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. 2024 Jun 11;42(16):3555-3563.
doi: 10.1016/j.vaccine.2024.04.061. Epub 2024 May 3.

Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease among children in the United States between 2010 and 2019: An indirect cohort study

Kristin L Andrejko  1 , Ryan Gierke  2 , Jemma V Rowlands  3 , Jennifer B Rosen  4 , Ann Thomas  5 , Zachary Q Landis  6 , Maria Rosales  7 , Sue Petit  8 , William Schaffner  9 , Corinne Holtzman  10 , Meghan Barnes  11 , Monica M Farley  12 , Lee H Harrison  13 , Lesley McGee  2 , Sopio Chochua  2 , Jennifer R Verani  2 , Adam L Cohen  2 , Tamara Pilishvili  2 , Miwako Kobayashi  2
Affiliations

Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease among children in the United States between 2010 and 2019: An indirect cohort study

Kristin L Andrejko et al. Vaccine. .

Abstract

Background: A U.S. case-control study (2010-2014) demonstrated vaccine effectiveness (VE) for ≥ 1 dose of the thirteen-valent pneumococcal conjugate vaccine (PCV13) against vaccine-type (VT) invasive pneumococcal disease (IPD) at 86 %; however, it lacked statistical power to examine VE by number of doses and against individual serotypes.

Methods: We used the indirect cohort method to estimate PCV13 VE against VT-IPD among children aged < 5 years in the United States from May 1, 2010 through December 31, 2019 using cases from CDC's Active Bacterial Core surveillance, including cases enrolled in a matched case-control study (2010-2014). Cases and controls were defined as individuals with VT-IPD and non-PCV13-type-IPD (NVT-IPD), respectively. We estimated absolute VE using the adjusted odds ratio of prior PCV13 receipt (1-aOR x 100 %).

Results: Among 1,161 IPD cases, 223 (19.2 %) were VT cases and 938 (80.8 %) were NVT controls. Of those, 108 cases (48.4 %; 108/223) and 600 controls (64.0 %; 600/938) had received > 3 PCV13 doses; 23 cases (17.6 %) and 15 controls (2.4 %) had received no PCV doses. VE ≥ 3 PCV13 doses against VT-IPD was 90.2 % (95 % Confidence Interval75.4-96.1 %), respectively. Among the most commonly circulating VT-IPD serotypes, VE of ≥ 3 PCV13 doses was 86.8 % (73.7-93.3 %), 50.2 % (28.4-80.5 %), and 93.8 % (69.8-98.8 %) against serotypes 19A, 3, and 19F, respectively.

Conclusions: At least three doses of PCV13 continue to be effective in preventing VT-IPD among children aged < 5 years in the US. PCV13 was protective against serotypes 19A and 19F IPD; protection against serotype 3 IPD did not reach statistical significance.

Keywords: 13-valent pneumococcal conjugate vaccine; Indirect cohort; Invasive pneumococcal disease; Pneumococcal infections; Streptococcus pneumoniae; Vaccine effectiveness.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Lee Harrison provides service on advisory boards (Pfizer, Sanofi, GSK) and a DSMB (Merck); while LH does not receive any fees for this work he is reimbursed for occasional travel. Tamara Pilishvili reports a relationship with GSK that includes: employment. During data collection, analysis, and write-up, TP was employed by CDC. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.].

Figures

Fig. 1.
Fig. 1.
Flow diagram of children included in the analytic dataset1. 1Cases for the late PCV13 Implementation period were enrolled from Active Bacterial Core surveillance (ABCs). Inclusion/exclusion of these cases are outlined in Figure S1. Cases from the early PCV13 Implementation period were included from a previously published case-control study.
Fig. 2.
Fig. 2.
Cases included in analysis stratified by serotype and receipt of PCV13.
See this image and copyright information in PMC

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