Mark P. Van der Linden,
Presenter of 2 Presentations
INVASIVE PNEUMOCOCCAL DISEASE AMONG ADULTS IN GERMANY, TEN YEARS AFTER PCV13 INTRODUCTION (ID 910)
Abstract
Background
Childhood PCV vaccination was generally recommended in Germany in 2006. Apart from a strong direct effect, herd protection effects among non-vaccinated children and adults were observed.
Methods
IPD in adults in Germany has been monitored since 1992. Isolates were serotyped using the Neufeld Quellung reaction.
Results
Prior to introduction of PCVs in infants, 45% of IPD serotypes found among adults were PCV7 types and 70% were PCV13 types. After the start of childhood vaccination, these percentages gradually reduced to 5% and 30% and remained stable in the past five seasons. In 2018-2019, prevalences were of serotypes 3, 4, 19F and 19A were 20.3%, 2.1%, 3.7% and 1.5% respectively. The prevalence of serotype 3 has reached its highest point ever since the introduction of PCVs. Among non-PCV13 types, serotypes 8 (14.0%), 22F (7.2%), 9N (6.4) and 12F (5.0%) were most prevalent. New PCV formulations would cover 38.7% (PCV15) and 65.2% (PCV20).
Conclusions
The herd protection effect of PCVs among adults has reached its limit. No herd protection effect was observed for serotype 3. The data implicate circulation of PCV13 serotypes among adults, which might only be interrupted by direct vaccination.
INVASIVE PNEUMOCOCCAL DISEASE AMONG CHILDREN IN GERMANY, TEN YEARS AFTER PCV13 INTRODUCTION (ID 899)
Abstract
Background
Childhood PCV vaccination was generally recommended in Germany in 2006. Here, we present data on invasive pneumococcal disease (IPD) cases following PCV introduction.
Methods
IPD in children in Germany has been monitored since 1997. Isolates were serotyped using the Neufeld Quellung reaction.
Results
In 2018-2019, the GNRCS received 102 IPD isolates from children <2 years, of which 14 had PCV13 serotypes. Two of these were from unvaccinated children, four from incompletely vaccinated children. This represents a 34% reduction compared to 2005/2006 (n=154), but an increase since 2011-2012 (n=75). However, the PCV13 proportion has decreased from 88% prior to vaccine introduction (2005-2006), to 69% at the introduction of higher-valent vaccines (2009-2010), to 14% in 2018-2019. Future vaccines PCV15 (25%) and PCV20 (46%) would increase coverage considerably. Residual PCV13 serotypes in 2018/2019 were 3 (n=5), 19F (n=4), 19A (n=2) and 6A, 14, 23F (n=1, each). Among all three age groups (0-1y, 2-4y, 5-15y), serotypes 3, 19F and 19A persist. Among non-vaccine serotypes, 10A (n=17) and 23B (n=12) were most prevalent.
Conclusions
Ten years after the introduction of higher-valent vaccines, PCV13 serotypes have been reduced among children, but serotypes 3, 19F and 19A persist. Future vaccine formulation would considerably increase serotype coverage.
Author Of 6 Presentations
DISCOVERY OF A NOVEL PNEUMOCOCCAL CAPSULE TYPE WITHIN SEROGROUP 24 (ID 818)
Abstract
Background
Pneumococcal capsules are important in pathogenesis and vaccine development. Serotype 24F capsule consists of a hexasaccharide repeating unit with arabinitol (WO 2019/050815 AI). Here, we describe the discovery of a novel serotype (“24X”) within serogroup 24.
Methods
Serological properties of pneumococcal isolates were studied using Quellung. Serotypes 24F, 24A, 24B and 24X were subjected to whole genome sequencing (WGS). The capsular polysaccharide (CPS) structures were elucidated by NMR and GC-MS.
Results
Multiple pneumococcal isolates from several countries reacted with both factor sera 24d and 24e. Since this reaction pattern has not been reported and is unique, the isolates were provisionally labelled to be serotype “24X.” Genetic studies of cps loci could not distinguish 24X from 24F or 24B. Chemical structure studies of serogroup 24 members showed that 24B CPS is like 24F except for having ribitol instead of arabinitol, 24X CPS contains both repeat units of 24F and 24B. These findings could explain their reactivity with factor sera 24d and 24e.
Conclusions
The 24X capsule has a distinct serology and repeating unit structure, which qualify it as a new serotype. According to the Danish naming system, 24X was named serotype 24C. Correlation of cps loci with the capsule structure is under investigation.
INVASIVE PNEUMOCOCCAL DISEASE AMONG CHILDREN IN GERMANY, TEN YEARS AFTER PCV13 INTRODUCTION (ID 899)
Abstract
Background
Childhood PCV vaccination was generally recommended in Germany in 2006. Here, we present data on invasive pneumococcal disease (IPD) cases following PCV introduction.
Methods
IPD in children in Germany has been monitored since 1997. Isolates were serotyped using the Neufeld Quellung reaction.
Results
In 2018-2019, the GNRCS received 102 IPD isolates from children <2 years, of which 14 had PCV13 serotypes. Two of these were from unvaccinated children, four from incompletely vaccinated children. This represents a 34% reduction compared to 2005/2006 (n=154), but an increase since 2011-2012 (n=75). However, the PCV13 proportion has decreased from 88% prior to vaccine introduction (2005-2006), to 69% at the introduction of higher-valent vaccines (2009-2010), to 14% in 2018-2019. Future vaccines PCV15 (25%) and PCV20 (46%) would increase coverage considerably. Residual PCV13 serotypes in 2018/2019 were 3 (n=5), 19F (n=4), 19A (n=2) and 6A, 14, 23F (n=1, each). Among all three age groups (0-1y, 2-4y, 5-15y), serotypes 3, 19F and 19A persist. Among non-vaccine serotypes, 10A (n=17) and 23B (n=12) were most prevalent.
Conclusions
Ten years after the introduction of higher-valent vaccines, PCV13 serotypes have been reduced among children, but serotypes 3, 19F and 19A persist. Future vaccine formulation would considerably increase serotype coverage.
ROOM FOR IMPROVEMENT: LOW PNEUMOCOCCAL VACCINATION RATES AND PERSISTENT VACCINE-TYPE DISEASE IN OLDER ADULTS WITH INVASIVE PNEUMOCOCCAL DISEASE IN GERMANY (ID 501)
Abstract
Background
Germany first recommended vaccination with 23-valent polysaccharide vaccine (PPV23) for adults 60 years of age and older in 1998. Despite the longstanding recommendation, pneumococcal vaccination rates among adults are low.
Methods
We are performing a two-year, prospective survey of treating physicians for the lifetime pneumococcal vaccination status of adults ages 60 and older with IPD. Vaccine effectiveness was estimated using the indirect cohort method.
Results
We determined the vaccination status for 839 cases of IPD (of 4751 eligible cases) occurring in older adults in 2018 or 2019. Of these, 616 (73.4%) had received no pneumococcal vaccination prior to illness. 177 (21.1%) cases had been vaccinated with PPV23, 35 (4.2%) had been vaccinated with PCV13, and 11 (1.3%) cases had received both vaccines. 413 cases were caused by PPV23 serotypes; 179 were caused by serotype 3. Preliminary, age-adjusted estimates of vaccine effectiveness for PPV23 are:
| Serotypes | age-adjusted Vaccine Effectiveness | 95% Confidence Intervals | |
| PPV23 serotypes | -20% |
| |
| PPV23 serotypes except 3 | 62% | 45% · 73% | |
| Serotype 3 alone | -128% | -231% · -56% | |
| PPV23nonPCV13 serotypes | 58% | 39% · 71% |
Conclusions
PPV23 provides modest direct protection against IPD caused by most targeted serotypes, but effectiveness against serotype 3 IPD is lacking.
INVASIVE PNEUMOCOCCAL DISEASE AMONG ADULTS IN GERMANY, TEN YEARS AFTER PCV13 INTRODUCTION (ID 910)
Abstract
Background
Childhood PCV vaccination was generally recommended in Germany in 2006. Apart from a strong direct effect, herd protection effects among non-vaccinated children and adults were observed.
Methods
IPD in adults in Germany has been monitored since 1992. Isolates were serotyped using the Neufeld Quellung reaction.
Results
Prior to introduction of PCVs in infants, 45% of IPD serotypes found among adults were PCV7 types and 70% were PCV13 types. After the start of childhood vaccination, these percentages gradually reduced to 5% and 30% and remained stable in the past five seasons. In 2018-2019, prevalences were of serotypes 3, 4, 19F and 19A were 20.3%, 2.1%, 3.7% and 1.5% respectively. The prevalence of serotype 3 has reached its highest point ever since the introduction of PCVs. Among non-PCV13 types, serotypes 8 (14.0%), 22F (7.2%), 9N (6.4) and 12F (5.0%) were most prevalent. New PCV formulations would cover 38.7% (PCV15) and 65.2% (PCV20).
Conclusions
The herd protection effect of PCVs among adults has reached its limit. No herd protection effect was observed for serotype 3. The data implicate circulation of PCV13 serotypes among adults, which might only be interrupted by direct vaccination.
SEROTYPE AND ANTIMICROBIAL CHARACTERISTICS OF STREPTOCOCCUS PNEUMONIAE ISOLATES OBTAINED FROM JAPANESE ADULT PATIENTS WITH COMMUNITY ONSET PNEUMONIA (COP) IN GOTO ISLAND, JAPAN (ID 611)
- Taiga Miyazaki, Japan
- Mark P. Van der Linden,
- Katsuji Hirano, Japan
- Shigeru Kohno, Japan
- Elisa N. Gonzalez, United States of America
- Pingping Zhang, United States of America
- Jose A. Suaya, United States of America
- Raul Isturiz, United States of America
- Bradford D. Gessner, United States of America
- Luis Jodar, United States of America
- Adriano Arguedas, United States of America