Mark Jit, United Kingdom
London School of Hygiene and Tropical Medicine Department of Infectious Disease EpidemiologyPoster Author Of 1 e-Poster
PREDICTING THE IMPACT OF PCV13 ON INVASIVE PNEUMOCOCCAL DISEASE (IPD) IN MAINLAND CHINA
Author Of 2 Presentations
PREDICTING THE IMPACT OF PCV13 ON INVASIVE PNEUMOCOCCAL DISEASE (IPD) IN MAINLAND CHINA (ID 823)
Abstract
Background
China is one of few countries yet to introduce PCV. We aimed to estimate the long-term impact of a PCV13 programme on childhood IPD in mainland China, accounting for provincial heterogeneity.
Methods
A Bayesian hierarchical model was fit to systematic review data on the proportion of vaccine-type IPD and carriage in each province. A mechanistic model was then used to predict the relative reduction in IPD incidence of a PCV13 programme, assuming VT circulation is eventually interrupted and replaced by NVTs.
Results
Across China, we estimate that a median 75% (95% HDI: 53 – 90%) of carriage and 88% (95% HDI: 76 - 94%) of IPD is caused by vaccine serotypes. A mature PCV programme would lead to a median 51% (95% HDI: -40 – 81%) reduction in the incidence of IPD, ranging from 33% in Hubei (95% HDI: -34 – 76%) to a median 76% in Beijing (95% HDI: 44 – 92%). All 95% credible intervals for province-level covariate effects contain zero for VT carriage and IPD, and as such the impact estimates in provinces with little or no serotype distribution data remain uncertain.
Conclusions
PCV13 has the potential to substantially reduce the pneumococcal disease burden in China, but data to underpin the estimates is sparse in Western China.
COMPARISON OF IMMUNOGENICITY OF TEN- AND THIRTEEN-VALENT PNEUMOCOCCAL CONJUGATE VACCINES – A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS (ID 567)
- Shuo Feng, United Kingdom
- Julie McLellan, United Kingdom
- Nicola Pidduck, United Kingdom
- Julian Higgins, United Kingdom
- Maria D. Knoll, United States of America
- Mark Jit, United Kingdom
- Yoon Hong Choi, United Kingdom
- Beth Temple, Australia
- Kim E. Mulholland, Australia
- Andrew J. Pollard, United Kingdom
- Merryn Voysey, United Kingdom
Abstract
Background
Streptococcus pneumoniae causes substantial morbidity and mortality globally, with serotype-specific disease burden varying geographically. Currently there are two widely used pneumococcal conjugate vaccines (PCV). Evidence is limited regarding their comparative serotype-specific immunogenicity and efficacy.
Methods
We conducted a systematic-review and network meta-analysis of studies in which the immunogenicity of PCVs was directly compared in head-to-head randomised trials. Network meta-analysis incorporates both direct pair-wise comparisons and indirect comparisons (e.g. PCV10 vs PCV7, and PCV13 vs PCV7) thereby increasing overall statistical precision for the main comparison of interest (PCV10 vs PCV13). The difference in immunogenicity, as measured by geometric mean ratio (GMR), was examined by serotype.
Results
27 trials were included in the network meta-analysis, 4 directly comparing PCV10 and PCV13, 7 comparing PCV7 and PCV10, and 16 comparing PCV7 and PCV13. For the 10 common serotypes, immunogenicity at 1 month after the primary vaccination series was higher for PCV13 for 7 serotypes, with GMRs ranging from 1.18 to 2.50. In contrast, serotype 5, 18C and 19F favoured PCV10. Similar results were observed post-booster dose except for serotype 5 and 7F.
Conclusions
Variation in serotype-specific immunogenicity exists between PCV10 and PCV13, indicating that further investigation into whether this translates to heterogeneity in protection is needed.