Effect of Serotype on Focus and Mortality of Invasive Pneumococcal Disease: Coverage of Different Vaccines and Insight into Non-Vaccine Serotypes
Open Access
- 16 July 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (7), e39150
- https://doi.org/10.1371/journal.pone.0039150
Abstract
Differences in pathogenicity between pneumococcal serotypes are important when assessing the potential benefit of different valency vaccines. We investigated the effect of serotype on clinical presentation, outcome, and quality of life lost from invasive pneumococcal disease (IPD) in the context of the 7, 10, and 13 valent pneumococcal conjugate vaccines (PCV7, PCV10, PCV13). Serotyped IPD cases in England were linked to the national dataset of hospital admissions for April 2002 to March 2011. Based on patients’ diagnostic codes and vital status at the end of the admission, disease focus (meningitis, empyema, sepsis, or respiratory disease) and case fatality rates by serotype and age group (5, 5–64, and 65 years and over) were obtained. Using these data the quality adjusted life years (QALY) lost from the IPD remaining when use of PCV7 stopped in 2010 was estimated for the serotypes covered by higher valency vaccines. The linked dataset contained 23,688 cases with information on diagnosis, mortality, and serotype. There were significant differences between serotypes in the propensity to cause meningitis, death, and QALY loss in each of the investigated age groups. As a result, vaccines’ coverage of disease burden differed by endpoint. For example, in children under 5 years in 2009/10, PCV10 covered 39% of meningitis, 19% of deaths and 28% of the QALY loss of attributable to IPD, whereas the respective percentages for PCV13 were 65%, 67%, and 66%. The highest QALY loss per serotype in this age group was for 6A. Non-PCV serotypes causing the highest QALY loss were 22F and 33F in <5 year olds and 31 in older individuals. Marked differences exist between serotypes in clinical presentation and outcome, and these should be considered when evaluating the potential impact of higher valency vaccines on overall disease burden and associated QALY loss.Keywords
This publication has 21 references indexed in Scilit:
- Herd immunity and serotype replacement 4 years after seven-valent pneumococcal conjugate vaccination in England and Wales: an observational cohort studyThe Lancet Infectious Diseases, 2011
- Population Structure of Invasive Streptococcus pneumoniae in the Netherlands in the Pre-Vaccination Era Assessed by MLVA and Capsular Sequence TypingPLOS ONE, 2011
- Effect of Pneumococcal Conjugate Vaccination on Serotype-Specific Carriage and Invasive Disease in England: A Cross-Sectional StudyPLoS Medicine, 2011
- Association of Serotype with Risk of Death Due to Pneumococcal Pneumonia: A Meta‐AnalysisClinical Infectious Diseases, 2010
- Nasopharyngeal Carriage of Streptococcus pneumoniae in Gambian Children who Participated in a 9-valent Pneumococcal Conjugate Vaccine Trial and in Their Younger SiblingsThe Pediatric Infectious Disease Journal, 2009
- Invasive Pneumococcal Disease among Adults: Associations among Serotypes, Disease Characteristics, and OutcomeClinical Infectious Diseases, 2009
- Pneumococcal Serotypes and Mortality following Invasive Pneumococcal Disease: A Population-Based Cohort StudyPLoS Medicine, 2009
- Discovery of a New Capsular Serotype (6C) within Serogroup 6 ofStreptococcus pneumoniaeJournal of Clinical Microbiology, 2007
- Capsular Serotype–Specific Attack Rates and Duration of Carriage ofStreptococcuspneumoniaein a Population of ChildrenThe Journal of Infectious Diseases, 2006
- Genetic Analysis of the Capsular Biosynthetic Locus from All 90 Pneumococcal SerotypesPLoS Genetics, 2006