 and a 60% decrease in PCV7 serotypes among persons not vaccine-eligible (born<2004). There was a 15% difference in serotype coverage between PCV13 and the 23-valent polysaccharide vaccine in adults≥50 years. During Ontario's PCV7 programme, serotype-specific decreases in IPD were observed, suggesting vaccine programme success, including herd immunity. Our results also suggest some early impact among infants from PCV10 introduction. A substantial burden of disease was also observed among older adults. Highlights • Impact of Ontario's pneumococcal conjugate vaccine (PCV) programme was investigated. • Invasive pneumococcal disease due to PCV7 serotypes declined in children <5 years. • There is also some suggestion of early impact among infants of the change to PCV10. • Evidence of herd immunity and serotype replacement was observed. • Our results also demonstrate the substantial burden of disease among older adults. Background Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent vaccines (PCV10, PCV13) in October 2009 and November 2010, respectively. Among adults>=65 years, a 23-valent polysaccharide vaccine (PPV23) has been universally available since 1996. In January 2012, PCV13 was approved for adults>=50 years. This study examines the impact of publicly funded vaccination programmes on invasive pneumococcal disease (IPD). Methods Laboratory data from population-based surveillance for IPD conducted at the Toronto Invasive Bacterial Disease Network and from Public Health Ontario Laboratories between January 1, 2008 and December 31, 2010 were analyzed. Results Between 2008 and 2010 there were 3259 cases of IPD; overall incidence was 7.4/9.3/8.3 per 100,000 in 2008/9/10, respectively. Incidence increased significantly among adults 65+ years during the period; this group had the highest incidence (21.5-25.6/100,000). The second highest incidence in 2008 and 2009 was in infants <1 year, whereas in 2010 it was in children 1-4 years. Among children <5 years, 68% and 19% of serotypes were covered by PCV13 and PCV10, respectively, between 2008 and 2010. In 2009, 6 cases with the 3 additional PCV10 serotypes were reported in infants compared with 2 in 2010. Among persons eligible for PCV7 (born>=2004), there was a 77% decrease in the rate of IPD due to PCV7 serotypes between 2008 and 2010 and a 60% decrease in PCV7 serotypes among persons not vaccine-eligible (born<2004). There was a 15% difference in serotype coverage between PCV13 and the 23-valent polysaccharide vaccine in adults>=50 years. Conclusions During Ontario's PCV7 programme, serotype-specific decreases in IPD were observed, suggesting vaccine programme success, including herd immunity. Our results also suggest some early impact among infants from PCV10 introduction. A substantial burden of disease was also observed among older adults. BACKGROUND: Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent vaccines (PCV10, PCV13) in October 2009 and November 2010, respectively. Among adults≥65 years, a 23-valent polysaccharide vaccine (PPV23) has been universally available since 1996. In January 2012, PCV13 was approved for adults ≥50 years. This study examines the impact of publicly funded vaccination programmes on invasive pneumococcal disease (IPD). METHODS: Laboratory data from population-based surveillance for IPD conducted at the Toronto Invasive Bacterial Disease Network and from Public Health Ontario Laboratories between January 1, 2008 and December 31, 2010 were analyzed. RESULTS: Between 2008 and 2010 there were 3259 cases of IPD; overall incidence was 7.4/9.3/8.3 per 100,000 in 2008/9/10, respectively. Incidence increased significantly among adults 65+ years during the period; this group had the highest incidence (21.5–25.6/100,000). The second highest incidence in 2008 and 2009 was in infants <1 year, whereas in 2010 it was in children 1–4 years. Among children <5 years, 68% and 19% of serotypes were covered by PCV13 and PCV10, respectively, between 2008 and 2010. In 2009, 6 cases with the 3 additional PCV10 serotypes were reported in infants compared with 2 in 2010. Among persons eligible for PCV7 (born≥2004), there was a 77% decrease in the rate of IPD due to PCV7 serotypes between 2008 and 2010 and a 60% decrease in PCV7 serotypes among persons not vaccine-eligible (born<2004). There was a 15% difference in serotype coverage between PCV13 and the 23-valent polysaccharide vaccine in adults≥50 years. CONCLUSIONS: During Ontario's PCV7 programme, serotype-specific decreases in IPD were observed, suggesting vaccine programme success, including herd immunity. Our results also suggest some early impact among infants from PCV10 introduction. A substantial burden of disease was also observed among older adults. |
| Author | Crowcroft, Natasha S Wormsbecker, Anne E Pillai, Dylan R Lim, Gillian H Low, Don E Gubbay, Jonathan B McGeer, Allison Deeks, Shelley L Rudnick, Wallis Green, Karen |
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| CitedBy_id | crossref_primary_10_1016_j_vaccine_2015_01_081 crossref_primary_10_3390_vaccines2010049 crossref_primary_10_1139_cjm_2013_0614 crossref_primary_10_1093_cid_cix850 crossref_primary_10_1016_j_vaccine_2016_07_003 crossref_primary_10_9778_cmajo_20160035 crossref_primary_10_1080_21645515_2015_1067351 crossref_primary_10_1016_j_meegid_2016_04_007 crossref_primary_10_1093_pch_pxaa066 crossref_primary_10_1371_journal_pone_0226353 crossref_primary_10_1007_s10096_014_2208_6 crossref_primary_10_1073_pnas_1400475111 crossref_primary_10_1016_j_annemergmed_2014_10_022 crossref_primary_10_1016_j_vaccine_2018_06_018 crossref_primary_10_1371_journal_pone_0120290 |
| Cites_doi | 10.1016/j.vaccine.2006.09.011 10.1371/journal.pone.0026190 10.1128/AAC.48.9.3305-3311.2004 10.1007/BF03403742 10.1001/jama.295.14.1668 10.1056/NEJM199710023371404 10.1542/peds.2008-1702 10.1016/j.vaccine.2009.12.026 10.1086/648593 10.1097/INF.0b013e31803df9ca 10.1086/313923 10.1097/INF.0b013e31803c56df 10.1128/AAC.00237-11 10.1016/j.vaccine.2009.03.063 10.1099/jmm.0.020016-0 10.1056/NEJMoa022823 10.1503/cmaj.080734 10.1086/599827 10.1001/jama.285.13.1729 |
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| Keywords | Canada Invasive pneumococcal disease Immunization programme impact Pneumococcal vaccines Streptococcus pneumonia Epidemiology Lung disease Immunization Pneumonia Respiratory disease Vaccination Vaccine Streptococcus pneumoniae Infection Streptococcaceae Streptococcal infection Bacteriosis Bacteria Micrococcales Pneumococcal infection |
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| Snippet | Highlights • Impact of Ontario's pneumococcal conjugate vaccine (PCV) programme was investigated. • Invasive pneumococcal disease due to PCV7 serotypes... •Impact of Ontario's pneumococcal conjugate vaccine (PCV) programme was investigated.•Invasive pneumococcal disease due to PCV7 serotypes declined in children... BACKGROUND: Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and... Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent vaccines... Background Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and... BACKGROUNDPublicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and 13-valent... Background: Publicly funded infant 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in Ontario, Canada in 2005 and was replaced by 10- and... |
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| Title | Have changing pneumococcal vaccination programmes impacted disease in Ontario? |
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