PCV13 Significantly Reduces Invasive Pneumococcal Disease in Pediatric Patients
Researchers explore trends from 2014 to 2022 among pediatric invasive pneumococcal diseases since introduction of the 13-valent pneumococcal conjugate vaccine.
Invasive pneumococcal diseases (IPDs) decreased dramatically after the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), according to data published in Vaccine.1 Cases declined even further during the COVID-19 pandemic among pediatric patients.
“Streptococcus pneumoniae is a major pathogenic bacterium that induces invasive diseases, such as meningitis and bacteremia, in children,” wrote the authors of the study. “The development of pneumococcal conjugate vaccines (PCVs) has significantly reduced invasive pneumococcal disease (IPD) in children in countries that have introduced PCV.”
The introduction of PCV7 and PCV13 has contributed to declining IPD rates in other countries. According to a study published in Open Forum Infectious Diseases, IPD significantly declined among children in Singapore after the introduction of PCV7 in 2009. Cases then declined even more dramatically when PCV13 replaced the 7-valent formula in 2011.2
Researchers aimed to understand the impact of PCV13 following its introduction into a routine immunization schedule. | image credit: Sirichai - stock.adobe.com
READ MORE: Cost-Effectiveness of PCV15, 20 Vaccines Expected to Decrease
Despite the eventual introduction of PCV15 and PCV20 in Japan, researchers of the current study explored IPD cases among pediatric patients in Japan during the timespan when PCV13 was the standard of pneumococcal immunization. With the study period ranging from 2014 to 2022, researchers attempted to gain further insights on IPD rates and PCV13 efficacy amid the unprecedented health crisis that was the COVID-19 pandemic.1
Although PCV7 was replaced by PCV13 in Singapore, 4 years later the same occurred in Japan toward the end of 2013. Researchers of the current study aimed to understand the impact of PCV13 following its introduction into the routine immunization schedule.
“Detailed clinical and epidemiological information on IPD cases in children aged <15 years was collected in 10 prefectures from January 2014 to December 2022,” they continued.1 “The population aged <5 years in these 10 prefectures corresponded to approximately 23% of Japan's population throughout the study period. IPD was defined as the isolation of S. pneumoniae or the detection of pneumococcal DNA from a normally sterile body site.”
Based on the ages of Japan’s pediatric population, researchers calculated the IPD incidence rate per 100,000 people of participants under 5 years old. They included data that compared the efficacy of PCV7 with PCV13 as well as IPD rates before and after PCV13 introduction.
The researchers identified a total of 1033 IPD cases across 10 prefectures in Japan. “Of these, 904 cases (87.5%) were children under 5 years of age, and 129 cases (12.5%) were children aged 5-15 years,” they wrote.1 Furthermore, children in the 1-year-old age group had the highest proportion of IPD cases (49.9%) among children under 5 years old.
When exploring the changes in IPD rates throughout the study period, researchers observed a 54.4% decrease among patients under 5 from the years 2014 to 2019. Rates then declined 21.3% “compared to the rate from 2008 to 2010, before the introduction of PCV7, and from 2011 to 2013, before the introduction of PCV13, respectively.”
Compared with 2014 to 2019, a time period that saw a 54.4% decline in IPD rates, 2020 to 2022 witnessed an even greater decline. In the previous 3 years of the study, IPD rates declined by another 49.7% among children under 5 when compared with the first 6 years. Among those between 5 and 15, rates decreased by 65.3% compared with the previous period.1
“This study revealed that in the post-PCV13 era, the incidence of IPD in children aged <5 years decreased by approximately 54.4 % and 21.3 % compared with that in the pre-PCV7 introduction (2008–2010) and pre-PCV13 (2011−2013) eras, respectively,” continued the authors.1 “The reductions of IPD incidence in these 2 periods were attributed to PCV7 and PCV13 unique serotypes, respectively. The serotype replacement after the introduction of PCV7 progressed with the introduction of PCV13.”
As many other academic journals and various countries continue to research and adapt pneumococcal vaccines, significantly successful results are robust and improving pediatric populations’ protection against IPD and other pneumococcal diseases. However, IPD cases continue to impact the global population, with 75% of cases caused by serotypes not included in common PCVs.3
Future research will further explore the efficacy of pneumococcal vaccines containing a variety of serotypes as more are introduced into countries’ vaccine programs.
“After the introduction of PCV13 into the routine immunization program in Japan, IPD caused by PCV13 serotypes decreased dramatically. During the COVID-19 pandemic, the incidence rate continued to decline further,” concluded the authors of the study.1 “The introduction of PCV15 and PCV20 is expected to reduce the incidence of IPDs. Therefore, it is important to continuously monitor the epidemiological characteristics of pediatric IPD.”
READ MORE: Pneumococcal Resource Center
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