914. Direct and Indirect Impact of 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Use on Invasive Pneumococcal Disease (IPD) among Children and Adults
Session: Oral Abstract Session: Vaccines, Vaccine Preventable Disease, and their Impact
Friday, October 28, 2016: 9:15 AM
Room: 275-277
Background: In February 2010, PCV13 was introduced for routine use among children aged <5 years. In June 2012, PCV13 was recommended for use in series with 23-valent polysaccharide vaccine (PPSV23) for adults ≥19 years with select medical conditions, and in August 2014, for all adults ≥65 years. We evaluated the direct and indirect effects of PCV13 5 years post-introduction on invasive pneumococcal disease (IPD).

Methods: IPD cases (isolation of pneumococcus from sterile sites) were identified among residents of Active Bacterial Core surveillance (ABCs) sites during July 2007–June 2015. Isolates were serotyped by Quellung and classified as PCV13 or non-PCV13. Incidence changes were estimated as percent changes (one minus rate ratio) and 95% confidence intervals (95%CI) between pre-PCV13 (2007-2009) and post-PCV13 (2013-2015) periods.

Results: ABCs identified 13,990 IPD cases, with 1321 cases among children <5 years. During post-PCV13 period, overall IPD rates declined by 27%-58% among all age groups (Figure). Significant reductions in PCV13-type IPD incidence were observed for all age groups, with 88% (95%CI 83-92) and 69% (95%CI 64-74) decline among children <5 years and adults >65 years, respectively. PCV13-type IPD reductions were driven by serotypes 19A and 7F. During the post-PCV13 period, 19.8% of IPD was due to PCV13 types. No significant increases were found in non-PCV13-type IPD. No significant changes were noted in IPD caused by types unique to PPSV23. Largest absolute increases in incidence were observed for serotypes 15B, 23B, and 35B (0.2 cases/100,000 each) among children <5 years and serotypes 23B, 20, and 8 (0.3/100,000 each) among adults ≥65 years. In 2010-2014, an estimated 230,000 IPD cases and 16,500 deaths were prevented among all ages through PCV13 use in the US.

Conclusion: PCV13 use among children reduced IPD incidence among children and adults. To date, we found no evidence of significant replacement disease with non-PCV13 types.

Tamara Pilishvili, MPH1, Ryan Gierke, MPH2, Monica Farley, MD, FIDSA3, William Schaffner, MD, FIDSA, FSHEA4, Ann Thomas, MD, MPH5, Arthur Reingold, MD, FIDSA6, Lee Harrison, MD7, Ruth Lynfield, MD, FIDSA8, S Zansky, PhD9, Susan Petit, MPH10, Lisa Miller, MD, MSPH11, Joseph Bareta, MS12, Bernard Beall, PhD13, Matthew R. Moore, MD13 and Cynthia Whitney, MD, MPH, FIDSA13, (1)National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, (2)Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, (3)Department of Medicine, Emory University School of Medicine and Atlanta VA Medical Center, Atlanta, GA, (4)Vanderbilt University School of Medicine, Nashville, TN, (5)Department of Human Services, Health Services, Portland, OR, (6)University of California - Berkeley, Berkeley, CA, (7)University of Pittsburgh, Pittsburgh, PA, (8)Minnesota Department of Health, St. Paul, MN, (9)NYS Dept. of Health EIP, Albany, NY, (10)Connecticut Emerging Infections Program, New Haven, CT, (11)Colorado Department of Public Health and Environment, Denver, CO, (12)New Mexico Department of Health, Santa Fe, NM, (13)Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

T. Pilishvili, None

R. Gierke, None

M. Farley, None

W. Schaffner, None

A. Thomas, None

A. Reingold, None

L. Harrison, None

R. Lynfield, None

S. Zansky, None

S. Petit, None

L. Miller, None

J. Bareta, None

B. Beall, None

M. R. Moore, None

C. Whitney, None

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