EPIDEMIOLOGY OF INVASIVE PNEUMOCOCCAL DISEASE (IPD) FOLLOWING 18 YEARS OF PNEUMOCOCCAL CONJUGATE VACCINE (PCV) USE IN THE UNITED STATES (ID 849)
- Ryan Gierke, United States of America
- Ryan Gierke, United States of America
- Monica Farley, United States of America
- William Schaffner, United States of America
- Ann Thomas, United States of America
- Arthur Reingold, United States of America
- Lee Harrison, United States of America
- Corinne Holtzman, United States of America
- Kari Burzlaff, United States of America
- Susan Petit, United States of America
- Rachel Herlihy, United States of America
- Salina Torres, United States of America
- Bernard Beall, United States of America
- Tamara Pilishvili, United States of America
Abstract
Background
PCVs have been recommended for U.S. children since 2000 and for adults aged ≥65 years since August 2014. We evaluated PCV impact on IPD.
Methods
IPD cases (isolation of pneumococcus from sterile sites) were identified through CDC’s Active Bacterial Core surveillance during 1998-2018. Isolates were serotyped by Quellung or whole genome sequencing and classified as PCV13-type and non-vaccine-type (NVT). Incidence rates (cases/100,000) were calculated using U.S. Census Bureau population denominators.
Results
During 1998-2018, overall and PCV13-type IPD rates declined significantly among children and adults aged ≥65 years (Figures); serotypes 3, 19A, and 19F caused most of the remaining PCV13-type IPD. NVT IPD rates did not change. The most common NVTs in 2018 were 22F (10% of all IPD), 9N (7%) and 15A (5%). Among children, the proportion of cases with meningitis increased from 5% to 14%(p<0.01), and the proportion with pneumonia/empyema increased from 17% to 31%(p<0.01). Among adults, the proportion of cases with meningitis did not change (3%), while the proportion with pneumonia/empyema increased from 72% to 76%(p=0.01).
Conclusions
Overall IPD incidence among children and adults decreased following PCV introduction for children, driven primarily by reductions in PCV-type IPD. Increases in NVT IPD were minimal compared with PCV benefits.