Effectiveness of 13-pneumococcal conjugate vaccine (PCV13) against invasive pneumococcal disease in children in the Dominican Republic

Details

• Alternative Title:
  BMC Infect Dis
• Personal Author:
  Tomczyk, Sara ; Lessa, Fernanda C. ; Sánchez, Jacqueline ; Peña, Chabela ; Fernández, Josefina ; Gloria Carvalho, M. ; Pimenta, Fabiana ; Cedano, Doraliza ; Whitney, Cynthia G. ; Verani, Jennifer R. ; Coradin, Hilma ; Garib, Zacarías ; De Oliveira, Lucia Helena ; Feris-Iglesias, Jesús
• Description:
  Background
  
  Limited data are available on the effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) in resource-poor settings and PCV naïve populations. The Dominican Republic introduced PCV13 in September 2013 using a 2 + 1 schedule (2, 4, and 12 months) without a catch-up campaign. We evaluated PCV13 effectiveness against vaccine-type (VT) invasive pneumococcal disease (IPD) among children in the Dominican Republic.
  
  Methods
  
  We conducted a matched case-control study. A case-patient was defined as VT-IPD identified by culture or polymerase chain reaction (PCR) from a normally sterile-site in a hospitalized child who was age-eligible to have received ≥1 PCV13 dose. Four age- and neighborhood-matched controls were enrolled for each case-patient. We collected demographic, vaccination history, and risk factor data. Conditional logistic regression was performed. Vaccine effectiveness was calculated as (1- adjusted matched odds ratio for vaccination) X 100%.
  
  Results
  
  We enrolled 39 case-patients and 149 matched-controls. Most case-patients had pneumonia with pleural effusion (64%), followed by meningitis (28%) and septicemia (13%). The most common pneumococcal serotypes identified included 14 (18%), 3 (13%), 19A (10%), and 1 (8%). Fewer case-patients had ≥1 PCV13 dose as compared to controls (61.5% vs. 80.0%; p = 0.006). Adjusting for malnutrition and socioeconomic status, VE of ≥1 PCV13 dose compared to no doses was 67.2% (95% CI: 2.3% to 90.0%). Only 44% of controls were up-to-date for PCV13, suggesting low vaccine coverage in the population.
  
  Conclusions
  
  We found that PCV13 provided individual protection against VT-IPD in this resource-poor setting with a PCV-naïve population, despite low PCV13 coverage. Expanding vaccination coverage might increase PCV13 impact.
  
  
• Subjects:
  Case-Control Studies Child, Hospitalized Female Humans Infant Male Pneumococcal Infections Pneumococcal Vaccines Sepsis Social Class Treatment Outcome Vaccination Vaccines, Conjugate

  More +
• Source:
  BMC Infect Dis. 18.
• Pubmed ID:
  29609548
• Pubmed Central ID:
  PMC5880020
• Document Type:
  Journal Article
• Place as Subject:
  Dominican Republic
• Volume:
  18
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ec7b576b6a12860bb531f27fe584814564fc0b893808aee5667e1c3e2bb66c00
• Download URL:
  https://stacks.cdc.gov/view/cdc/53543/cdc_53543_DS1.pdf
• File Type:
  [PDF - 570.39 KB ]