Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom

Rama Kandasamy; Merryn Voysey; Sarah Collins; Guy Berbers; Hannah Robinson; Irene Noel; Harri Hughes; Susan Ndimah; Katherine Gould; Norman Fry; Carmen Sheppard; Shamez Ladhani; Matthew D. Snape; Jason Hinds; Andrew J. Pollard

doi:10.1093/infdis/jiz178

Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom

Rama Kandasamy^*, Merryn Voysey, Sarah Collins, Guy Berbers, Hannah Robinson, Irene Noel, Harri Hughes, Susan Ndimah, Katherine Gould, Norman Fry, Carmen Sheppard, Shamez Ladhani, Matthew D. Snape, Jason Hinds, Andrew J. Pollard

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

50 Citations (Scopus)

Abstract

Background: Following programmatic introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), there is residual carriage and disease due to PCV13-covered serotypes.

Methods. PCV13-immunized children aged 13-48 months, N = 988, were enrolled between February 2014 and August 2015 (“late PCV13”), and had nasopharyngeal pneumococcal carriage compared with 7-valent pneumococcal conjugate vaccine (PCV7) immunized children, N = 567, enrolled between November 2010 and September 2011 (“early PCV13”). Nasopharyngeal pneumococci were molecularserotyped by microarray. Invasive pneumococcal disease (IPD) cases were identified through enhanced national surveillance.

Results. Compared with PCV7-immunized children, carriage among PCV13-immunized children was significantly lower for serotypes 19A (odds ratio [OR], 0.08 [95% confidence interval {CI},.02-.25]), 6C (OR, 0.11 [95% CI,.03-.32]), and 7F (8 vs 0 cases). IPD incidence in children <5 years was significantly lower for serotypes 1 (incidence rate ratio [IRR], 0.03 [95% CI, 0-.19]) and 7F (IRR, 0.13 [95% CI,.05-.36]) but not 19A (IRR, 0.6 [95% CI,.3-1.12]) or serotype 3 (IRR, 2.3 [95% CI,.86-6.15]) in the late PCV13 period than in the early PCV13 period. The most significant rises in IPD incidence were for serotypes 8, 12F, and 24F.

Conclusions. PCV13 has reduced serotype 19A carriage among vaccinated children. We found no impact of PCV13 on serotype 3 carriage or disease, and emergence of non-PCV13-serotype disease.

Original language	English
Pages (from-to)	1361-1370
Number of pages	10
Journal	Journal of Infectious Diseases
Volume	221
Issue number	8
DOIs	https://doi.org/10.1093/infdis/jiz178
Publication status	Published - 10 Jun 2020

Bibliographical note

Funding Information: This work was supported by an Investigator-Initiated Grant from Pfizer UK and the National Institute for Health Research. A. J. P. has previously conducted vaccine studies on behalf of Oxford University that were sponsored by manufacturers of pneumococcal vaccines. The University of Oxford received unrestricted educational grants from pneumococcal vaccine manufacturers in 2016. This study was funded by an investigator-initiated grant to Oxford University. A. J. P. is chair of the Department of Health’s Joint Committee on Vaccination and Immunisation, but the views expressed herein do not represent necessarily those of these organizations. He is also a member of the World Health Organization’s Strategic Advisory Group of Experts. R. K. received the Robert Austrian Award in Pneumococcal Vaccinology, which was supported by Pfizer, at the 10th International Symposium on Pneumococci and Pneumococcal Diseases 2016. M. D. S. is an investigator on studies conducted on behalf of the University of Oxford that are sponsored and/or funded by vaccine manufacturers including Pfizer, GlaxoSmithKline, Janssen, Novavax, and MedImmune. Prior to 2017, M. D. S. spoke at industry-sponsored symposia and attended advisory boards; payment for these activities was made to the University of Oxford and M. D. S. received no personal financial benefit from these activities. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Open Access: Free to read, but no Open Access licence.

Publisher Copyright:© The Author(s) 2019.

Citation:

Rama Kandasamy, Merryn Voysey, Sarah Collins, Guy Berbers, Hannah Robinson, Irene Noel, Harri Hughes, Susan Ndimah, Katherine Gould, Norman Fry, Carmen Sheppard, Shamez Ladhani, Matthew D Snape, Jason Hinds, Andrew J Pollard, Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom, The Journal of Infectious Diseases, Volume 221, Issue 8, 15 April 2020, Pages 1361–1370.

DOI: https://doi.org/10.1093/infdis/jiz178

Keywords

Adults
Carriage
Children
Disease
Invasive
Pneumococcus
Seroprevalence

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/infdis/jiz178

Cite this

Kandasamy, R., Voysey, M., Collins, S., Berbers, G., Robinson, H., Noel, I., Hughes, H., Ndimah, S., Gould, K., Fry, N., Sheppard, C., Ladhani, S., Snape, M. D., Hinds, J., & Pollard, A. J. (2020). Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom. Journal of Infectious Diseases, 221(8), 1361-1370. https://doi.org/10.1093/infdis/jiz178

@article{a4d7ff8f9cdf4081abf19f2a455eae79,

title = "Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom",

abstract = "Background: Following programmatic introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), there is residual carriage and disease due to PCV13-covered serotypes. Methods. PCV13-immunized children aged 13-48 months, N = 988, were enrolled between February 2014 and August 2015 (“late PCV13”), and had nasopharyngeal pneumococcal carriage compared with 7-valent pneumococcal conjugate vaccine (PCV7) immunized children, N = 567, enrolled between November 2010 and September 2011 (“early PCV13”). Nasopharyngeal pneumococci were molecularserotyped by microarray. Invasive pneumococcal disease (IPD) cases were identified through enhanced national surveillance. Results. Compared with PCV7-immunized children, carriage among PCV13-immunized children was significantly lower for serotypes 19A (odds ratio [OR], 0.08 [95% confidence interval {CI},.02-.25]), 6C (OR, 0.11 [95% CI,.03-.32]), and 7F (8 vs 0 cases). IPD incidence in children <5 years was significantly lower for serotypes 1 (incidence rate ratio [IRR], 0.03 [95% CI, 0-.19]) and 7F (IRR, 0.13 [95% CI,.05-.36]) but not 19A (IRR, 0.6 [95% CI,.3-1.12]) or serotype 3 (IRR, 2.3 [95% CI,.86-6.15]) in the late PCV13 period than in the early PCV13 period. The most significant rises in IPD incidence were for serotypes 8, 12F, and 24F. Conclusions. PCV13 has reduced serotype 19A carriage among vaccinated children. We found no impact of PCV13 on serotype 3 carriage or disease, and emergence of non-PCV13-serotype disease.",

keywords = "Adults, Carriage, Children, Disease, Invasive, Pneumococcus, Seroprevalence",

author = "Rama Kandasamy and Merryn Voysey and Sarah Collins and Guy Berbers and Hannah Robinson and Irene Noel and Harri Hughes and Susan Ndimah and Katherine Gould and Norman Fry and Carmen Sheppard and Shamez Ladhani and Snape, {Matthew D.} and Jason Hinds and Pollard, {Andrew J.}",

note = "Funding Information: This work was supported by an Investigator-Initiated Grant from Pfizer UK and the National Institute for Health Research. A. J. P. has previously conducted vaccine studies on behalf of Oxford University that were sponsored by manufacturers of pneumococcal vaccines. The University of Oxford received unrestricted educational grants from pneumococcal vaccine manufacturers in 2016. This study was funded by an investigator-initiated grant to Oxford University. A. J. P. is chair of the Department of Health{\textquoteright}s Joint Committee on Vaccination and Immunisation, but the views expressed herein do not represent necessarily those of these organizations. He is also a member of the World Health Organization{\textquoteright}s Strategic Advisory Group of Experts. R. K. received the Robert Austrian Award in Pneumococcal Vaccinology, which was supported by Pfizer, at the 10th International Symposium on Pneumococci and Pneumococcal Diseases 2016. M. D. S. is an investigator on studies conducted on behalf of the University of Oxford that are sponsored and/or funded by vaccine manufacturers including Pfizer, GlaxoSmithKline, Janssen, Novavax, and MedImmune. Prior to 2017, M. D. S. spoke at industry-sponsored symposia and attended advisory boards; payment for these activities was made to the University of Oxford and M. D. S. received no personal financial benefit from these activities. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Open Access: Free to read, but no Open Access licence. Publisher Copyright:{\textcopyright} The Author(s) 2019. Citation: Rama Kandasamy, Merryn Voysey, Sarah Collins, Guy Berbers, Hannah Robinson, Irene Noel, Harri Hughes, Susan Ndimah, Katherine Gould, Norman Fry, Carmen Sheppard, Shamez Ladhani, Matthew D Snape, Jason Hinds, Andrew J Pollard, Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom, The Journal of Infectious Diseases, Volume 221, Issue 8, 15 April 2020, Pages 1361–1370. DOI: https://doi.org/10.1093/infdis/jiz178 ",

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language = "English",

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Kandasamy, R, Voysey, M, Collins, S, Berbers, G, Robinson, H, Noel, I, Hughes, H, Ndimah, S, Gould, K, Fry, N, Sheppard, C , Ladhani, S, Snape, MD, Hinds, J & Pollard, AJ 2020, 'Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom', Journal of Infectious Diseases, vol. 221, no. 8, pp. 1361-1370. https://doi.org/10.1093/infdis/jiz178

Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom. / Kandasamy, Rama; Voysey, Merryn; Collins, Sarah et al.
In: Journal of Infectious Diseases, Vol. 221, No. 8, 10.06.2020, p. 1361-1370.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom

AU - Kandasamy, Rama

AU - Voysey, Merryn

AU - Collins, Sarah

AU - Berbers, Guy

AU - Robinson, Hannah

AU - Noel, Irene

AU - Hughes, Harri

AU - Ndimah, Susan

AU - Gould, Katherine

AU - Fry, Norman

AU - Sheppard, Carmen

AU - Ladhani, Shamez

AU - Snape, Matthew D.

AU - Hinds, Jason

AU - Pollard, Andrew J.

N1 - Funding Information: This work was supported by an Investigator-Initiated Grant from Pfizer UK and the National Institute for Health Research. A. J. P. has previously conducted vaccine studies on behalf of Oxford University that were sponsored by manufacturers of pneumococcal vaccines. The University of Oxford received unrestricted educational grants from pneumococcal vaccine manufacturers in 2016. This study was funded by an investigator-initiated grant to Oxford University. A. J. P. is chair of the Department of Health’s Joint Committee on Vaccination and Immunisation, but the views expressed herein do not represent necessarily those of these organizations. He is also a member of the World Health Organization’s Strategic Advisory Group of Experts. R. K. received the Robert Austrian Award in Pneumococcal Vaccinology, which was supported by Pfizer, at the 10th International Symposium on Pneumococci and Pneumococcal Diseases 2016. M. D. S. is an investigator on studies conducted on behalf of the University of Oxford that are sponsored and/or funded by vaccine manufacturers including Pfizer, GlaxoSmithKline, Janssen, Novavax, and MedImmune. Prior to 2017, M. D. S. spoke at industry-sponsored symposia and attended advisory boards; payment for these activities was made to the University of Oxford and M. D. S. received no personal financial benefit from these activities. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Open Access: Free to read, but no Open Access licence. Publisher Copyright:© The Author(s) 2019. Citation: Rama Kandasamy, Merryn Voysey, Sarah Collins, Guy Berbers, Hannah Robinson, Irene Noel, Harri Hughes, Susan Ndimah, Katherine Gould, Norman Fry, Carmen Sheppard, Shamez Ladhani, Matthew D Snape, Jason Hinds, Andrew J Pollard, Persistent Circulation of Vaccine Serotypes and Serotype Replacement After 5 Years of Infant Immunization With 13-Valent Pneumococcal Conjugate Vaccine in the United Kingdom, The Journal of Infectious Diseases, Volume 221, Issue 8, 15 April 2020, Pages 1361–1370. DOI: https://doi.org/10.1093/infdis/jiz178

PY - 2020/6/10

Y1 - 2020/6/10

N2 - Background: Following programmatic introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), there is residual carriage and disease due to PCV13-covered serotypes. Methods. PCV13-immunized children aged 13-48 months, N = 988, were enrolled between February 2014 and August 2015 (“late PCV13”), and had nasopharyngeal pneumococcal carriage compared with 7-valent pneumococcal conjugate vaccine (PCV7) immunized children, N = 567, enrolled between November 2010 and September 2011 (“early PCV13”). Nasopharyngeal pneumococci were molecularserotyped by microarray. Invasive pneumococcal disease (IPD) cases were identified through enhanced national surveillance. Results. Compared with PCV7-immunized children, carriage among PCV13-immunized children was significantly lower for serotypes 19A (odds ratio [OR], 0.08 [95% confidence interval {CI},.02-.25]), 6C (OR, 0.11 [95% CI,.03-.32]), and 7F (8 vs 0 cases). IPD incidence in children <5 years was significantly lower for serotypes 1 (incidence rate ratio [IRR], 0.03 [95% CI, 0-.19]) and 7F (IRR, 0.13 [95% CI,.05-.36]) but not 19A (IRR, 0.6 [95% CI,.3-1.12]) or serotype 3 (IRR, 2.3 [95% CI,.86-6.15]) in the late PCV13 period than in the early PCV13 period. The most significant rises in IPD incidence were for serotypes 8, 12F, and 24F. Conclusions. PCV13 has reduced serotype 19A carriage among vaccinated children. We found no impact of PCV13 on serotype 3 carriage or disease, and emergence of non-PCV13-serotype disease.

AB - Background: Following programmatic introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), there is residual carriage and disease due to PCV13-covered serotypes. Methods. PCV13-immunized children aged 13-48 months, N = 988, were enrolled between February 2014 and August 2015 (“late PCV13”), and had nasopharyngeal pneumococcal carriage compared with 7-valent pneumococcal conjugate vaccine (PCV7) immunized children, N = 567, enrolled between November 2010 and September 2011 (“early PCV13”). Nasopharyngeal pneumococci were molecularserotyped by microarray. Invasive pneumococcal disease (IPD) cases were identified through enhanced national surveillance. Results. Compared with PCV7-immunized children, carriage among PCV13-immunized children was significantly lower for serotypes 19A (odds ratio [OR], 0.08 [95% confidence interval {CI},.02-.25]), 6C (OR, 0.11 [95% CI,.03-.32]), and 7F (8 vs 0 cases). IPD incidence in children <5 years was significantly lower for serotypes 1 (incidence rate ratio [IRR], 0.03 [95% CI, 0-.19]) and 7F (IRR, 0.13 [95% CI,.05-.36]) but not 19A (IRR, 0.6 [95% CI,.3-1.12]) or serotype 3 (IRR, 2.3 [95% CI,.86-6.15]) in the late PCV13 period than in the early PCV13 period. The most significant rises in IPD incidence were for serotypes 8, 12F, and 24F. Conclusions. PCV13 has reduced serotype 19A carriage among vaccinated children. We found no impact of PCV13 on serotype 3 carriage or disease, and emergence of non-PCV13-serotype disease.

KW - Adults

KW - Carriage

KW - Children

KW - Disease

KW - Invasive

KW - Pneumococcus

KW - Seroprevalence

UR - http://www.scopus.com/inward/record.url?scp=85082561708&partnerID=8YFLogxK

U2 - 10.1093/infdis/jiz178

DO - 10.1093/infdis/jiz178

M3 - Article

C2 - 31004136

AN - SCOPUS:85082561708

SN - 0022-1899

VL - 221

SP - 1361

EP - 1370

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 8

ER -

Persistent circulation of vaccine serotypes and serotype replacement after 5 years of infant immunization with 13-valent pneumococcal conjugate vaccine in the United Kingdom

Abstract

Bibliographical note

Keywords

UN SDGs

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