Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease among children in the United States between 2010 and 2019: An indirect cohort study

Kristin L Andrejko; Ryan Gierke; Jemma V Rowlands; Jennifer B Rosen; Ann Thomas; Zachary Q Landis; Maria Rosales; Sue Petit; William Schaffner; Corinne Holtzman; Meghan Barnes; Monica M Farley; Lee H Harrison; Lesley McGee; Sopio Chochua; Jennifer R Verani; Adam L Cohen; Tamara Pilishvili; Miwako Kobayashi

doi:10.1016/j.vaccine.2024.04.061

Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease among children in the United States between 2010 and 2019: An indirect cohort study

Vaccine. 2024 May 3:S0264-410X(24)00499-7. doi: 10.1016/j.vaccine.2024.04.061. Online ahead of print.

Authors

Kristin L Andrejko¹, Ryan Gierke², Jemma V Rowlands³, Jennifer B Rosen⁴, Ann Thomas⁵, Zachary Q Landis⁶, Maria Rosales⁷, Sue Petit⁸, William Schaffner⁹, Corinne Holtzman¹⁰, Meghan Barnes¹¹, Monica M Farley¹², Lee H Harrison¹³, Lesley McGee², Sopio Chochua², Jennifer R Verani², Adam L Cohen², Tamara Pilishvili², Miwako Kobayashi²

Affiliations

¹ Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: kandrejko@cdc.gov.
² Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
³ New York State Department of Health, New York, NY, USA.
⁴ Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York, NY, USA.
⁵ Oregon Public Health Division, Portland, OR, USA.
⁶ New Mexico Department of Health, Santa Fe, NM, USA.
⁷ California Emerging Infections Program, Richmond, CA, USA.
⁸ Connecticut Department of Public Health, Hartford, CT, USA.
⁹ Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA.
¹⁰ Minnesota Department of Health, St. Paul, MN, USA.
¹¹ Colorado Department of Public Health and Environment, Denver, CO, USA.
¹² Department of Medicine, Emory University School of Medicine and Atlanta VA Medical Center, Atlanta, GA, USA.
¹³ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

PMID: 38704263
DOI: 10.1016/j.vaccine.2024.04.061

Abstract

Background: A U.S. case-control study (2010-2014) demonstrated vaccine effectiveness (VE) for ≥ 1 dose of the thirteen-valent pneumococcal conjugate vaccine (PCV13) against vaccine-type (VT) invasive pneumococcal disease (IPD) at 86 %; however, it lacked statistical power to examine VE by number of doses and against individual serotypes.

Methods: We used the indirect cohort method to estimate PCV13 VE against VT-IPD among children aged < 5 years in the United States from May 1, 2010 through December 31, 2019 using cases from CDC's Active Bacterial Core surveillance, including cases enrolled in a matched case-control study (2010-2014). Cases and controls were defined as individuals with VT-IPD and non-PCV13-type-IPD (NVT-IPD), respectively. We estimated absolute VE using the adjusted odds ratio of prior PCV13 receipt (1-aOR x 100 %).

Results: Among 1,161 IPD cases, 223 (19.2 %) were VT cases and 938 (80.8 %) were NVT controls. Of those, 108 cases (48.4 %; 108/223) and 600 controls (64.0 %; 600/938) had received > 3 PCV13 doses; 23 cases (17.6 %) and 15 controls (2.4 %) had received no PCV doses. VE ≥ 3 PCV13 doses against VT-IPD was 90.2 % (95 % Confidence Interval75.4-96.1 %), respectively. Among the most commonly circulating VT-IPD serotypes, VE of ≥ 3 PCV13 doses was 86.8 % (73.7-93.3 %), 50.2 % (28.4-80.5 %), and 93.8 % (69.8-98.8 %) against serotypes 19A, 3, and 19F, respectively.

Conclusions: At least three doses of PCV13 continue to be effective in preventing VT-IPD among children aged < 5 years in the US. PCV13 was protective against serotypes 19A and 19F IPD; protection against serotype 3 IPD did not reach statistical significance.

Keywords: 13-valent pneumococcal conjugate vaccine; Indirect cohort; Invasive pneumococcal disease; Pneumococcal infections; Streptococcus pneumoniae; Vaccine effectiveness.