Direct effect of 10-valent conjugate pneumococcal vaccination on pneumococcal carriage in children Brazil
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2014
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Background: 10-valent conjugate pneumococcal vaccine/PCV10 was introduced in the Brazilian National Immunization
Program along the year of 2010. We assessed the direct effectiveness of PCV10 vaccination in preventing nasopharyngeal/
NP pneumococcal carriage in infants.
Methods: A cross-sectional population-based household survey was conducted in Goiania Brazil, from December/2010-
February/2011 targeting children aged 7–11 m and 15–18 m. Participants were selected using a systematic sampling. NP
swabs, demographic data, and vaccination status were collected from 1,287 children during home visits. Main outcome and
exposure of interest were PCV10 vaccine-type carriage and dosing schedules (3p+0, 2p+0, and one catch-up dose),
respectively. Pneumococcal carriage was defined by a positive culture and serotyping was performed by Quellung reaction.
Rate ratio/RR was calculated as the ratio between the prevalence of vaccine-types carriage in children exposed to different
schedules and unvaccinated for PCV10. Adjusted RR was estimated using Poisson regression. PCV10 effectiveness/VE on
vaccine-type carriage was calculated as 1-RR*100.
Results: The prevalence of pneumococcal carriage was 41.0% (95%CI: 38.4–43.7). Serotypes covered by PCV10 and PCV13
were 35.2% and 53.0%, respectively. Vaccine serotypes 6B (11.6%), 23F (7.8%), 14 (6.8%), and 19F (6.6%) were the most
frequently observed. After adjusted for confounders, children who had received 2p+0 or 3p+0 dosing schedule presented a
significant reduction in pneumococcal vaccine-type carriage, with PCV10 VE equal to 35.9% (95%CI: 4.2–57.1; p = 0.030) and
44.0% (95%CI: 14.–63.5; p = 0.008), respectively, when compared with unvaccinated children. For children who received one
catch-up dose, no significant VE was detected (p = 0.905).
Conclusion: PCV10 was associated with high protection against vaccine-type carriage with 2p+0 and 3p+0 doses for
children vaccinated before the second semester of life. The continuous evaluation of carriage serotypes distribution is likely
to be useful for evaluating the long-term effectiveness and impact of pneumococcal vaccination on serotypes reduction.
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ANDRADE, Ana Lucia et. al. Direct effect of 10-valent conjugate pneumococcal vaccination on pneumococcal carriage in children Brazil. Plos One, San Francisco, v. 9, n. 6, e98128, 2014.