1219. Impact of 13-Valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease, U.S, 2010-11
Session: Oral Abstract Session: Childhood Vaccines: New Epidemiology
Friday, October 19, 2012: 3:00 PM
Room: Ballroom 6 DE

Background: Pediatric use of 7-valent pneumococcal conjugate vaccine (PCV7) dramatically reduced the incidence of invasive pneumococcal disease (IPD) among children (direct effects) and adults (indirect effects). U.S. introduction of 13-valent pneumococcal conjugate vaccine (PCV13) began in March 2010. We evaluated the impact of routine PCV13 use on rates of IPD among children and adults.

Methods: IPD cases (isolation of pneumococcus from sterile sites) were identified through 10 Active Bacterial Core surveillance (ABCs) sites. Isolates were serotyped at reference laboratories. To distinguish effects of PCV13 from residual effects of PCV7, we focused on the 6 serotypes (PCV6) included in PCV13 that are not included in PCV7. We compared quarterly rates (cases per 100,000) of IPD in 2011 with baseline rates from 2006-08 (excluding 2009, year of influenza pandemic). To account for multiple comparisons, we considered P<0.0025 as significant.

Results: During 2006-2008 and 2011, 12,181 and 3,523 cases of IPD were identified, respectively; 88% of isolates had serotype results. Among children <5 years old, a statistically significant reduction (65%) in the rate of PCV6-type IPD was evident by the first quarter of 2011. By the second quarter of 2011, reductions were evident among adults ≥65 years old. By the fourth quarter of 2011, rates of PCV6-type IPD had declined by nearly 90% among children <5 years old and by 45-64% among all adult age groups (Table). Reductions were driven primarily by declines in serotypes 19A and 7F.

Table. Change in rates, expressed as cases per 100,000, of PCV6-type IPD by age and quarter, 2011 vs. baseline (2006-2008).

 

Jan-Mar

Apr-Jun

Jul-Sep

Oct-Dec

Age, yrs

Baseline

2011

% Change

Baseline

2011

% Change

Baseline

2011

% Change

Baseline

2011

% Change

<5

16.5

5.7

-65*

12.8

2.9

-77*

6.4

1.7

-73*

15.8

1.9

-88*

5-17

2.1

1.5

-29

1.7

0.8

-53

0.7

0.2

-71

1.9

0.9

-53

18-49

5.2

3.7

-29

3.1

2.0

-35

1.5

1.0

-33

3.9

1.4

-64*

50-64

10.8

11.9

10

7.4

5.9

-20

3.5

2.4

-31

9.7

5.3

-45*

>65

19.4

13.7

-29

11.9

6.7

-44*

3.9

3.4

-13

18.4

7.1

-61*

*P<0.0025

Conclusion: PCV13 introduction was followed by rapid and dramatic reductions in the incidence of IPD caused by the 6 new serotypes included in the vaccine. Indirect effects of PCV13 use in children are evident in all adult age groups.

Matthew Moore, MD, MPH1, Ruth Link-Gelles, MPH2, Monica M. Farley, MD3, William Schaffner, MD4, Ann Thomas, MD, MPH5, Arthur Reingold, MD6, Lee Harrison, MD7, Catherine Lexau, PhD, MPH, RN8, Shelley Zansky, PhD9, Susan Petit, MPH10, Ken Gershman, MD11, Karen Scherzinger, MS12, Kerry MacInnes13, Bernard Beall, PhD1 and C. Whitney, MD, MPH14, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Centers for Disease Control & Prevention, Atlanta, GA, (3)Emory University / VA Medical Center, Decatur, GA, (4)Vanderbilt University School of Medicine, Nashville, TN, (5)Oregon Public Health Division, Portland, OR, (6)CA EIP, Berkeley, CA, (7)University of Pittsburgh Graduate School, Pittsburgh, PA, (8)Infectious Disease Epidemiology Prevention and Control, Minnesota Department of Health, St. Paul, MN, (9)NY State Dept of Health, Albany, NY, (10)Connecticut Emerging Infections Program, New Haven, CT, (11)Colorado Department of Public Health and Environment, Denver, CO, (12)University of New Mexico, Albuquerque, NM, (13)Minnesota Dept. of Health, St. Paul, MN, (14)CDC, Atlanta, GA

Disclosures:

M. Moore, None

R. Link-Gelles, None

M. M. Farley, None

W. Schaffner, Sanofi-pasteur: Consultant, Consulting fee
GSK: Consultant, Consulting fee
Pfizer: Consultant, Consulting fee
Merck: Consultant, Consulting fee

A. Thomas, None

A. Reingold, None

L. Harrison, Pfizer: Consultant, Independent Contractor and Scientific Advisor, Consulting fee

C. Lexau, None

S. Zansky, None

S. Petit, None

K. Gershman, None

K. Scherzinger, None

K. MacInnes, None

B. Beall, None

C. Whitney, None

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