IMPACT OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE ON INVASIVE PNEUMOCOCCAL DISEASE IN MASSACHUSETTS CHILDREN, 2010/2017 (ID 495)
- Inci Yildirim, United States of America
- Inci Yildirim, United States of America
- Hillary Johnson,
- Stephen I. Pelton, United States of America
Abstract
Background
The 13-valent-pneumococcal conjugate vaccine (PCV13) replaced PCV7 in Massachusetts(MA) beginning in April,2010. We describe the current epidemiology of invasive pneumococcal disease (IPD) in MA children after 7 years of PCV13 use.
Methods
Cases of IPD in children <18 years of age were detected through an enhanced surveillance system. Parents/physicians/providers are interviewed for confirmation of demographic and clinical data. All Streptococcus pneumoniae from sterile body sites are submitted to Department of Public Health and serotyped by Quellung reaction.
Results
Incidence of IPD declined to 2.8/100,000 in 2017/18 (71% decline compared to prePCV13 baseline 9.8/100,000; incidence rate ratio 0.29,95%CI 0.24-0.32) mostly due to reduction in additional serotypes included in PCV13 (Figure). The most common clinical presentation was bacteremia(55%), followed by pneumonia(32%) and CNS disease(7%); 91(27%) children had >1 comorbidity [asthma(12%), hematologic malignancy(12%), prematurity(10%), sickle cell disease(10%)]. Mortality rate was 4.4%. Isolates from 302 (89%) were available for serotyping. Vaccine serotypes (VST) were identified in 98 (33%) IPD cases [19A(48%),7F(20%),3(18%), 19F(7%), 6A(3%), 14,18C,5(1% each). Serotypes 15BC(14%), 22F(12%) and 33F(12%) were the most common nonvaccine serotypes(NVST).
Conclusions
IPD declined >70% following 7-years of PCV13 use.NVSTs, specifically serotypes 15BC,33F and 22F are responsible for majority of the remaining disease which is disproportionately observed in children with comorbid conditions.