Debby Hurlburt,
Author Of 3 Presentations
IMPACT OF THE 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) ON INVASIVE PNEUMOCOCCAL DISEASE IN ALASKAN CHILDREN (ID 1076)
Abstract
Background
In April 2010, PCV13 was introduced statewide in Alaska. To evaluate the impact of PCV13 on IPD in children, we assessed IPD rates by serotype, prior to and 8 years after PCV13 introduction.
Methods
Pneumococcal sterile site isolates, reported through state-wide surveillance, were serotyped using standard methods. We defined the pre-PCV13 period 2005-2008 and post-PCV13 period 2011-2018. We compared proportions using chi-squared or Fisher’s exact test. Population denominators were obtained from the Alaska Department of Labor website.
Results
Among Alaska children <5 years, PCV13 serotypes comprised 62%(78/126) of IPD isolates in the pre-PCV13 period and 19%(18/95) in the post-PCV13 period. Among all Alaska children <5 years, IPD rates decreased 64% from 60.9(pre) to 22.2(post) per 100,000/yr (95%CI:52%-72%); PCV13 serotype IPD decreased 89% from 37.7 to 4.2 (95%CI:81%-94%). Among Alaska Native children <5 years, IPD rates decreased 64% from 149.2 to 54.1 (95%CI:49%-74%); PCV13 serotype IPD decreased 89% from 87.0 to 10.0 (95%CI:78%-94%). Rates of non-PCV13 serotype IPD did not change significantly. Similar declines were observed among both rural and urban children; PCV13 IPD rates declined 91% (95%CI:80%-96%) and 86% (95%CI:70%-94%), respectively.
Conclusions
Eight years after PCV13 introduction, overall IPD and PCV13-serotype IPD rates decreased in Alaska children <5 years when compared with 2005-2008.
IMPACT OF THE 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) ON INVASIVE PNEUMOCOCCAL DISEASE IN ALASKAN ADULTS (ID 1075)
Abstract
Background
Background: In April 2010, PCV13 was introduced statewide for children in Alaska. To evaluate the impact of PCV13 on IPD in adults, we assessed IPD rates by serotype, prior to and 8 years after PCV13 introduction.
Methods
Pneumococcal sterile site isolates, reported through state-wide surveillance, were serotyped using standard methods. We defined the pre-PCV13 time period as 2005-2008 and the post-PCV13 time period as 2011-2018. We compared proportions using chi-squared or Fisher’s exact test. Population denominators were obtained from the Alaska Department of Labor website.
Results
Among all adults 18-49 years, IPD rates decreased from 13.6(pre) to 8.9(post) per 100,000/yr (P<.001); PCV13 serotype IPD decreased (4.8 to 1.7,P<.001). Among Alaska Native adults 18-49 years, IPD rates decreased (41.1 to 25.5,P<.001); PCV13 serotype IPD decreased (9.0 to 3.7,P=.006); rates of non-PCV13 serotype IPD decreased (29.9 to 20.4,P=.016). Among adults >50 years, overall IPD rates did not change significantly; PCV13 serotype IPD decreased (14.1 to 7.2,P<.001); rates of non-PCV13 serotype IPD increased (16.7 to 23.1,P=.002) from pre- to post-PCV13 time periods.
Conclusions
Eight years after PCV13 introduction, overall IPD and PCV13-serotype IPD rates decreased in Alaskan adults 18-49. We observed an increase in non-PCV13 serotype IPD rates among adults 50+ when compared with 2005-2008.
RISK OF INVASIVE STREPTOCOCCUS PNEUMONIAE INFECTION AMONG ADULTS EXPERIENCING HOMELESSNESS IN ANCHORAGE, ALASKA, 2005–2018 (ID 1078)
Abstract
Background
Invasive pneumococcal disease (IPD) among people experiencing homelessness (PEH) is not well understood.
Methods
We investigated age-adjusted IPD incidence and serotype distribution among adult PEH compared to the general adult population in Anchorage, Alaska from 2005-2018. We calculated IPD incidence per 100,000 person-years using statewide IPD surveillance of pneumococcal sterile site isolates, Census data, and the Anchorage Point in Time count of homeless persons. We examined incidence rate ratios and risk differences using Poisson exact, Chi square and Fisher’s exact tests.
Results
In 2012, PEH accounted for 0.4% of the adult population, but 14.4% of IPD. Compared to the adult population, PEH were 32.5 (95% CI 25.7-41.2) times as likely to have IPD and 34.2 (26.6-44.0) times as likely to have IPD with pneumonia. Compared to the general population with IPD, PEH with IPD were younger (mean age 48.6 vs. 56.7, P<.01), and more likely to abuse alcohol (82.4% vs. 25.1%, P<.01), but not different in the proportion with non-PCV13 serotypes (92.9% vs. 88.7%, P= 0.25). Non-PCV13 serotypes among PEH with IPD included serotype 20 (18.6%), 31 (14.0%), 12F (11%), 16F (9.3%) and 22F/6C/9N (7.0%).
Conclusions
Interventions are warranted for adult PEH who bear a disproportionate burden of IPD in Anchorage.