Evaluation strategies for measuring pneumococcal conjugate vaccine impact in low-resource settings. (3rd August 2022)

• Record Type: Journal Article
• Authors: von Mollendorf, Claire; Lim, Ruth; Choummanivong, Molina; Sychareun, Vanphanom; Vilivong, Keoudomphone; Lai, Jana Y. R.; Chan, Jocelyn; Dunne, Eileen M.; Phommachanh, Sysavanh; Moore, Kerryn A.; Ortika, Belinda D.; Gray, Amy; Weaver, Rupert; Mayxay, Mayfong; Phetsouvanh, Rattanaphone; Datta, Siddhartha S.; Fox, Kimberley; Newton, Paul N.; Mulholland, Kim E.; Nguyen, Cattram D.; Dance, David A. B.; Satzke, Catherine; Russell, Fiona M.
• Is Part Of: Expert review of vaccines. Volume 21:Number 8(2022)
• Page Start: 1137
• Page End: 1145
• Publication Date: 2022-08-03
• Subjects: Children -- Laos -- lao pdr -- low-middle income country -- 13-valent pneumococcal conjugate vaccine -- vaccine impact -- surveillance; Vaccines -- Periodicals; Vaccination -- Periodicals; 615.37205
• DOI: 10.1080/14760584.2021.1965474
• Languages: English
• ISSNs: 1476-0584

Abstract

ABSTRACT: Objectives: Pneumococcal conjugate vaccines (PCVs) are effective in reducing pneumococcal disease. We measured 13-valent PCV (PCV13) effect on different pneumococcal outcomes using diverse studies in Lao People's Democratic Republic. Methods: Studies included: pre-PCV13 population-based record review of hospitalized childhood pneumonia cases; acute respiratory infection (ARI) study post-PCV13 to demonstrate effectiveness (VE) against hypoxic pneumonia; invasive pneumococcal disease (IPD) surveillance in all ages (2004–2018); carriage studies in children hospitalized with ARI (2013–2019); community carriage surveys pre- and post-PCV13. Results: Annual pneumonia incidence rate in children pre-PCV13 was 1, 530 (95% confidence interval [CI] 1, 477–1, 584) per 100, 000. Adjusted VE against hypoxic pneumonia was 37% (95% CI 6–57%). For IPD, 85% (11/13) of cases were due to vaccine-types pre-PCV13, and 43% (3/7) post-PCV13 in children aged <5 years; for ≥5 years, 61% (27/44) and 42% (17/40), respectively. For ARI cases, adjusted VE for vaccine-type carriage was 39% (95% CI 4–60) in <5 year olds; slightly higher than community surveys (23% [95% CI 4–39%] in 12–23 month olds). Conclusions: Despite limited baseline data, we found evidence of PCV13 impact on disease and carriage. Our approach could be used in similar settings to augment existing WHO PCV evaluation guidelines.