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. 2025 Jun 1;44(6):564-570.
doi: 10.1097/INF.0000000000004730. Epub 2025 Jan 17.

Characteristics of Invasive Pneumococcal Diseases Cases Among U.S. Children With Hematologic Malignancies Before and After Introduction of Thirteen-valent Pneumococcal Conjugate Vaccine, 2005-2019

Katie Hamilton  1   2 , Ulzii-Orshikh Luvsansharav  1 , Wei Xing  1 , Ryan Gierke  1 , Jessica King  1 , Monica M Farley  3 , William Schaffner  4 , Ann Thomas  5 , Shua J Chai  6 , Lee H Harrison  7 , Corinne Holtzman  8 , Suzanne M McGuire  9 , Susan Petit  10 , Meghan Barnes  11 , Kathy M Angeles  12 , Sopio Chochua  1 , Lesley McGee  1 , Miwako Kobayashi  1
Affiliations

Characteristics of Invasive Pneumococcal Diseases Cases Among U.S. Children With Hematologic Malignancies Before and After Introduction of Thirteen-valent Pneumococcal Conjugate Vaccine, 2005-2019

Katie Hamilton et al. Pediatr Infect Dis J. .

Abstract

Background: Children with hematologic malignancies (HMs) are at increased risk of invasive pneumococcal disease (IPD). Data on long-term IPD trends in U.S. children with HM after 13-valent pneumococcal conjugate vaccine (PCV13) introduction are limited. We assessed IPD trends in children with HM before and after PCV13 introduction and the proportion of IPD cases caused by serotypes contained in new pneumococcal conjugate vaccines (PCV15 and PCV20, introduced after 2019).

Methods: During 2005-2019, IPD cases among children <18 years old were identified through the Active Bacterial Core surveillance. We characterized IPD cases by underlying conditions (HM, other IPD risk factors, no IPD risk factors) and time periods [pre-PCV13 (2005-2009), early-PCV13 (2010-2014) and late-PCV13 (2015-2019)]. We estimated incidence rate ratios (IRRs) in children <5 years of age with and without HM and during 2010-2019.

Results: We identified 5912 cases of IPD in children <18 years old; 215 (3.6%) were among children with HM. The proportion of IPD cases with PCV13 serotypes decreased over time in all risk groups; however, IRRs among children with vs. without HM were 215.8 [95% confidence interval (CI): 146.1-292.4] and 240.9 (95 CI: 152.3-341.1) in early and late-PCV13 periods, respectively. In late-PCV13 period, PCV15/non-PCV13 serotypes and PCV20/non-PCV15 serotypes caused 19.4% and 4.8% of IPD cases among children with HM.

Conclusions: The proportion of PCV13-type IPD decreased in all children after PCV13 introduction. However, children with HM remain at an increased risk of IPD. Continued monitoring of the impact of PCV15 and PCV20 use among children with HM is needed.

Keywords: hematologic malignancies; invasive pneumococcal disease; pneumococcal conjugate vaccines.

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Conflict of interest statement

L.H. served on scientific advisory boards for Merck, Sanofi Pasteur, GSK and Pfizer, and a DSMB for Merck, all without compensation other than reimbursement for travel expenses. M.F. received funding from the NIH that was awarded to her institution (Emory University). The remaining authors have no conflicts of interest to disclose.

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References

    1. Centers for Disease Control and Prevention. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among children aged 6-18 years with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). PMC4604951, Updated June 28.
    1. Centers for Disease Control and Prevention. Pneumococcal disease risk factors. Updated September 21, 2023. Available at:. Pneumococcal Disease: Causes and How It Spreads | Pneumococcal Disease | CDC. Accessed November 11, 2023.
    1. Pelton SI, Weycker D, Farkouh RA, et al. Risk of pneumococcal disease in children with chronic medical conditions in the era of pneumococcal conjugate vaccine. Clin Infect Dis. 2014;59:615–623.
    1. Lages PM, Carlesse F, Boettger BC, et al. Invasive pneumococcal disease in children with cancer: incidence density, risk factors and isolated serotypes. Braz J Infect Dis. 2020;24:489–496.
    1. Lee YJ, Huang YT, Kim SJ, et al. Trends in invasive pneumococcal disease in cancer patients after the introduction of 7-valent pneumococcal conjugate vaccine: a 20-year longitudinal study at a major urban cancer center. Clin Infect Dis. 2018;66:244–253.

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