1892. Primary School Children Constitute an Important Pneumococcal Vaccine Serotype (VT) Reservoir, 5 Years after Initiation of Widespread Pneumococcal Conjugate Vaccine (PCV) Program
Session: Poster Abstract Session: Vaccines: PCV
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • POSTER IDWeek 2015 School carriage 25-9-2015.pdf (2.0 MB)
  • Background: A major constituent of PCV impact on mordibity burden is the indirect protection (herd protection) achieved by reducing nasopharyngeal pneumococcal carrige (NPPnC) in vaccinated individuals.  Reduction in NPPnC in older children (who were either non-vaccinated or are several years post-vaccination) is delayed.  We studied NPPnC in primary school children 6-10 years old, in an attempt to evaluate this population as a potential reservoir of VT in the community, 5 years post initiation of PCV National Immunization Plan in Israel.

    Methods: PCV7 was introduced to Israel National Immunization Plan in Jul 2009 (3 dose regimen: ages 2, 4, 12m) and was gradually replaced by PCV13 from Nov 2010.  2 distinct ethnic populations, Jews and Bedouins, inhabit  the region. The latter are of lower socio-economic conditions, with higher crowding and a higher number of children per family. We initiated an ongoing surveillance in primary school children from these two ethnic populations, by obtaining nasopharyngeal cultures 3 times yearly: Fall, winter and spring.  Serotypes were determined by the Quellung reaction.

    Results: Overall,  3263 cultures were obtained during the 5-year study period in children attending the first 4 years of primary school (Figure 1).  From 2010-11 to 2013-14, carriage of PCV13 serotype was reduced by 63% from 15.1% to 5.6% (P<0.001). Carriage of  PCV7 serotypes and  serotype 6A were reduced by 70% and 84%, respectively (p<0.001 for both); serotypes 1, 5 and 7F (grouped) were reduced by 68% (p=0.07 ); and serotypes 3 and 19A have not yet achieved a reduction. NPPnC rate was lower significantly in Jewish children than in Bedouin children and in children 6-8 years old vs. children 9-10 years old (P<0.001) (Figure 2).  The main drastic reduction (81%) from 15.8% to 3.0% (P<0.001) was seen among Bedouin children in PCV7 serotypes + serotype 6A.

    Conclusion: A significant reduction in carriage of vaccine serotypes in early school children indicated an important impact of PCV7/13 introduction on circulation of these serotypes in the community.  However, 5 years after PCV introduction, early school children still serve as an important vaccine serotype reservoir.

    Description: Y:\DAGAN 2015\ABSTRACTS 2015\IDWEEK School 2015 figure 1.jpgDescription: Y:\DAGAN 2015\ABSTRACTS 2015\IDWEEK School 2015 figure 2.jpg

    David Greenberg, MD, Noga Givon-Lavi, PhD, Shalom Ben-Shimol, MD and Ron Dagan, MD, FIDSA, Soroka Univ Med Ctr and Ben-Gurion Univ, Beer-Sheva, Israel

    Disclosures:

    D. Greenberg, Pfizer: Consultant and Speaker's Bureau , Consulting fee and Speaker honorarium
    GlaxoSmithKline: Consultant and Speaker's Bureau , Consulting fee and Speaker honorarium
    Merck Sharp & Dohme: Consultant , Grant Investigator and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium

    N. Givon-Lavi, None

    S. Ben-Shimol, None

    R. Dagan, Genocea: Consultant and Scientific Advisor , Consulting fee
    MeMed: Consultant and Scientific Advisor , Consulting fee
    Merck Sharpe and Dohme: Consultant , Grant Investigator and Scientific Advisor , Consulting fee and Research grant
    GlaxoSmithKline: Speaker's Bureau , Speaker honorarium
    Pfizer: Consultant , Grant Investigator , Scientific Advisor and Speaker's Bureau , Consulting fee , Research grant and Speaker honorarium

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