Invasive pneumococcal disease in children under 16 years of age: Incomplete rebound in incidence after the maximum effect of PCV13 in 2012/13 in Germany. Issue 4 (25th January 2018)

• Record Type: Journal Article
• Authors: Weinberger, Raphael; von Kries, Rüdiger; van der Linden, Mark; Rieck, Thorsten; Siedler, Anette; Falkenhorst, Gerhard
• Is Part Of: Vaccine. Volume 36:Issue 4(2018)
• Page Start: 572
• Page End: 577
• Publication Date: 2018-01-25
• Subjects: Invasive pneumococcal disease -- Pneumococcal conjugate vaccination -- School-aged children -- Germany; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2017.11.085
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Objective: To identify a potential nadir of the impact of pneumococcal conjugate vaccination (PCV) in infancy on invasive pneumococcal diseases (IPD) in children under 16 in Germany. Methods: Active surveillance on IPD based on two independent data sources with capture-recapture correction for underreporting. Annual incidence rates by age group, serotypes, site of infection, and relative incidence reduction compared to pre-vaccination period (1997–2001) at nadir and for the most recent season are reported. We calculated vaccine coverage at the age of 24 months using health insurance claims data. Results: 96–97% of children had received at least two doses of PCV since 2009. The maximum impact on overall IPD incidence was achieved in 2012/13 (−48% [95% CI: −55%; −39%]) with a rebound to −26% [95% CI: −36%; −16%] in 2015/16. Non-PCV13 serotypes accounted for 84.1% of the IPD cases in 2015/16. The most frequent non-PCV serotypes in IPD in 2014/15 and 2015/16 were 10A, 24F, 15C, 12F, 38, 22F, 23B, and 15B. The impact at nadir was highest in children 0–1 years of age both in meningitis and non-meningitis cases, whereas the impact for other age groups was higher for meningitis cases. The rebound mainly pertained to non-meningitis cases. Conclusion: The maximum impact of pneumococcal conjugate vaccination has been attained and signs of a rebound are apparent. Sustained surveillance for IPD in children is warranted to assess whether these trends will continue. There may be a need for vaccines using antigens common to all serotypes.