Andreas Palmborg, Sweden

Pfizer Vaccines

Poster Author Of 1 e-Poster

Author Of 2 Presentations

PNEUMOCCOCAL DISEASE AMONG ELDERLY IN NORDIC COUNTRIES: DIFFERENT NEEDS FOR BROADER PROTECTION (ID 229)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults

Abstract

Background

The Nordic countries have different pediatric PCV programmes. In 2017, Norway and Denmark were using PCV13, Sweden both PCV10 and PCV13 and Finland used PCV10. All programmes have demonstrated high effectiveness in children, but with different indirect effect among elderly.

Methods

The IPD incidence for the year 2017 in +65 years of age was evaluated together with serotype specific coverage of licensed vaccines and developmental pneumococcal conjugate vaccines (PCVs) using data from the ECDC.

Results

Table: IPD incidence per 100 000 (%) by vaccine serotypes in +65 population, 2017

Norway

Denmark

Sweden

Finland

Pneumococcal Conjugate Vaccines:

PCV10-types

1,74 (4,8)

1,9 (4,5)

2,2 (5,1)

3,9 (10,3)

PCV13-types

8,6 (23,9)

5,4 (12,8)

12,5 (29,1)

19,7 (51,9)

PCV15-types

16,5 (45,8)

10,7 (25,4)

17,9 (41,7)

23,1 (60,9)

PCV20-types

22,2 (61,6)

28,5 (67,7)

24,9 (58,0)

25,7 (67,7)

Pneumococcal Polysaccharide Vaccine:

PPV23-types

26,2 (72,9)

34,26 (81,1)

27,2 (63,4)

26,1 (68,8)

Total IPD:

All serotypes

36,0 (100)

42,2 (100)

42,9 (100)

38,0 (100)

Conclusions

There are major differences in the serotype distribution in IPD among elderly between the Nordic countries associated with the choice of PCV in the pediatric programme. A substantial amount of IPD amongst elderly can be addressed by direct vaccination.

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PNEUMOCOCCAL SEROTYPE DISTRIBUTION IN ADULTS HOSPITALIZED WITH RADIOLOGICALLY-CONFIRMED COMMUNITY-ACQUIRED PNEUMONIA IN MALMÖ, SWEDEN (ID 904)

Abstract

Background

In Sweden, pneumococcal serotype distribution in adults with community-acquired pneumonia (CAP) and potential coverage of licensed and developmental pneumococcal conjugate vaccines (PCVs) are unknown.

Methods

2016-2018, consecutive patients aged ≥18 years hospitalized with chest x-ray positive (CXR+) CAP were enrolled at Skåne University Hospital. Streptococcus pneumoniae (Spn) blood culture isolates were serotyped by multiprime PCR and Quellung reaction. Urine was tested by the pan-pneumococcal urinary antigen test (BinaxNOW®) and Pfizer’s proprietary serotype-specific urine antigen detection assays (UAD1/UAD2). UAD1 detects serotypes in PCV13, UAD2 detects additional serotypes in PCV15 and PCV20 plus serotypes 2,9N,17F and 20.

Results

Of 567 enrollees, 518 had CXR+CAP and urine sample collected and were included in analysis. Spn serotypes were identified by UAD or blood culture isolates.

Table CXR+CAP by age group and vaccine serotype categories.

Spn detected:

18-64 years
n=169 (32.6%)

≥65 years
n=349 (67.4%)

≥18 years
n=518 (100%)

PCV13-types*

12.4%

10.0%

10.8%

PCV15-types*

13.6%

12.0%

12.5%

PCV20-types*

20.7%

15.2%

17.0%

Any Spn

27.2%

22.9%

24.3%

*PCV13:1,3,4,5,6A/6C,6B,7F,9V,14,18C,19A,19F,23F

PCV15:PCV13+22F,33F

PCV20:PCV15+8,10A,11A,12F,15B/C

Conclusions

In the context of robust pediatric PCV immunization, PCV13 serotypes were relatively common in adult CXR+CAP, emphasizing the limits of relying on indirect protection. PCV20 will further increase the ability of direct vaccination to reduce adult pneumonia morbidity.

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