IMPACT OF PNEUMOCOCCAL CONJUGATED VACCINES ON CHILDHOOD PNEUMOCOCCAL MENINGITIS, 2002/2017 (ID 498)
- Inci Yildirim, United States of America
- Inci Yildirim, United States of America
- Hillary Johnson,
- Stephen I. Pelton, United States of America
Abstract
Background
7-valent-pneumococcal-conjugated-vaccine(PCV7) was implemented in Massachusetts in 2000 and was replaced by PCV13 in 2010. We assessed the impact of PCVs on the epidemiology of pneumococcal central nervous system disease(PCNS).
Methods
A population-based, enhanced surveillance for IPD among Massachusetts children is ongoing since 2001. Pneumococcal isolates from normally sterile body sites are sent to the Department of Public Health and serotyped using Quellung-reaction. Parents/guardians/providers are interviewed to obtain demographic and clinical information.
Results
Eighty-three PCNS cases were identified between 04/2002-03/2017. Incidence of PCNS declined 65% in all ages in 2016/2017 compared to prePCV13 baseline (0.27/100,000 vs 0.77/100,000, rate ratio 0.38, 95%CI 0.02-0.47)(Figure). Median age was 17-months in prePCV13-era and 41-months in postPCV13-era. Twenty-seven (32.5%) children had >1 comorbidity. Mortality rate was 8.4%. Serotypes 19A(17.0%), 22F(9.4%), 6C,7F (7.6% each), 3,33F(5.7% each) were the most frequent serotypes in the prePCV13-era; 15B,23B(16% each), 3, 33F, 10A, 20(10.5% each) were the most frequent serotypes in the postPCV13-era. Nonvaccine serotypes (NVST) were isolated in 30(56.6%) and 16(84.2%) PCNS cases in prePCV13 and postPCV13 eras, respectively. Five(14.4%) and one(5.3%) isolates were ceftriaxone non-susceptible in prePCV13 and postPCV13-era, respectively.
Conclusions
Incidence of PCNS has declined 65% since 2002. It now occurs in older children and is most often caused by NVST.