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[Preprint]. 2024 Dec 13:2024.12.12.24318944.
doi: 10.1101/2024.12.12.24318944.

PNEUMOCOCCAL SEROTYPE DISTRIBUTION AND COVERAGE OF EXISTING AND PIPELINE PNEUMOCOCCAL VACCINES

Laura M King  1 , Kristin L Andrejko  2 , Miwako Kobayashi  2 , Wei Xing  2 , Adam L Cohen  2 , Wesley H Self  3 , J Jackson Resser  3 , Cynthia G Whitney  4 , Adrienne Baughman  3 , Mai Kio  5 , Carlos G Grijalva  3 , Jessica Traenkner  5 , Nadine Rouphael  5 , Joseph A Lewnard  1
Affiliations

PNEUMOCOCCAL SEROTYPE DISTRIBUTION AND COVERAGE OF EXISTING AND PIPELINE PNEUMOCOCCAL VACCINES

Laura M King et al. medRxiv. .

Update in

Abstract

Background: Streptococcus pneumoniae (pneumococcus) causes invasive pneumococcal disease (IPD) and non-invasive acute respiratory infections (ARIs). Three pneumococcal conjugate vaccines (PCVs) are recommended in the United States with additional products in clinical trials. We aimed to estimate 1) proportions of IPD cases and pneumococcal ARIs caused by serotypes targeted by existing and pipeline PCVs and 2) annual U.S. pneumococcal burdens potentially preventable by PCVs.

Methods: We estimated serotype distribution and proportions of non-invasive pneumococcal ARIs (AOM [children only], sinusitis, non-bacteremic pneumonia) and IPD attributable to serotypes targeted by each PCV using Markov chain Monte Carlo approaches incorporating data from studies of serotype distribution in ARIs and Active Bacterial Core Surveillance (ABCs) data. We then estimated annual numbers of outpatient-managed pneumococcal ARIs, non-bacteremic pneumococcal pneumonia hospitalizations, and IPD cases potentially preventable by PCVs in the United States by multiplying pneumococcal disease incidence rates by PCV-targeted proportions of disease and vaccine effectiveness estimates.

Results: In children, PCV15, PCV20, PCV24, PCV25, and PCV31 serotypes account for 16% (95% confidence interval: 15-17%), 31% (30-32%), 34% (32-35%), 43% (42-44%), and 68% (67-69%) of pneumococcal acute otitis media cases, respectively. In adults, PCV15, PCV20, PCV21, PCV24, PCV25, and PCV31 serotypes account for 43% (38-47%), 52% (47-57%), 69% (64-73%), 65% (61-70%), 62% (57-67%), and 87% (83-90%) of pneumococcal non-bacteremic pneumonia cases. For IPD, 42-85% of pediatric and 42-94% of adult cases were due to PCV-targeted serotypes. PCV-preventable burdens encompassed 270 thousand-3.3 million outpatient-managed ARIs, 2-17 thousand non-bacteremic pneumonia hospitalizations, and 3-14 thousand IPD cases in the United States annually.

Conclusions: Across pneumococcal conditions, coverage and preventable burdens were lowest for PCV15 and highest for PCV31, with PCV21 also targeting sizeable burdens of adult disease. Serotype distribution across syndromes may inform vaccine formulations and policy.

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Conflict of interest statement

LMK reports consulting fees from Merck Sharpe & Dohme for unrelated work and Vaxcyte for related and unrelated work and reports support for attending a meeting from UC Berkeley Center for Effective Global Action. CGG reports consulting fees from Merck & Co., Inc and research funding from NIH, CDC, AHRQ, FDA, and Campbell Alliance/Syneos Health for unrelated work. NR reports research funding from Merck, Sanofi, Pfizer, Vaccine Company, Immorna, Quidel and Lilly for unrelated work, reports consulting fees from Krog, reports honoraria from Virology Education and Medscape, reports support for attending a meeting from Sanofi and Moderna, reports participation in advisory boards for Moderna, Sanofi, Seqirus, Pfizer, EMMES, ICON, and Micron, and reports leadership roles with ARLG, TMRC, CDC-Pertussis challenge, and Clinical Infectious Diseases. JAL reports research grants from Pfizer and Merck Sharpe & Dohme for unrelated work and consulting fees from Pfizer, Merck, Sharpe & Dohme, Vaxcyte, Seqirus Inc., and Valneva SE for unrelated work and Vaxcyte for related work, and reports support for attending a meeting from Vaxcyte. All other authors reported no conflicts of interest.

Figures

Figure 1.
Figure 1.
Pneumococcal serotypes targeted by pneumococcal conjugate vaccine products The 24-valent Pn-MAPS24v uses a Multiple Antigen Presenting System platform rather than the traditional conjugate protein platform. PCV24 and Pn-MAPS24v target the same serotypes and so are considered together.
Figure 2.
Figure 2.
Serotype-specific proportions of pneumococcal infections by condition and age group Serotypes accounting for <0.05% of pneumococcal isolates within a condition and age group not displayed. All serotype distribution estimates detailed in Table S7.
See this image and copyright information in PMC

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