Program Schedule

1091
Serotype Distribution of S. pneumoniae Community Acquired Pneumonia (CAP) in Adults in the Netherlands in the CAPiTA (Community-Acquired Pneumonia Immunization Trial In Adults) Study Period

Session: Poster Abstract Session: Vaccines: Pneumococcal
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • PAP14187.3030.pdf (954.3 kB)
  • Background: The CAPiTA (Community-Acquired Pneumonia Immunization Trial in Adults) trial was conducted in the Netherlands from Sept 2008-Oct 2013 to evaluate the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) for the prevention of vaccine-type (VT) pneumococcal community-acquired pneumonia (CAP) in adults aged ≥65 years.  This trial provides a unique opportunity to evaluate the serotype distribution of PCV13 serotypes in CAP in adults over time in a setting where pneumococcal conjugate vaccines have been part of the infant national immunization program (NIP) since 2006, and where 23-valent pneumococcal polysaccharide vaccine (PPSV23) is not routinely administered to adults aged 65+.

    Methods: In this double-blind, placebo-controlled, study, 84,496 immunocompetent adults aged ≥65 years were vaccinated with a single dose of PCV13 or placebo. The study continued until a pre-specified number of VT-CAP cases had occurred; episodes were identified using a PCV13-serotype-specific urinary antigen detection assay or by isolation of VT pneumococcus from a sterile site. Seven-valent pneumococcal conjugate vaccine (PCV7) was introduced for Dutch infants in 2006 as a 3+1 schedule, replaced by ten-valent pneumococcal conjugate vaccine (PCV10) in 2011; vaccination uptake is ~95%. Serotype distribution of PCV13 serotypes overall, and among placebo recipients (as a surrogate for the 65+ Dutch population) is described for each study year.

    Results: All 13 PCV13 serotypes were confirmed among first episodes of VT-CAP (per-protocol population) over the duration of the study; most frequently identified were serotypes 1, 3, 7F, 19A. There were 4 episodes of PCV7-type CAP in placebo recipients in 2009, 3 in 2010, 6 in 2011, 2 in 2012, and 3 in 2013. For the additional serotypes in PCV13, there were 12, 17, 18, 16, and 9 episodes in 2009, 2010, 2011, 2012, and 2013 (7 months only), respectively. 

    Conclusion: Despite an infant NIP recommending PCV10, the most frequently observed serotypes in CAP among CAPiTA subjects included 1 and 7F. PCV7 serotypes persisted and their prevalence remained stable over the study. Furthermore, there was no evidence of a change in the frequency of the additional PCV13 serotypes.

    Rosalind Hollingsworth, PhD1, Susanne M Huijts, MD2, Marieke Bolkenbaas, MD2, Chris Webber, MD, PhD3, Samantha Gault, Msc3, Scott D. Patterson, PhD1, William Gruber, MD4, Diederick E. Grobbee, MD, PhD2,5, Marc Bonten, MD PhD2,6 and CAPiTA study team, (1)Pfizer Vaccine Clinical Research, Collegeville, PA, (2)Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands, (3)Pfizer Vaccine Clinical Research, Maidenhead, United Kingdom, (4)Pfizer Vaccine Clinical Research, Pearl River, NY, (5)Julius Clinical, Zeist, Netherlands, (6)Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands

    Disclosures:

    R. Hollingsworth, Pfizer Vaccine Clinical Research: Employee and Shareholder, Salary

    S. M. Huijts, None

    M. Bolkenbaas, None

    C. Webber, Pfizer Vaccines Clinical Research: Employee and Shareholder, Salary

    S. Gault, Pfizer Vaccine Clinical Research: Employee and Shareholder, Salary

    S. D. Patterson, Pfizer Vaccines Clinical Research: Employee, Salary

    W. Gruber, Pfizer Vaccines Clinical Research: Employee and Shareholder, Salary

    D. E. Grobbee, Pfizer Vaccines Clinical Research: Investigator, Research grant

    M. Bonten, Pfizer Vaccines Clinical Research: Investigator, Research grant

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