Nick Andrews (United Kingdom)
UK Health Security Agency
Immunisation
Prof Nick Andrews is Head of Vaccines Analysis within the Immunisation Department of the UK Health Security Agency. In this role he has worked extensively on post licensure vaccine safety, impact and effectiveness assessment, clinical trials and correlates of protection. He is currently part of the Global Vaccine Datanet, works on European influenza vaccine effectiveness projects with the IMove group, and was a member of the World Health Organization Global Advisory Committee on Vaccine Safety from 2012-2018. He is currently on the WHO Ebola vaccine sub-committee and is on the advisory group for pilot implementation of RTS,S malaria vaccine in Africa. He is a project lead on a research collaboration on using electronic health records for vaccine assessment with the London School of Hygiene and Tropical Medicine (LSHTM). During the COVID-19 pandemic he has worked on sero-epidemiology, risk factors, excess mortality, and has published multiple studies on vaccine effectiveness and safety. He regularly provides evidence on COVID-19 vaccine effectiveness to the Joint Committee on Vaccination and Immunisation. He lectures at the LSHTM, New York University in London and on vaccine courses internationally. He has over 400 publications with more than half of these in the vaccine field.

Presenter of 1 Presentation

 Conference Calendar

O032 - INVASIVE PNEUMOCOCCAL DISEASE (IPD) MORTALITY RATES AND RISK FACTORS ASSOCIATED WITH 30-DAY MORTALITY IN ENGLAND; A PROSPECTIVE COHORT STUDY, 2000-2019 (ID 733)

Session Name
0520 - Parallel Session 05: Global Pneumonia Control and Pneumococcal Epidemiology (ID 45)
Session Type
Parallel Session
Date
Tue, 21.06.2022
Session Time
14:50 - 16:20
Room
Grand Ballroom East
Presenter
Lecture Time
15:35 - 15:45

Abstract

Background

Invasive pneumococcal disease (IPD) is a large burden on global morbidity and mortality, disproportionately affecting young children, the elderly and immunocompromised.

Methods

We used national IPD surveillance data from the UK Health Security Agency to study pre- to post- PCV vaccination trends in mortality in England (2000-2019) and used enhanced surveillance data (2014-2019) to identify clinical and epidemiological risk factors for 30-day case-fatality using logistic regression.

Results

There were 94,579 IPD cases between July 2000 and June 2019. Over 80-year-olds had the highest mortality rate which decreased by 61% from 104.4 deaths per 100,000 in 2000/01 to a nadir of 40.9 deaths per 100,000 in 2013/14, before increasing to 69.1 deaths per 100,000 in 2017/18. Additionally, mortality rate in <2-year-olds reduced by 67% from an average of 41.6 deaths per 100,000 in the pre-PCV7 period to 13.6 deaths per 100,000 in 2018/19.

During 2014-2019 (n=22,160), after adjusting for age-group, epidemiological year and serotype group, chronic diseases of the liver (adjusted Odds Ratio (aOR): 2.86, 95%CI (2.47-3.32)), kidneys (aOR: 1.22, (1.11-1.35)) and heart (aOR: 1.19, (1.10-1.30)), sickle-cell disease (aOR: 2.52 (1.27-5.00)), cerebrospinal fluid leaks (aOR: 1.36, (1.10-1.68)) and malignancy/immunosuppression (aOR: 1.14, (1.04-1.24)) were associated with increased 30-day case-fatality rate. PCV7, additional PCV13 and non-vaccine serotypes were associated with increased risk (aOR range: 1.34-1.60) compared to additional PPV23 serotypes.

Conclusions

Mortality rates in young children and older adults showed the greatest decline following pneumococcal conjugate vaccine introduction. Several comorbidities were independently associated with increased risk of death, notably, chronic liver disease.

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