Invasive Pneumococcal Disease in Latvia in PCV10 Vaccination Era, 2012–2018

Larisa Savrasova*, Angelika Krumina, Hedija Cupeca, Indra Zeltina, Anita Villerusha, Ilze Grope, Ludmila Viksna, Elina Dimina, Sooria Balasegaram

*Corresponding author for this work

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    In 2010 in Latvia, invasive pneumococcal disease (IPD) became a cause for concern and vaccination of infants with four doses of 7–valent pneumococcal conjugate vaccine (PCV7) commenced. In 2012, 10–valent pneumococcal conjugate vaccine (PCV10) (three doses at 2, 4, and 12–15 month of age) vaccination was introduced. We described incidence and serotype distribution of IPD in Latvia and investigated serotypes associated with death from IPD based on surveillance data. Adult vaccination against pneumococcal infection is not included in the national immunization program. Laboratory confirmed IPD cases are passively notified to the Center for Disease Prevention and Control of Latvia (CDPC) by laboratories and clinicians. We calculated incidence by age, sex, case fatality, and trend in serotypes by conducting a retrospective population-based cross-sectional study based on national IPD surveillance data. From 2012 to 2018 466 cases of IPD were reported. The highest notified incidence was in 2015 at 4.4/100,000, which fell to 3.9 in 2018. The highest mean annual IPD incidence was in infants (4.8) and in the elderly (6.0). PCV10 vaccine serotypes were the most prevalent in IPD cases up to 2015 with a decreasing trend from 50% (20/40) in 2012 to 19% (14/74) in 2018 (chi2 test for trend of odds = 0.000). PCV23nonPCV13 vaccine serotypes had an increasing trend and rose from 18% (7/40) to 34% (25/74) (chi2 test for trend of odds = 0.000). Non-Vaccine serotypes had an increasing trend and rose from 13% (5/40) to 27% (20/74) (chi2 test for trend of odds = 0.038). Reported total case fatality was 19% (87/466). The highest, at 36% (20/56), was reported in 2013. After adjusting for age, Streptococcus pneumoniae serotype 3 was associated with death from IPD (adjusted OR 2.3 95%CI 1.25–4.12 p 0.007). Surveillance data indicate evidence of serotype replacement with an increasing trend of serotype 19A and PPV23nonPCV13 and Non-Vaccine serotypes. Serotype 3 and age were associated with fatal IPD outcome. Further studies of S. pneumoniae carriage would be useful in providing more evidence to characterize serotypes' circulation.

    Original languageEnglish
    Article number532489
    JournalFrontiers in Pediatrics
    Publication statusPublished - 7 Oct 2021

    Bibliographical note

    Financial Information: This work was supported by the Latvijas Infektologu un Hepatologu asociacija.

    Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    Publisher Copyright: Copyright © 2021 Savrasova, Krumina, Cupeca, Zeltina, Villerusha, Grope, Viksna, Dimina and Balasegaram.

    Citation: Savrasova L, Krumina A, Cupeca H, Zeltina I, Villerusha A, Grope I, Viksna L, Dimina E and Balasegaram S (2021) Invasive Pneumococcal Disease in Latvia in PCV10 Vaccination Era, 2012–2018. Front. Pediatr. 9:532489.

    DOI: 10.3389/fped.2021.532489


    • Latvia
    • PCV10
    • S. pneumoniae serotype replacement
    • invasive pneumococcal disease
    • pneumococcal conjugate vaccine (PCV)


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