Lindsay R. Grant, United States of America

Poster Author Of 4 e-Posters

Online Abstracts Population Sciences - Epidemiology, Economics, and Mathematical Modelling D1 Epidemiology, Economics, and Mathematical Modelling

Presenter Of 4 Presentations

COVERAGE OF THE 20-VALENT CONJUGATE VACCINE AGAINST INVASIVE PNEUMOCOCCAL DISEASE BY AGE GROUP IN THE UNITED STATES, 2017 (ID 237)

Abstract

Background

The United States experienced a substantial reduction in the incidence of invasive pneumococcal disease (IPD) following the introduction of pneumococcal conjugate vaccines (PCVs), PCV7 in 2000 and PCV13 in 2010, yet, disease remains. Expanded valency PCVs, PCV15 and PCV20 that contain two and seven additional serotypes compared to PCV13, are in advanced development.

Methods

We used the CDC Active Bacterial Core surveillance (ABCs) data from 2017 to quantify the incidence and to assess PCV coverage of IPD. ABC is an active laboratory and population-based surveillance system in 10 geographically diverse sites in the United States. Analyses were limited to the serotypes covered by PCV13 (1,3,4,5,6A,6B, 7F,9V,14,18C,19A,19F,23F, plus 6C, which is highly-related to 6A), PCV15 (PCV13-types, 22F,33F), and PCV20 (PCV15-types, 8,10A,11A,12F, plus 15C, which is highly-related to 15B).

Results

In 2017, non-PCV13 and PCV13 serotypes accounted for 63.1-75.0% and 25.0-36.9% of IPD cases across different age groups. The additional two serotypes in PCV15 and the seven serotypes in PCV20 accounted for 8.3-17.0% and 23.8-37.1% of the remaining IPD cases, respectively (Table).

isppd 2020_usbod_2020.0102 table.jpg

Conclusions

PCV20 could address a substantial remaining burden of IPD, covering an estimated 55.1-66.1% of cases across all age groups.

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COVERAGE OF NEXT GENERATION PNEUMOCOCCAL CONJUGATE VACCINES FOR INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN OF HIGH-INCOME COUNTRIES (ID 608)

Abstract

Background

The serotype distribution of invasive pneumococcal disease (IPD) informs the coverage of next generation pneumococcal conjugate vaccines (PCVs). This analysis describes IPD coverage by the current PCVs (PCV10/PCV13) and next generation, PCV15 and PCV20.

Methods

Serotype counts for children <5 years were obtained from national or regionally-representative IPD surveillance systems from high-income countries. Up to the three most recent years of data were included. Excluded countries reported <20 cases overall or only reported data prior to pediatric PCV introduction into the National Immunization Program (NIP). Coverage was calculated for PCV10 (1,4,5,6B,7F,9V,14,18C,19F,23F), PCV13 (PCV10-types, 3,6A,19A, plus 6C, which is highly-related to 6A), PCV15 (PCV13-types, 22F,33F), and PCV20 (PCV15-types, 8,10A,11A,12F,15B, plus 15C, which is highly-related to 15B) as the number of cases in PCVs divided by the total number of cases (excluding missing and non-typeable cases) reported for each country.

Results

Twenty-seven of 80 (34%) high-income countries met inclusion criteria, reporting >5,000 cases that were included in the analysis. Coverage by current and next generation PCVs varied by country and World Health Organization (WHO) region (Table).

global ipd st dist_isppd2020 lt5 table_2020.1010.jpg

Conclusions

PCV20 offers substantial coverage above current PCVs and next generation PCV15 and could address the considerable remaining IPD burden among children in high-income countries globally.

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COVERAGE OF NEXT GENERATION PNEUMOCOCCAL CONJUGATE VACCINES FOR INVASIVE PNEUMOCOCCAL DISEASE IN OLDER ADULTS OF HIGH-INCOME COUNTRIES (ID 612)

Abstract

Background

Despite the indirect effects of routine pediatric pneumococcal conjugate vaccine (PCV) use, invasive pneumococcal disease (IPD) persists in older adults. This analysis describes IPD coverage of current PCVs (PCV10/PCV13) and next generation, PCV15 and PCV20.

Methods

Serotype counts for adults ≥60/≥65 years were obtained from national or regionally-representative IPD surveillance systems in high-income countries. Up to the three most recent years of data were included. Excluded countries reported <20 cases overall or only reported data prior to pediatric PCV introduction into the National Immunization Program (NIP). Coverage was calculated for PCV10 (1,4,5,6B,7F,9V,14,18C,19F,23F), PCV13 (PCV10-types,3,6A,19A, plus 6C, which is highly-related to 6A), PCV15 (PCV13-types, 22F,33F), and PCV20 (PCV13-types, 8,10A,11A,12F,15B, plus 15C, which is highly-related to 15B) as the number of cases in PCVs divided by total number of cases (excluding missing and non-typeable) reported for each country.

Results

Twenty-eight of 80 (35%) high-income countries met inclusion criteria, reporting >25,000 cases that were included in the analysis. Coverage by current and next generation PCVs varied by country and World Health Organization (WHO) region (Table).

global ipd st dist_isppd2020 65+ table_2020.1010.jpg

Conclusions

PCV20 offers substantial coverage above current PCVs and next generation PCV15 and could address the considerable remaining IPD burden among older adults in high-income countries globally.

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STREPTOCOCCUS PNEUMONIAE SEROTYPE DISTRIBUTION AND COVERAGE OF PNEUMOCOCCAL CONJUGATE VACCINES IN ADULTS HOSPITALIZED WITH COMMUNITY-ACQUIRED PNEUMONIA IN THE UNITED STATES (ID 879)

Abstract

Background

The study objective was to determine the prevalence of serotypes and coverage provided by currently licensed and next generation pneumococcal conjugate vaccines (PCVs) in adults hospitalized with community-acquired pneumonia (CAP) in the United States.

Methods

Hospitalized adults aged ≥18 years with radiologically-confirmed (CXR+) CAP were enrolled from 10 U.S. cities between October 2013 and September 2016. S. pneumoniae isolates cultured from normally-sterile standard-of-care specimens were serotyped by Quellung. Urine was tested using BinaxNOW® and a serotype-specific urine antigen detection (UAD) assay that detects serotypes contained in PCV13 plus 6C (highly-related to 6A), PCV15 (PCV13 serotypes, 22F, and 33F), PCV20 (PCV15 serotypes, 8, 10A, 11A, 12F, and 15B plus 15C (highly-related to 15B)), and non-PCV serotypes 2, 9N, 17F, and 20. Coverage was calculated as the percent of CXR+CAP participants positive for a serotype in PCV13, PCV15, and PCV20.

Results

Of 15,572 enrolled participants, 12,055 with CXR+CAP were included in the analysis; 52.7% (n=6347) were ≥65 years. Coverage of CXR+CAP varied by PCV formulation (Table). About 1% of CXR+CAP was due to serotypes 2, 9N, 17F, and 20 combined.

b1851147_uad2 isppd2020 table_2020.0108.docx.png

Conclusions

Compared to PCV13, PCV20 increased coverage of CXR+CAP due to PCV serotypes by 71% (18-64 years) and 64% (≥65 years).

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Author Of 7 Presentations

COVERAGE OF NEXT GENERATION PNEUMOCOCCAL CONJUGATE VACCINES FOR INVASIVE PNEUMOCOCCAL DISEASE IN CHILDREN OF HIGH-INCOME COUNTRIES (ID 608)

Abstract

Background

The serotype distribution of invasive pneumococcal disease (IPD) informs the coverage of next generation pneumococcal conjugate vaccines (PCVs). This analysis describes IPD coverage by the current PCVs (PCV10/PCV13) and next generation, PCV15 and PCV20.

Methods

Serotype counts for children <5 years were obtained from national or regionally-representative IPD surveillance systems from high-income countries. Up to the three most recent years of data were included. Excluded countries reported <20 cases overall or only reported data prior to pediatric PCV introduction into the National Immunization Program (NIP). Coverage was calculated for PCV10 (1,4,5,6B,7F,9V,14,18C,19F,23F), PCV13 (PCV10-types, 3,6A,19A, plus 6C, which is highly-related to 6A), PCV15 (PCV13-types, 22F,33F), and PCV20 (PCV15-types, 8,10A,11A,12F,15B, plus 15C, which is highly-related to 15B) as the number of cases in PCVs divided by the total number of cases (excluding missing and non-typeable cases) reported for each country.

Results

Twenty-seven of 80 (34%) high-income countries met inclusion criteria, reporting >5,000 cases that were included in the analysis. Coverage by current and next generation PCVs varied by country and World Health Organization (WHO) region (Table).

global ipd st dist_isppd2020 lt5 table_2020.1010.jpg

Conclusions

PCV20 offers substantial coverage above current PCVs and next generation PCV15 and could address the considerable remaining IPD burden among children in high-income countries globally.

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CHARACTERIZATION OF STREPTOCOCCUS PNEUMONIAE SEROTYPE 3 CARRIAGE AND DISEASE ISOLATES AMONG NATIVE AMERICANS IN THE SOUTHWEST UNITED STATES (ID 1020)

Abstract

Background

Despite inclusion in PCV13, Streptococcus pneumoniae serotype 3 (ST3) continues to cause significant morbidity and mortality. In Native American communities in the southwest US in 2015-2017, the ST3 carriage prevalence among children was 2.7% and the incidence of ST3 invasive pneumococcal disease (IPD) among adults was 9.0/100,000. An emerging lineage of ST3 belonging to Clonal Complex (CC) 180, termed clade II, has recently increased.

Methods

We analyzed the genomic epidemiology of 202 ST3 isolates collected from 133 adults and 69 children with carriage (n=71) or IPD (n=131) from 1999–2018. Using phylogenetics based on whole-genome sequencing data, we determined clade membership of each isolate and assessed how the population structure changed over time.

Results

The percent of isolates belonging to clade II increased from 22.3% (n=94) in 1999-2010 to 65.7% (n=108) in 2010-2018 (Figure A). Carriage isolates were comprised equally by three clades (CC180 clade Ia n=24 and II n=23 and non-CC180 n=24); however, IPD isolates were more likely to be clade II (1a n=37, II n=69, non-CC180 n=25; OR=2.32, 95% CI 1.27-4.25) (Figure B).

figure a.pngfigure b.png

Conclusions

Overall, we find that ST3 clade II has increased significantly since the introduction of PCV13 and is found more commonly in invasive disease compared to other clades.

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COVERAGE OF NEXT GENERATION PNEUMOCOCCAL CONJUGATE VACCINES FOR INVASIVE PNEUMOCOCCAL DISEASE IN OLDER ADULTS OF HIGH-INCOME COUNTRIES (ID 612)

Abstract

Background

Despite the indirect effects of routine pediatric pneumococcal conjugate vaccine (PCV) use, invasive pneumococcal disease (IPD) persists in older adults. This analysis describes IPD coverage of current PCVs (PCV10/PCV13) and next generation, PCV15 and PCV20.

Methods

Serotype counts for adults ≥60/≥65 years were obtained from national or regionally-representative IPD surveillance systems in high-income countries. Up to the three most recent years of data were included. Excluded countries reported <20 cases overall or only reported data prior to pediatric PCV introduction into the National Immunization Program (NIP). Coverage was calculated for PCV10 (1,4,5,6B,7F,9V,14,18C,19F,23F), PCV13 (PCV10-types,3,6A,19A, plus 6C, which is highly-related to 6A), PCV15 (PCV13-types, 22F,33F), and PCV20 (PCV13-types, 8,10A,11A,12F,15B, plus 15C, which is highly-related to 15B) as the number of cases in PCVs divided by total number of cases (excluding missing and non-typeable) reported for each country.

Results

Twenty-eight of 80 (35%) high-income countries met inclusion criteria, reporting >25,000 cases that were included in the analysis. Coverage by current and next generation PCVs varied by country and World Health Organization (WHO) region (Table).

global ipd st dist_isppd2020 65+ table_2020.1010.jpg

Conclusions

PCV20 offers substantial coverage above current PCVs and next generation PCV15 and could address the considerable remaining IPD burden among older adults in high-income countries globally.

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VACCINE-PREVENTABLE CLINICAL VERSUS RADIOLOGICALLY- OR ETIOLOGICALLY-CONFIRMED DISEASE IN PNEUMOCOCCAL CONJUGATE VACCINE EFFICACY TRIALS: A SYSTEMATIC LITERATURE REVIEW AND RE-ANALYSIS (ID 762)

Abstract

Background

While regulatory endpoints for pneumococcal conjugate vaccines (PCVs) routinely include radiologically- or vaccine serotype (VST) confirmed disease, public health decision-making benefits from consideration of all disease prevented regardless of diagnostic or etiological confirmation.

Methods

We followed PRISMA guidelines to perform a systematic literature review for Phase III/IV efficacy trials of PCVs from 1997 through 2019. We estimated study-specific vaccine-preventable disease incidence (VPDI) (control group minus intervention group incidences) for all-cause disease versus radiologically- and/or etiologically-confirmed outcomes. VPDI ratios between the broadest clinical and most narrowly defined outcomes were calculated [PROSPERO registration, CRD42019145268].

Results

Ten studies met the criteria. In children < 5 years, VPDI ratios ranged from 0.6 to 3.7 for otitis media (clinical versus VST etiologically-confirmed); from 1.3 to 1.8 for pneumonia (clinical versus radiologically-confirmed); 3.1 and 19.0 for pneumonia (clinical versus bacterial or VST); and 3.8 in one study of invasive pneumococcal disease (non-laboratory to laboratory-confirmed). In adults, VPDI ratios ranged from 2.2 to 2.9 for pneumonia (clinical to pneumococcal or VST).

table_fig2.gif

Conclusions

Relying on only radiologically-confirmed or etiologically-confirmed outcomes substantially underestimated PCVs’ public health benefits. Broader clinical outcomes should be considered by vaccine technical committees when making decisions for pediatric and adult PCV use.

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STREPTOCOCCUS PNEUMONIAE SEROTYPE DISTRIBUTION AND COVERAGE OF PNEUMOCOCCAL CONJUGATE VACCINES IN ADULTS HOSPITALIZED WITH COMMUNITY-ACQUIRED PNEUMONIA IN THE UNITED STATES (ID 879)

Abstract

Background

The study objective was to determine the prevalence of serotypes and coverage provided by currently licensed and next generation pneumococcal conjugate vaccines (PCVs) in adults hospitalized with community-acquired pneumonia (CAP) in the United States.

Methods

Hospitalized adults aged ≥18 years with radiologically-confirmed (CXR+) CAP were enrolled from 10 U.S. cities between October 2013 and September 2016. S. pneumoniae isolates cultured from normally-sterile standard-of-care specimens were serotyped by Quellung. Urine was tested using BinaxNOW® and a serotype-specific urine antigen detection (UAD) assay that detects serotypes contained in PCV13 plus 6C (highly-related to 6A), PCV15 (PCV13 serotypes, 22F, and 33F), PCV20 (PCV15 serotypes, 8, 10A, 11A, 12F, and 15B plus 15C (highly-related to 15B)), and non-PCV serotypes 2, 9N, 17F, and 20. Coverage was calculated as the percent of CXR+CAP participants positive for a serotype in PCV13, PCV15, and PCV20.

Results

Of 15,572 enrolled participants, 12,055 with CXR+CAP were included in the analysis; 52.7% (n=6347) were ≥65 years. Coverage of CXR+CAP varied by PCV formulation (Table). About 1% of CXR+CAP was due to serotypes 2, 9N, 17F, and 20 combined.

b1851147_uad2 isppd2020 table_2020.0108.docx.png

Conclusions

Compared to PCV13, PCV20 increased coverage of CXR+CAP due to PCV serotypes by 71% (18-64 years) and 64% (≥65 years).

Hide

COVERAGE OF THE 20-VALENT CONJUGATE VACCINE AGAINST INVASIVE PNEUMOCOCCAL DISEASE BY AGE GROUP IN THE UNITED STATES, 2017 (ID 237)

Abstract

Background

The United States experienced a substantial reduction in the incidence of invasive pneumococcal disease (IPD) following the introduction of pneumococcal conjugate vaccines (PCVs), PCV7 in 2000 and PCV13 in 2010, yet, disease remains. Expanded valency PCVs, PCV15 and PCV20 that contain two and seven additional serotypes compared to PCV13, are in advanced development.

Methods

We used the CDC Active Bacterial Core surveillance (ABCs) data from 2017 to quantify the incidence and to assess PCV coverage of IPD. ABC is an active laboratory and population-based surveillance system in 10 geographically diverse sites in the United States. Analyses were limited to the serotypes covered by PCV13 (1,3,4,5,6A,6B, 7F,9V,14,18C,19A,19F,23F, plus 6C, which is highly-related to 6A), PCV15 (PCV13-types, 22F,33F), and PCV20 (PCV15-types, 8,10A,11A,12F, plus 15C, which is highly-related to 15B).

Results

In 2017, non-PCV13 and PCV13 serotypes accounted for 63.1-75.0% and 25.0-36.9% of IPD cases across different age groups. The additional two serotypes in PCV15 and the seven serotypes in PCV20 accounted for 8.3-17.0% and 23.8-37.1% of the remaining IPD cases, respectively (Table).

isppd 2020_usbod_2020.0102 table.jpg

Conclusions

PCV20 could address a substantial remaining burden of IPD, covering an estimated 55.1-66.1% of cases across all age groups.

Hide