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O063 - EVALUATION OF REDUCED DOSE PCV SCHEDULES IN A NAIVE POPULATION IN VIETNAM (ID 838)
Abstract
Background
We investigated whether a mature Pneumococcal Conjugate Vaccine (PCV) schedule with a single priming and a booster dose (1p+1) offers non-inferior protection compared to 3 dose schedules (2p+1 and 3p+0).
Methods
Between October 2016 and October 2020 we conducted a cRCT with four arms using PCV10 in a 1p+1, 0p+1, 2p+1 or 3p+0 schedule, in 24 communes in Nha Trang, Vietnam, a PCV-naïve population. A catch-up campaign was offered to all <3y olds at the start of vaccination in February 2017. Annual carriage surveys in 1440 infants, 1440 toddlers and their mothers were conducted. Vaccine type (VT) carriage was determined by lytA RT-PCR positivity, culture and microarray serotyping. The primary endpoint was non-inferiority of VT carriage in infants in 1p+1 vs 2p+1 and 3p+0 arms; non-inferiority was defined as an absolute difference of less than 5%.
Results
VT carriage in infants before PCV was 11.6% (161/1383). In 2020, VT carriage in infants had reduced to 2.0% (7/353) vs 1.5% (5/343) and 1.2% (4/331) in 1p+1, 2p+1, and 3p+0 arms respectively: a non-inferior difference of 0.5% (-1.4, 2.5%) and 0.8% (-1.1, 2.7%). Vaccine cross reactive ST6A prevalence in infants was 6.4% (89/1383) before PCV use and reduced to 3.3% (12/353) vs 2.9% (10/343) and 0.9% (3/331) in 1p+1, 2p+1, and 3p+0 arms in 2020. Reductions were similar for toddlers and marginally lower for the 0p+1 arm.
Conclusions
The 1p+1 was non-inferior to 3 dose PCV10 schedules in sustaining combined direct and indirect protection against carriage in infants.