Andrew Simor,

Author Of 1 Presentation

CHANGES IN SEROTYPE 3 (ST3) INVASIVE PNEUMOCOCCAL DISEASE (IPD) AFTER 13-VALENT CONJUGATE VACCINE (PCV13) INTRODUCTION IN SOUTHERN ONTARIO (ID 506)

Abstract

Background

We asked whether the epidemiology of ST3 IPD changed after implementation of infant PCV13 (2010) and immunosuppressed 50+ (2014) programs.

Methods

Our research network conducts population-based surveillance for IPD in Toronto/Peel, Ontario. We assessed incidence of IPD due to ST3 and compared the characteristics of IPD due to ST3 and other STs (OST) pre- (2001-2009) and post- (2013-2018) PCV13 introduction.

Results

8183 cases of IPD occurred from 2001-present (733 ST3). Figure shows ST3 incidence: compared to pre-PCV13, the incidence post-PCV13 was lower in 65+ was lower (IRR 0.66 (0.53-0.81), P<0.001), but higher in 50-64yrolds (IRR 1.45 (1.14-1.85), P=0.003).

serotype3_ipd_incidence_2001-2018_colourblind.png

Post-PCV13 compared to pre-PCV13, the proportion of IPD in homeless persons increased in both ST3 and OST (1.5-6.6% and 1.8-5.4%), while the proportion of cases with any underlying chronic illness and immunosuppression trended down in ST3 (67-61% and 25-21%), but increased significantly in OST (63-69%, 29-34%, both P<0.0012). The ICU admission and case fatality rate of ST3 declined (45-40%, P=NS and 29-21%, P=0.03), while those due to OST did not change (25-27% and 17-17%, P=NS).

Conclusions

In our population, pediatric PCV13 program implementation was temporally associated with a decline in ST3 disease in older adults but an increase in 50-64yrolds; case fatality also declined.

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