Update on the success of the pneumococcal conjugate vaccine

Question 1

What is the reduction of vaccine serotype invasive pneumococcal infections since introduction of PCV7?

Answer 1

94% in PCV7 serotype invasive pneumococcal disease in <2yo

79% overall invasive pneumococcal disease in <2yo

Question 2

What percentage of invasive pneumococcal infections are meningitis?

Answer 2

7%

Question 3

What is the reduction of pneumococcal meningitis since introduction of PCV7?

Answer 3

97% PCV7 serotype meningitis in <5yo
64% all ipneumococcal meningitis in <5yo
78% increase in non-PCV7 serotype meningitis in <5yo

Question 4

What is the reduction of pneumococcal pneumonia hospitalizations since introduction of PCV7?

Answer 4

72% decline in lobar pneumonia in <5yo

13% decline in all-cause pneumonia in <5yo

Question 5

What is the reduction of OM and myringotomy tube placements since introduction of PCV7?

Answer 5

17-28% reduction in OM in <2yo

16-23% decline in myringotomy tube placement in <2yo

Question 6

What is the effect of replacement IPD with nonvaccine serotypes?

Answer 6

Non-PCV7 serotypes including 19A have increased but overall rates of pneumococcal disease have decreased

Question 7

What are the trends regarding increasing complicated empyema and introduction of PCV7?

Answer 7

Increases started prior to introduction of PCV7 so unclear as to the cause

Question 8

What is the recommended vaccine schedule for healthy children?

Answer 8

A two or three infant dose schedule with booster dose >12mo are equally effective in low risk children

Question 9

What is the recommended vaccine schedule for high risk children?

Answer 9

High risk children should receive the four dose schedule

Question 10

What are recommendations from 2010 regarding PCV?

Answer 10

1. There is good evidence to recommend PCV13 for a routine infant immunization schedule.
2. There is good evidence for a three-dose PCV7 schedule in healthy infants; however, there is insufficient evidence for a three-dose PCV10 or PCV13 schedule. Therefore, currently, a four-dose routine schedule is recommended.
3. There is good evidence that all healthy children 12 to 35 months of age should receive one dose of PCV13 and fair evidence that children at high risk for IPD should additionally receive a dose of 23-valent polysaccharide pneumococcal vaccine after two years of age.
4. There is good evidence that, for children 36 to 59 months of age, healthy Aboriginal children, children attending group daycare and children at high risk for IPD should receive a dose of PCV13, and that a dose should be considered for all other children in this age group.
5. There is fair evidence to suggest that children at high risk for IPD who are five years of age and older should receive a dose of PCV13.