Alejandro Cane, ArgentinaPfizer Inc Vaccines Medical Development & Scientific/Clinical Affairs
Poster Author Of 3 e-Posters
UNMET NEED IN CONTROLLING INVASIVE PNEUMOCOCCAL DISEASE (IPD) AMONG CANADIAN OLDER ADULTS IN THE CONTEXT OF THE CURRENT AND POTENTIAL FUTURE PNEUMOCOCCAL VACCINATION PROGRAMS
CANADIAN ADULTS 50-64 YEARS OF AGE CONTRIBUTE SUBSTANTIALLY TO THE CASES OF INVASIVE PNEUMOCOCCAL DISEASE (IPD) POTENTIALLY PREVENTABLE BY THE 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE
NUMBER OF CHILDREN WITHOUT 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) SERIES COMPLETION AT 2 YEARS OF AGE IN CANADA
Author Of 5 Presentations
MIDDLE-EAR FLUID AND NASO-OROPHARYNGEAL STREPTOCOCCUS PNEUMONIAE SEROTYPE DISTRIBUTION IN 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINATED CHILDREN WITH AND WITHOUT ACUTE OTITIS MEDIA IN ROCHESTER, NEW YORK, 2010-2013 (ID 627)
SEROTYPE DISTRIBUTION OF STREPTOCOCCUS PNEUMONIAE IN NASO-OROPHARYNGEAL CARRIAGE OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINATED CHILDREN IN ROCHESTER, NEW YORK, 2010-2013 (ID 629)
UNMET NEED IN CONTROLLING INVASIVE PNEUMOCOCCAL DISEASE (IPD) AMONG CANADIAN OLDER ADULTS IN THE CONTEXT OF THE CURRENT AND POTENTIAL FUTURE PNEUMOCOCCAL VACCINATION PROGRAMS (ID 824)
In Canadian adults aged ≥65, routine pneumococcal-polysaccharide-vaccine (PPV23) use has been recommended for several decades, and 13-valent pneumococcal conjugate vaccine (PCV13) on an individual basis - since 2016. When PCV13 is administered, sequential PPV23 is recommended to broaden serotype coverage.
We aimed to assess the proportion of PCV13-, PPV23/non13-, PCV15-, and PCV20-type IPD among Canadian older adults.
Proportions of IPD due to PCV13, PPV23/non13, PCV15 and PCV20 serotypes were calculated from case counts reported, by serotype and age group, from the National Microbiology Laboratory between 2010 and 2017.
Among all IPD, the contribution of PCV13-type declined from 50% (487/967) to 23% (287/1,238). PPV23/non13-type IPD increased from 25% (240/967) to 39% (487/1,238). In 2017, IPD proportions due to PCV15- and PCV20-types were 36% (447/1,238) and 52% (646/1,238) (Figure 1).
Despite routine PPV23 program, increasing trend in cases and proportions of PPV23/non13-type IPD was noted during the observation period. Initial decline in PCV13-type IPD, likely an indirect effect of pediatric program, leveled off in recent years supporting the need for broad PCV13 use in older adults. PCV20, which shares 19 serotypes with PPV23, could address limitations of the PPV23 program in the ability to control vaccine-type IPD.
CANADIAN ADULTS 50-64 YEARS OF AGE CONTRIBUTE SUBSTANTIALLY TO THE CASES OF INVASIVE PNEUMOCOCCAL DISEASE (IPD) POTENTIALLY PREVENTABLE BY THE 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (ID 1230)
In Canada, age-based recommendation for adult pneumococcal vaccination starts at 65 years (routine for PPV23, on an individual basis for PCV13). Recent literature reports large additional pneumococcal pneumonia and non-pneumonia IPD burden in Canadian adults aged 50-64 years.
Case counts of IPD by serotype and age group were obtained from published annual National Microbiology Laboratory (NML) reports of passive laboratory-based surveillance. We calculated the proportion of all IPD cases occurring in adults 50-64, ≥65, and ≥50 years of age and trends in the proportion of PCV13-type IPD in these age groups, for 2010-2017.
Between 2010 and 2017, adults aged 50-64 and ≥65 contributed 27% and 38% of 21, 610 reported IPD cases, respectively. The proportion of PCV13-type IPD declined from 52% to 34% in 50-64 cohort, and 50% to 23% in ≥65 cohort, showing a plateau since 2014 in all three age groups (Figure 1).
Adults ≥65 years contributed 38%, and those 50-64 years an incremental 27% of all IPD in Canada over the study period. In 2017, 23% and 34% of IPD in these two cohorts, respectively, was of PCV13-type. These findings support the rationale for intensified PCV13 immunization efforts in both age groups.
NUMBER OF CHILDREN WITHOUT 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) SERIES COMPLETION AT 2 YEARS OF AGE IN CANADA (ID 591)
Despite more than 6 years of routine pediatric PCV13 implementation in Canada, PCV13 serotypes still contributed to roughly 25% of invasive pneumococcal disease in older adults in 2017. One of the elements that can affect disease transmission and immunization program effectiveness is vaccine schedule completion. With transition to PCV13 in 2010/2011, a reduced, 2+1 routine immunization schedule was adopted across Canadian provinces, with the third dose recommended at 12 months of age.
We estimated the cumulative number of children with incomplete routine PCV13 vaccination series from 2011 to 2017, measured at 2 years of age. National Immunization Survey Coverage rates (available for 2011, 2013, 2015 and 2017; averaged for 2012, 2014 and 2016) along with Canadian census data were used to derive the number of children with incomplete PCV13 series.
There were ~609,000 children with incomplete PCV13 series at 2 years of age in Canada in 2011-2017 (Table 1).
The substantial estimated number of children with incomplete PCV13 series by 2 years of age over the study period, coupled with reduced-dose schedule may have undermined achievement of optimal public health impact. Potential role of these factors in PCV13 program effectiveness in Canada requires better understanding.