442. Invasive Pneumococcal Disease (IPD) in Young Children in Israel shortly after Sequential Introduction of PCV7 followed by PCV13
Session: Poster Abstract Session: Pneumococcal Vaccine in Children and Adults
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Shalom Poster-IDSA 2013 23.9.13.pdf (1.0 MB)
  • Background: The 7-valent pneumococcal conjugated vaccine (PCV7) was introduced to the Israeli national immunization plan (NIP) in July 2009, with a fast reduction of PCV7 serotypes disease (Ben-Shimol et al. Vaccine 2012 ;30:6600-7). In November 2010, PCV13 was introduced to the Israeli NIP without any catch-up and gradually replaced PCV7. Our aim was to report PCVs impact on IPD in children <5 years in Israel, after PCVs introduction to the NIP.

    Methods: An ongoing, nationwide, prospective, population-based, active surveillance, initiated in 1989. All children <5 years with IPD episode (S. pneumoniae isolated from blood, CSF or both) were included.

    Results: Total IPD incidence (per 100,000) declined from a mean of 50.22.1 in the pre-PCV era (July 2004 through June 2009) by 38% and 71% in 2009-2010 (PCV7 era) and 2012-2013 (PCV13 era), respectively (Figure 1).

    Comparing the years 2012 vs. mean 2003-2008, over 90% reduction of IPD caused by PCV7 serotypes and serotype 6A was observed, rates of serotypes 1, 3, 5, 7F and 19A (grouped) declined by 57% and incidence of IPD caused by non-PCV13 serotypes, increased by 84% (Table 1).

    Conclusion: Substantial reduction of PCV13 serotypes IPD in children <5 years was observed shortly after PCV13 introduction to the NIP, while maintaining PCV7 impact. A continuous surveillance is needed to determine PCV13 effect on IPD caused by non-vaccine serotypes.

    Table 1: Serotype-specific IPD Incidence per 100,000 in Israeli children <5 Years, 2003 2012

    Year

    Serotypes

    7VT

    6A

    19A

    1,3,5,7F

    Non-13VT

    2003

    28.9

    3.3

    4.5

    10.7

    5.1

    2004

    25.9

    2.4

    4.3

    6.1

    7.4

    2005

    28.7

    4.1

    4.5

    12.0

    5.5

    2006

    25.5

    5.1

    3.3

    8.5

    6.1

    2007

    30.1

    2.5

    4.4

    9.0

    5.6

    2008

    25.7

    2.5

    4.8

    10.6

    3.5

    2009

    15.9

    2.9

    5.5

    8.8

    5.8

    2010

    5.4

    0.6

    4.5

    10.6

    8.2

    2011

    1.8

    0.8

    3.5

    15.0

    9.9

    2012

    1.0

    0.2

    1.1

    4.8

    10.2

    Relative Risk

    0.04*

    0.06*

    0.26*

    0.51*

    1.84*

     

    7VT serotypes included in PCV7, Non-13VT serotypes not included in PCV13, Relative Risk: comparing 2012 vs. mean 2003-2008.

    *P-value <0.001


    Shalom Ben-Shimol, MD1, David Greenberg, MD1, Noga Givon-Lavi, PhD1, Yechiel Schlesinger, MD2, Eli Somekh, MD3, Shraga Aviner, MD4, Dan Miron, MD5, Ron Dagan, MD1 and on behalf of the Israel Bacteremia and Meningitis Surveillance Group, (1)Ben-Gurion Univ of the Negev and Soroka Univ Med Ctr, Beer-Sheva, Israel, (2)Shaare Zedek Med Ctr, Jerusalem, Israel, (3)Wolfson Medical Center, Holon, Israel, (4)Barzilai Med Ctr, Ashkelon, Israel, (5)Haemek Med Ctr, Afula, Israel

    Disclosures:

    S. Ben-Shimol, None

    D. Greenberg, Pfizer: Speaker's Bureau, Speaker honorarium
    MSD: Investigator, Scientific Advisor and Speaker's Bureau, Consulting fee, Research grant and Speaker honorarium
    GSK: Scientific Advisor and Speaker's Bureau, Consulting fee and Speaker honorarium

    N. Givon-Lavi, None

    Y. Schlesinger, None

    E. Somekh, None

    S. Aviner, None

    D. Miron, None

    R. Dagan, Pfizer: Investigator, Scientific Advisor and Speaker's Bureau, Consulting fee, Research grant and Speaker honorarium
    Berna/Crucell: Investigator, Scientific Advisor and Speaker's Bureau, Consulting fee, Research grant and Speaker honorarium
    MSD: Investigator and Scientific Advisor, Consulting fee and Research grant
    Novartis: Investigator and Scientific Advisor, Consulting fee and Research grant
    Novartis: Scientific Advisor, Consulting fee
    Protea/NASVAX: Investigator, Scientific Advisor and Shareholder, Consulting fee, Research grant and shares

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.