Clinical Efficacy of Pneumococcal Conjugate 13-valent Vaccine in Young Children

Objective: Our aim was to study the clinical efficacy of pneumococcal conjugate 13-valent vaccine (PCV13) in children aged less than 3 years.

Methods: retrospective comparative study of the incidence of acute respiratory infections (ARI), otitis and pneumonia during the first three years of life in 184 children vaccinated with PKV13 and 186 unvaccinated peers.

Results: 91 of 184 children (49.4%) were vaccinated during the 1st year of life, 61 (33.2%) — during the 2nd year, and 32 (17.4%) — during the 3rd year. Number of ARI per 1 child among children vaccinated in the 1st year of life was 5.5 times less than among unvaccinated children (0.42 and 2.31 cases); frequency of otitis during the second year of life was 6.8 times less (7.6% and 52.1%, р < 0,01), and during the third — 34.7 times less (1.1% and 38.2%, р < 0,01). All children vaccinated before the age of 1 were 6.3 times less (1.1% and 6.9%) ill with pneumonias. Additionally it was noted that number of ARI per 1 person among children, vaccinated during the 1st year of life, during the third year of life was lower than among children vaccinated later (0.42; 1.02; 2.03 respectively). There also was a significant in otitis number between children vaccinated during the first and the third years of life (1.1 and 15.6% р < 0,01).

Conclusion: to reduce the incidence of ARI, otitis and pneumonia in children, it is necessary to vaccinate children with PCV13 in the age under 1 year. «Catching up» immunization of the second and third years of life is effective, but to a lesser extent.

1. who.int [Internet]. The Weekly Epidemiological Record (WER). Pneumococcal vaccines WHO position paper — 2012 [cited 2016 Sep 9]. Available from: http://www.who.int/wer.

2. Plotkin SA, Orenstein W, Offit PA. Vaccines. 6th ed. Edinburgh: Elsevier Inc; 2013. 3690 р.

3. European Centre for Disease Prevention and Control. Surveillance of invasive pneumococcal disease in Europe, 2010. Stockholm: ECDC; 2012. 45 р.

4. Вакцинопрофилактика пневмококковой инфекции. Руко водство для врачей / Под ред. Л.С. Намазовой-Барановой. — М.: ПедиатрЪ; 2016. — 31 с. [Vaktsinoprofilaktika pnevmokokkovoi infektsii. Rukovodstvo dlya vrachei. Ed by L.S. Namazova-Baranova. Moscow: Pediatr; 2016. 31 p. (In Russ).]

5. WHO/UNICEF. Ending preventable child deaths from pneumonia and diarrhoea by 2025. The integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD) [Internet]. 2013. 64 p. [cited 2016 Oct 9] Available from: http://www.who.int/maternal_child_adolescent/documents/global_action_plan_pneumoni a_diarrhoea/en/.

6. Tamir SO, Roth Y, Dalal I, et al. Changing trends of acute otitis media bacteriology in central Israel in the pneumococcal conjugate vaccines era. Pediatr Infect Dis J. 2015;34(2):195–199. doi: 10.1097/INF.0000000000000536.

7. О состоянии санитарно-эпидемиологического благополучия населения в Российской Федерации в 2014 г. Государственный доклад. — М.: Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; 2015. — 206 с. [O sostoyanii sanitarno-epidemiologicheskogo blagopoluchiya naseleniya v Rossiiskoi Federatsii v 2014 g. Gosudarstvennyi doklad. Moscow: Federal’naya sluzhba po nadzoru v sfere zashchity prav potrebitelei i blagopoluchiya cheloveka; 2015. 206 p. (In Russ).]

8. О состоянии санитарно-эпидемиологического благополучия населения в Российской Федерации в 2014 г. Государственный доклад. — М.: Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; 2016. — 200 с. [O sostoyanii sanitarno-epidemiologicheskogo blagopoluchiya naseleniya v Rossiiskoi Federatsii v 2014 g. Gosudarstvennyi doklad. Moscow: Federal’naya sluzhba po nadzoru v sfere zashchity prav potrebitelei i blagopoluchiya cheloveka; 2016. 200 p. (In Russ).

9. gks.ru [интернет]. Естественное движение населения в разрезе субъектов Российской Федерации за январь-февраль 2016 года [доступ от 21.09.2016]. Доступ по ссылке http://www.gks.ru/free_doc/2016/demo/edn02-16.htm.

10. Centers for Disease Control and Prevention (CDC). Progress in introduction of pneumococcal conjugate vaccine — worldwide, 2000–2012. MMWR Morb Mortal Wkly Rep. 2013; 62(16):308–311.

11. Moore MR, Link-Gelles R, Schaffner W, et al. Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease in children in the USA: a matched case-control study. Lancet Respir Med. 2016;4(5):399–406. doi: 10.1016/S2213-2600(16)00052-7.

12. Wiese AD, Grijalva CG, Zhu Y, et al. Changes in childhood pneumonia hospitalizations by race and sex associated with pneumococcal conjugate vaccines. Emerg Infect Dis. 2016;22(6). doi: 10.3201/eid2206.152023.

13. Pirez MC, Algorta G, Chamorro F, et al. Changes in hospitalizations for pneumonia after universal vaccination with pneumococcal conjugate vaccines 7/13 valent and haemophilus influenzae type b conjugate vaccine in a Pediatric Referral Hospital in Uruguay. Pediatr Infect Dis J. 2014;33(7):753–759. doi: 10.1097/INF.0000000000000294.

14. Davis SM, Deloria-Knoll M, Kassa HT, O’Brien KL. Impact of pneumococcal conjugate vaccines on nasopharyngeal carriage and invasive disease among unvaccinated people: review of evidence on indirect effects. Vaccine. 2013;32(1):133–145. doi: 10.1016/j.vaccine.2013.05.005.

15. Ricketson LJ, Wood ML, Vanderkooi OG, et al. Trends in asymptomatic nasopharyngeal colonization with streptococcus pneumoniae after introduction of the 13-valent pneumococcal conjugate vaccine in Calgary, Canada. Pediatr Infect Dis J. 2014;33(7):724– 730. doi: 10.1097/INF.0000000000000267.

16. Nicholls TR, Leach AJ, Morris PS. The short-term impact of each primary dose of pneumococcal conjugate vaccine on nasopharyngeal carriage: systematic review and meta- analyses of randomised controlled trials. Vaccine. 2016;34(6):703–713. doi: 10.1016/j.vaccine.2015.12.048.

17. Tomczyk S, Jorgensen J, Lynfield R, et al. Prevention of antimicrobial resistant infection among children aged < 5 years with the 13-valent pneumococcal conjugate vaccine — selected U.S. Areas, 2005–2013. Proceedings of the IDWeek 2014; 2014 Oct 07–12; Philadelphia, PA [cited 2016 Oct 9]. Available from: https://idsa.confex.com/idsa/2014/webprogram/Paper46665.html.

18. Vissers M, Ahout IM, van den Kieboom CH, et al. High pneumococcal density correlates with more mucosal inflammation and reduced respiratory syncytial virus disease severity in infants. BMC Infect Dis. 2016;16:129. doi: 10.1186/s12879-016-1454-x.

19. Skevaki CL1, Tsialta P, Trochoutsou AI, et al. Associations between viral and bacterial potential pathogens in the nasopharynx of children with and without respiratory symptoms. Pediatr Infect Dis J. 2015;34(12):1296–1301. doi: 10.1097/INF.0000000000000872.