1. Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults
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Pilar Ciruela, Sonia Broner, Conchita Izquierdo, Roman Pallarés, Carmen Muñoz-Almagro, Sergi Hernández, Imma Grau, Angela Domínguez, Mireia Jané, P. Ciruela, C. Izquierdo, S. Broner, S. Hernández, M. Jané, C. Muñoz-Almagro, C. Esteva, M.F. de Sevilla, D. Henares, R. Pallarés, C. Ardanuy, I. Grau, F. Marco, N. Margall, A. González-Cuevas, A. Díaz, M.T. Martin, J. Llaberia, M. Curriu, C. Gallés, E. Capdevila, P. Gassiot, M. Martínez-Zurita, C. Martí, M. Morta, G. Sauca, A. Gassós, E. Sanfeliu, F. Ballester, I. Pujol, M. Olsina, X. Raga, F. Gómez-Bertomeu, M.O. Pérez-Moreno, A. Vilamala, M. Navarro, M. Ribelles, M. Garcia, E. Padilla, N. Prim, D. Fontanals, I. Sanfeliu, M.A. Benitez, E. Jou, C. Sanjosé, M. Giménez, M.D. Quesada, J.C. de la Fuente, A. Calderon, P.J. Ayala, L. Vega, J. Pérez-Jové, A. Blanco, C. Balado, I. Valle, M.T. Bastida, O. Gonzalez-Moreno, A. Ubanell, A. Fenoll, J. Yuste, European Centre for Disease Prevention and Control (ECDC), Centro de Investigación Biomedica en Red - CIBER, [Ciruela P, Jané M] Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. [Broner S, Izquierdo C, Hernández S] Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain. [Pallarés R, Grau I] Hospital Universitari Bellvitge, Universitat de Barcelona (UB), L’Hospitalet, Spain. CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. [Muñoz-Almagro C] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Hospital Universitari Sant Joan de Déu, Esplugues, Spain. Department of Medicine, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Spain. [Domínguez A] CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. Departament de Medicina, Universitat de Barcelona (UB), Barcelona, Spain, and Departament de Salut
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0301 basic medicine ,Male ,Bacteria::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMOS] ,PCV13 ,Infeccions per pneumococs ,Pneumococcal conjugate vaccine ,Persones grans ,Comorbidities ,Pneumococcal Vaccines ,0302 clinical medicine ,Mezclas Complejas::Productos Biológicos::Vacunas::Vacunas Bacterianas::Vacunas Estreptocócicas::Vacunas Neumococicas [COMPUESTOS QUÍMICOS Y DROGAS] ,Case fatality rate ,030212 general & internal medicine ,Vacunació ,Bacterias::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMOS] ,Aged, 80 and over ,Pneumococs ,Mortality rate ,Incidence (epidemiology) ,Incidence ,Vaccination ,Complex Mixtures::Biological Products::Vaccines::Bacterial Vaccines::Streptococcal Vaccines::Pneumococcal Vaccines [CHEMICALS AND DRUGS] ,General Medicine ,Bacteria::Firmicutes::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [ORGANISMS] ,Infectious Diseases ,Streptococcus pneumoniae ,Persons::Age Groups::Adult::Aged [NAMED GROUPS] ,Child, Preschool ,Female ,Meningitis ,medicine.drug ,Microbiology (medical) ,medicine.medical_specialty ,030106 microbiology ,Serogroup ,Pneumococcal Infections ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Internal medicine ,medicine ,Mortalitat ,Adults ,Humans ,lcsh:RC109-216 ,Mortality ,personas::Grupos de Edad::adulto::anciano [DENOMINACIONES DE GRUPOS] ,Aged ,mezclas complejas::productos biológicos::vacunas::vacunas bacterianas::vacunas antiestreptocócicas::vacunas antineumocócicas [COMPUESTOS QUÍMICOS Y DROGAS] ,Vaccines, Conjugate ,business.industry ,Cerebrospinal meningitis ,Meningitis cerebrospinal epidèmica ,Infant ,Odds ratio ,medicine.disease ,Confidence interval ,Vacuna antipneumocòccica ,IPD ,business - Abstract
OBJECTIVES: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people ≥65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. METHODS: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. RESULTS: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age ≥85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and ≥1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). CONCLUSIONS: The incidence of IPD in people ≥65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, ≥1 high-risk condition, and PCV13 serotypes. This study was partially supported by SpIDnet (Assessing the impact of vaccination with conjugate vaccines on the epidemiology of invasive pneumococcal disease in Europe), a network funded by the European Centre for Disease Prevention and Control ( ECDC/2015/031 ); the Catalan Agency for the Management of Grants for University Research ( AGAUR Grant number 2017/SGR 1342 and 2017/SGR 0742 ); the Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública ( CIBERESP CB06/02/0076 and CB15/00067 ); and the Centro de Investigación Biomédica en Red de Enfermedades Respiratorias ( CIBERES CB06/06/0037 ). Sí
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- 2019