EVOLVING RISK PROFILE OF PATIENTS WITH INVASIVE PNEUMOCOCCAL DISEASE DURING THE PNEUMOCOCCAL CONJUGATE VACCINE ERA (ID 1144)
- Carlos Grijalva, United States of America
- Carlos Grijalva, United States of America
- Andrew D. Wiese, United States of America
- Danielle Ndi,
- Keipp Talbot,
- William Schaffner, United States of America
- Marie R. Griffin, United States of America
Abstract
Background
The incidence of invasive pneumococcal disease (IPD) due to serotypes covered by pneumococcal conjugate vaccines (PCVs) has declined since PCVs introduction. Whether the risk profile of IPD cases have changed following PCVs introduction is unclear.
Methods
We examined the comorbidity profile of all laboratory-confirmed IPD cases identified in Tennessee through active population and laboratory-based surveillance (1998-2017). Comorbidities were identified through chart review, and classified as high-risk and at-risk, as previously described (Figure). We examined changes in the proportion of patients with relevant comorbidities over time, and stratified estimates according to serotype information.
Results
The proportion of IPD cases with high-risk and at-risk comorbidities increased over time from 9% (1998-1999) to 26% (2016-2017) and from 22% to 59%, respectively. For IPD caused by vaccine-covered serotypes (PCV7 or those only covered by PCV13), increases in comorbidities prevalence were attenuated during recent years, but estimates’ precision was limited. For IPD caused by serotypes not in PCV13, the prevalence of comorbidities increased continuously (Figure).
Conclusions
After widespread use of PCVs, patients with residual IPD in Tennessee have a higher prevalence of relevant comorbidities than in previous years. These risk profile changes need to be considered in future prevention plans.