THE CHANGING EPIDEMIOLOGY OF INVASIVE PNEUMOCOCCAL DISEASE (IPD) IN ADULTS OF 65 YEARS OR OVER. IMPACT OF THE PAEDIATRIC PNEUMOCOCCAL VACCINATION PROGRAMME, SPAIN 2010-2017
The paediatric heptavalent pneumococcal conjugate vaccine (PCV7) was first available in Spain in June 2001 and incorporated in the Madrid regional immunisation programme (RIP) in 2006, remaining in the private market for other regions. From mid-2010 through 2016, Spanish regions introduced the 13-valent conjugate vaccine (PCV13) in their RIPs. Adult vaccination with the 23-valent polysaccharide (PPV23) officially started in 2004, and with PCV13 in 2016 for some cohorts, without expected impact for this analysis.
Data source: cases reported through the European Centre for Disease Prevention and Control surveillance system (available online). IPD serotype specific counts were aggregated into PCV13-, PCV13 non-PCV7, 20-valent conjugate vaccine (PCV20) non-PCV13, PPV23-, and PPV23 non-PCV13-type groups. The percentage change in annual number of cases was estimated using linear regression analysis of the log of the annual number of cases.
During 2010-17, an 8.1% average annual decline (95%CI -13.7 to -2.2; p=0.02) in PCV13 non-PCV7-type IPD in adults was observed. Despite vaccination, PPV23 non-PCV13-type IPD increased an average 13.2% annually (95%CI 8.6 to 17.9; p<0.001).
Implementation of regional paediatric PCV13 programmes in Spain has been associated with decline of PCV13-types IPD in adults ≥ 65 years. However, further reductions may only be achieved with direct immunisation