High Prevalence of Vaccine-Type Infections Among Children with Pneumococcal Pneumonia and Effusion After 13-Valent Pneumococcal Conjugate Vaccine Introduction in the Dominican Republic. (1st September 2021)

• Record Type: Journal Article
• Authors: Ahmed, Sana S; Lessa, Fernanda C; Coradin, Hilma; Sánchez, Jacqueline; Carvalho, Maria da G; Soda, Elizabeth; Peña, Chabela; Fernández, Josefina; Cedano, Doraliza; Whitney, Cynthia G; Feris-Iglesias, Jesús
• Is Part Of: Journal of infectious diseases. Volume 224:Supplement 3(2021)
• Page Start: S228
• Page End: S236
• Publication Date: 2021-09-01
• Subjects: Streptococcus pneumoniae -- pneumococcal pneumonia -- 13-valent pneumococcal vaccine -- Dominican Republic -- pleural effusion; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab134
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: In 2013, the Dominican Republic introduced 13-valent pneumococcal conjugate vaccine (PCV13) using a 3-dose schedule (at 2, 4 and 12 months of age). We evaluated the impact of PCV13 on serotypes causing pneumococcal pneumonia with pleural effusion. Methods: Surveillance data after PCV13 introduction (July 2014 to June 2016) were compared with data before PCV13 introduction (July 2009 to June 2011). Cases were defined as radiologic evidence of pneumonia with pleural effusion in a child aged <15 years. Pneumococcus was detected in pleural fluid by either culture or polymerase chain reaction, and serotyping was performed. The Ministry of Health's PCV13 uptake data for 2014–2016 were obtained. Results: The prevalence of pneumococcus among cases was similar before and after PCV13 introduction (56.4% and 52.8%, respectively). The proportion of pneumococcal cases caused by vaccine serotypes was 86% for children <2 years old both before and PCV13 introduction. Compared with before PCV13, serotype 14 accounted for a smaller (28% vs 13%, respectively; P = .02) and serotype 1 for a larger (23% vs 37%; P = .09) proportion of pneumococcal cases after PCV13 introduction. National uptake for the first, second, and third PCV13 doses was 94%, 81%, and 28%, respectively, in 2014 and 75%, 61%, and 26% in 2015. Discussion: While the decrease in pneumococcal pneumonia with pleural effusion caused by serotype 14 may reflect an early effect of PCV13 implementation, other vaccine serotypes, including serotype 1, are not well controlled. Better PCV13 coverage for all 3 doses is needed. Abstract : Two years after PCV13 introduction in the Dominican Republic, vaccine serotypes, including serotype 1, caused most pneumococcal pneumonia with pleural effusion, possibly due to low coverage of PCV13 booster dose. Vaccination of more birth cohorts and improved PCV13 coverage is needed.