AI Article Synopsis

  • - In 2014, the PCV13 vaccine was recommended for adults 65 and older, aiming to reduce invasive pneumococcal disease (IPD), yet cases of serotype 3 lingered despite overall declines in other serotypes.
  • - A study conducted from 2014 to 2020 within Kaiser Permanente Northern California evaluated the effectiveness of PCV13 in preventing IPD in this age group, analyzing over 610,000 participants.
  • - The findings showed that the vaccine was 61.5% effective against PCV13-serotype IPD and 46.3% effective against serotype 3, highlighting the need for ongoing monitoring of vaccine impact on IPD across different serotypes. *

Article Abstract

Background: In 2014, the Advisory Committee on Immunization Practices recommended routine use of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults age ≥ 65 years. Incidence of most PCV13-serotype cases declined, however serotype 3 cases have persisted. We estimated PCV13 vaccine effectiveness (VE) against PCV13-serotypes and serotype 3 invasive pneumococcal disease (IPD) among Kaiser Permanente Northern California (KPNC) adults.

Methods: This observational study included adults ≥65 years between September 1, 2014-December 31, 2020. We used active laboratory-based surveillance to identify and serotype all Streptococcus pneumoniae isolates obtained from normally-sterile sites. We estimated the odds ratio (OR) of vaccine-type IPD using conditional logistic regression stratified by age and calendar day, adjusting for sex, age, race, ethnicity, influenza vaccine receipt, 23-valent pneumococcal polysaccharide vaccine receipt since age 65, pneumonia risk factors, healthcare utilization, and KPNC service area. We estimated VE as (1-OR) × 100 %.

Results: There were 610,576 adults ≥65 years in the study population. By the end of the study period, PCV13 coverage was nearly 80 %. There were 307 IPD cases during the study period, of which 98 (31.9 %) were serotype 3. PCV13 was associated with a VE of 61.5 % (95 % CI: 36.2, 76.7; p < 0.001) against PCV13-serotype IPD and 46.3 % (95 % CI: -2.4, 77.9; p = 0.06) against serotype 3 IPD.

Conclusions: PCV13 vaccination protected adults ≥65 years against IPD due to PCV13 serotypes. Continued surveillance will be critical in the ≥65-year-old population to assess the impact of higher valent PCVs on IPD serotype distribution, including individual serotypes such as serotype 3.

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http://dx.doi.org/10.1016/j.vaccine.2024.126543DOI Listing

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