Sanjay Jayasinghe, Australia

Presenter of 2 Presentations

BREAKTHROUGH IPD FOLLOWING 13VPCV SCHEDULE CHANGE FROM 3+0 TO 2+1 AMONG AUSTRALIAN CHILDREN (ID 921)

Session Name
Population Sciences - Epidemiology, Economics, and Mathematical Modelling

Abstract

Background

In mid-2018, the Australian infant 13vPCV schedule changed from three primary doses (3+0) to two primary doses and a 12 month booster (2+1) to address increasing breakthrough cases of invasive pneumococcal disease (IPD), predominantly in children >12 months. We assess the impact of this schedule change on breakthrough IPD.

Methods

All cases of breakthrough IPD following 13vPCV (2012-2018) reported to the national notifiable diseases surveillance system were analysed by age, serotype and clinical syndrome. In addition, cases in the first 3 quarters post-schedule change were compared to corresponding period pre-change.

Results

Annual 13vPCV breakthrough case counts in children aged <5yrs (figure) increased progressively from 2012(n=3) to 2017(n=73) but declined in 2018 (n=65). Of 306 total cases, 297 were caused by serotypes 3(41%),19A(38%) and 19F(19%). Those aged 12-24 months accounted for 41% (n=125) of cases. Over two thirds of cases (n=211) were pneumonia and 12 were meningitis. Breakthrough cases in children aged >12 months post-schedule change were still more than that in the comparison pre-change period (41 versus 31).

jayasinghe_vf_isppd_2020.png

Conclusions

The change to administer the third scheduled PCV dose as a booster (2+1)is expected to reduce breakthrough IPD by improving both direct and indirect protection from 13vPCV but discernible impact is not yet observed.

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CHANGES IN PNEUMONIA HOSPITALISATIONS IN AUSTRALIAN INDIGENOUS CHILDREN FOLLOWING PNEUMOCOCCAL VACCINATION (ID 512)

Abstract

Background

Aboriginal and Torres Strait Islander (Indigenous) children in four Australian states/territories were funded from 2001 to receive 3 infant doses of 7-valent pneumococcal conjugate vaccine (7vPCV) followed by 23-valent pneumococcal polysaccharide vaccine in the second year of life. In 2011 all four doses were replaced with 13vPCV. We assessed impact of these vaccination programs on pneumonia hospitalisations in Indigenous children from 1999 to 2017.

Methods

We analysed hospitalisation data for Indigenous children aged <5 years with primary diagnosis of pneumonia and categorised into pneumococcal, unspecified, specified non-pneumococcal and all-cause using ICD-10-AM codes. Age-specific pneumonia hospitalisation rates (per 100,000) were calculated by year and rate changes by vaccine period.

Results

table 1.jpgOver the study duration from pre-7vPCV introduction (1999-2002) to post-13vPCV change (2014-2017) the hospitalisation rate declined by 53% (2811 to 1324/100,000) for all-cause, 85% (133 to 20/100,000) for pneumococcal and 66% (2449 to 842/100,000) for unspecified pneumonia, with the greatest declines in infants <12 months (Table 1). Between 2013-2017 all-cause pneumonia hospitalisations increased in children 12-23 months (1663 to 2859/100,000) and 2-4 years (569 to 828/100,000), largely driven by increasing specified non-pneumococcal pneumonia.

Conclusions

Large declines in pneumonia hospitalisations following 4-dose pneumococcal vaccination in Australian Indigenous children add to reductions in invasive disease previously documented.

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Author Of 3 Presentations

CHANGES IN PNEUMONIA HOSPITALISATIONS IN AUSTRALIAN INDIGENOUS CHILDREN FOLLOWING PNEUMOCOCCAL VACCINATION (ID 512)

Abstract

Background

Aboriginal and Torres Strait Islander (Indigenous) children in four Australian states/territories were funded from 2001 to receive 3 infant doses of 7-valent pneumococcal conjugate vaccine (7vPCV) followed by 23-valent pneumococcal polysaccharide vaccine in the second year of life. In 2011 all four doses were replaced with 13vPCV. We assessed impact of these vaccination programs on pneumonia hospitalisations in Indigenous children from 1999 to 2017.

Methods

We analysed hospitalisation data for Indigenous children aged <5 years with primary diagnosis of pneumonia and categorised into pneumococcal, unspecified, specified non-pneumococcal and all-cause using ICD-10-AM codes. Age-specific pneumonia hospitalisation rates (per 100,000) were calculated by year and rate changes by vaccine period.

Results

table 1.jpgOver the study duration from pre-7vPCV introduction (1999-2002) to post-13vPCV change (2014-2017) the hospitalisation rate declined by 53% (2811 to 1324/100,000) for all-cause, 85% (133 to 20/100,000) for pneumococcal and 66% (2449 to 842/100,000) for unspecified pneumonia, with the greatest declines in infants <12 months (Table 1). Between 2013-2017 all-cause pneumonia hospitalisations increased in children 12-23 months (1663 to 2859/100,000) and 2-4 years (569 to 828/100,000), largely driven by increasing specified non-pneumococcal pneumonia.

Conclusions

Large declines in pneumonia hospitalisations following 4-dose pneumococcal vaccination in Australian Indigenous children add to reductions in invasive disease previously documented.

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SUBSTANTIAL INDIRECT PROTECTION AGAINST IPD AND PNEUMONIA HOSPITALISATIONS AT LOW LEVELS OF VACCINE COVERAGE IN AUSTRALIA, YET HIGH COVERAGE REQUIRED FOR NEAR-ELIMINATION (ID 854)

BREAKTHROUGH IPD FOLLOWING 13VPCV SCHEDULE CHANGE FROM 3+0 TO 2+1 AMONG AUSTRALIAN CHILDREN (ID 921)

Session Name
Population Sciences - Epidemiology, Economics, and Mathematical Modelling

Abstract

Background

In mid-2018, the Australian infant 13vPCV schedule changed from three primary doses (3+0) to two primary doses and a 12 month booster (2+1) to address increasing breakthrough cases of invasive pneumococcal disease (IPD), predominantly in children >12 months. We assess the impact of this schedule change on breakthrough IPD.

Methods

All cases of breakthrough IPD following 13vPCV (2012-2018) reported to the national notifiable diseases surveillance system were analysed by age, serotype and clinical syndrome. In addition, cases in the first 3 quarters post-schedule change were compared to corresponding period pre-change.

Results

Annual 13vPCV breakthrough case counts in children aged <5yrs (figure) increased progressively from 2012(n=3) to 2017(n=73) but declined in 2018 (n=65). Of 306 total cases, 297 were caused by serotypes 3(41%),19A(38%) and 19F(19%). Those aged 12-24 months accounted for 41% (n=125) of cases. Over two thirds of cases (n=211) were pneumonia and 12 were meningitis. Breakthrough cases in children aged >12 months post-schedule change were still more than that in the comparison pre-change period (41 versus 31).

jayasinghe_vf_isppd_2020.png

Conclusions

The change to administer the third scheduled PCV dose as a booster (2+1)is expected to reduce breakthrough IPD by improving both direct and indirect protection from 13vPCV but discernible impact is not yet observed.

Hide