Effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae among children in São Paulo, Brazil
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2016
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In March 2010, Brazil introduced the 10-valent pneumococcal conjugate vaccine (PCV10) in the routine
infant immunization program using a 4-dose schedule and catch-up for children <23 months. We inves tigated PCV10 effect on nasopharyngeal carriage with vaccine-type Streptococcus pneumoniae (Spn) and
non-typeable Haemophilus influenzae (NTHi) among children in São Paulo city. Cross-sectional surveys
were conducted in 2010 (baseline) and 2013 (post-PCV10). Healthy PCV-naïve children aged
12–23 months were recruited from primary health centers during immunization campaigns.
Nasopharyngeal swabs were collected and tested for Hi; for Spn, all baseline and a stratified random sam ple of 400 post-PCV10 swabs were tested. We compared vaccine-type Spn and NTHi carriage prevalence
pre-/post-PCV10, and used logistic regression to estimate PCV10 effectiveness (1-adjusted odds
ratio 100%). Overall 501 children were included in the baseline and 1167 in the post-PCV10 survey
(including 400 tested for Spn). Spn was detected in 40.3% of children at baseline and 48.8% post PCV10; PCV10 serotypes were found in 19.8% and 1.8% respectively, representing a decline of 90.9%
(p < 0.0001). Carriage of vaccine-related serotypes increased (10.8–21.0%, p < 0.0001), driven primarily
by a rise in serotype 6C (1.8–11.2%, p < 0.0001); carriage of serotypes 6A and 19A did not significantly
change. PCV10 effectiveness (4 doses) against vaccine-type carriage was 97.3% (95% confidence interval
88.7–99.3). NTHi prevalence increased from 26.0% (130/501) to 43.6% (509/1167, p < 0.0001); PCV10 vac cination seemed significantly associated with NTHi carriage, even after adjusting for other known risk
factors. Carriage with PCV10 serotypes among toddlers declined dramatically following PCV10 introduc tion in São Paulo, Brazil. No protection of PCV10 against NTHi was observed. Our findings contribute to a
growing body of evidence of PCV10 impact on vaccine-type carriage and highlight the importance of
PCV10 as a tool to reduce the burden of pneumococcal disease in Brazil and globally.
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Streptococcus pneumonia, Haemophilus influenza, Pneumococcal colonization, Pneumococcal conjugate vaccine, Pneumococcal serotypes, Pneumococcal carrier
Citação
BRANDILEONE, Maria-Cristina de C. et al. Effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae and Haemophilus influenzae among children in São Paulo, Brazil. Vaccine, Amsterdam, v. 34, n. 46, p. 5604-5611, 2016. DOI: 10.1016/j.vaccine.2016.09.027. Disponível em: https://www.sciencedirect.com/science/article/pii/S0264410X16308404. Acesso em: 12 ago. 2024.