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O007 - IMPACT OF THE INTRODUCTION OF THE PNEUMOCOCCAL CONJUGATE VACCINE ON PAEDIATRIC PNEUMONIA CASES IN NEPAL (ID 511)
PCV10 was introduced into the infant immunisation programme in Nepal in 2015. We assessed the impact of PCV10 on the pneumococcal nasopharyngeal carriage in children with pneumonia.
All children with clinician diagnosed pneumonia aged 2 months to <14 years admitted to Patan Hospital, Nepal, between March 2014-2015 (pre-vaccine), and between 2018- 2019 (post-vaccine), were included in the study. Nasopharyngeal swabs collected after informed consent were transported in STGG medium, cultured and serotyped by the Quellung method.
Pneumococcal carriage was 35.7 % among 423 pneumonia cases in the pre-vaccine and 41.3 % among 683 pnemonia cases in the post-vaccine period. PCV10 vaccine-type carriage decreased significantly, from 13.7% pre-vaccine to 6.7% post-vaccine (prevalence ratio=0.52, p=0.0005). Serotypes 14 (4.7%) and 1 (3.3%) were most prevalent pre-vaccine; post-vaccine, they decreased to 1.2% and 1.9%, respectively. In 2018-2019, serotypes exceeding 2% were 19A (3.22%) and 6A (2.93%).Cumulatively, the three additional PCV13-types significantly increased (3.8% pre-vaccine, 7.3% post vaccine; prevalence ratio=1.94, p=0.0158). Non-typeable pneumococcus was common in both periods (7.1% pre-vaccine vs. 6.4% in 2018-2019).
Nasopharyngeal carriage of PCV10 serotypes has declined in pneumonia cases after vaccine introduction. The PCV13 additional serotypes have increased but by less than 4%. This information is important when considering changing to vaccines with broader serotype coverage.