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Imputing direct and indirect vaccine effectiveness of childhood pneumococcal conjugate vaccine against invasive disease by surveying temporal changes in nasopharyngeal pneumococcal colonization
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Nzenze, Susan A., Madhi, Shabir A., Shiri, Tinevimbo, Klugman, Keith P., de Gouveia, Linda, Moore, David P., Karstaedt, Alan S., Tempia, Stefano, Nunes, Marta C. and von Gottberg, Anne (2017) Imputing direct and indirect vaccine effectiveness of childhood pneumococcal conjugate vaccine against invasive disease by surveying temporal changes in nasopharyngeal pneumococcal colonization. American Journal of Epidemiology, 186 (4). pp. 435-444. doi:10.1093/aje/kwx048 ISSN 0002-9262.
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Official URL: https://doi.org/10.1093/aje/kwx048
Abstract
The limited capabilities in most low-middle income countries to study the benefit of pneumococcal conjugate vaccine (PCV) against invasive pneumococcal disease (IPD), calls for alternate strategies to assess this. We used a mathematical model, to predict the direct and indirect effectiveness of PCV by analyzing serotype specific colonization prevalence and IPD incidence prior to and following childhood PCV immunization in South Africa. We analyzed IPD incidence from 2005-2012 and colonization studies undertaken in HIV-uninfected and HIV-infected child-mother dyads from 2007-2009 (pre-PCV era), in 2010 (7-valent PCV era) and 2012 (13-valent PCV era). We compared the model-predicted to observed changes in IPD incidence, stratified by HIV-status in children >3 months to 5 years and also in women aged >18-45 years. We observed reductions in vaccine-serotype colonization and IPD due to vaccine serotypes among children and women after PCV introduction. Using the changes in vaccine-serotype colonization data, the model-predicted changes in vaccine-serotype IPD incidence rates were similar to the observed changes in PCV-unvaccinated children and adults, but not among children <24 months. Surveillance of colonization prior and following PCV use can be used to impute PCVs' indirect associations in unvaccinated age groups, including in high HIV-prevalence settings.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RC Internal medicine | |||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Pneumococcal vaccine -- Effectiveness -- Mathematical models | |||||||||
| Journal or Publication Title: | American Journal of Epidemiology | |||||||||
| Publisher: | Oxford University Press | |||||||||
| ISSN: | 0002-9262 | |||||||||
| Official Date: | 15 August 2017 | |||||||||
| Dates: |
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| Volume: | 186 | |||||||||
| Number: | 4 | |||||||||
| Page Range: | pp. 435-444 | |||||||||
| DOI: | 10.1093/aje/kwx048 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Restricted or Subscription Access | |||||||||
| Date of first compliant deposit: | 2 June 2017 | |||||||||
| Date of first compliant Open Access: | 6 May 2018 | |||||||||
| Funder: | National Research Foundation (South Africa) (NRF), South African Medical Research Council | |||||||||
| RIOXX Funder/Project Grant: |
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