EFFECT OF PCV-10 ON INVASIVE PNEUMOCOCCAL DISEASE AMONG BANGLADESHI CHILDREN
Bangladesh introduced PCV-10 in March 2015 using a 3+0 schedule. We evaluated PCV-10 effect on invasive pneumococcal disease (IPD) among children <5 years.
IPD surveillance is ongoing in four sentinel hospitals. Numbers of children with pneumococcus detected from a sterile site (IPD cases) were adjusted using number of febrile children tested with blood and/ CSF each year as the denominator. Data from pre-vaccine baseline (January 2012 to March 2015) and post-vaccine (April 2015 to September 2019) periods were compared to determine PCV-10 impact by age group. Serotypes in PCV-10 plus 6A were considered vaccine types (VT).
We identified 543 children with IPD among 60,921 children tested during 2012 to September 2019. IPD rates among children <5 years decreased 61% (CI: 45.8-72.4%) between baseline (137/10,000 tested) and 2019 (53/10,000; Figure-A); VT IPD rates fell 71% (CI: 47.2-85.4%; 53 to 15/10,000). Among children 3-23 months, IPD declined 70% (CI: 54.9-81.9%) between baseline (207/10,000) and 2019 (63/10,000; Figure-B); VT rates dropped 87% [(CI: 65.2-96.5%); 81 to 10/10,000]. Nonvaccine-serotype IPD rates were stable.
PCV-10 introduction resulted in large reductions of overall and VT IPD among young children. In contrast to reports from elsewhere, serotype replacement is not yet evident in Bangladesh.