Tropical Regional Services, Queensland Health, Cairns, QLD, Australia.
Med J Aust. 2010 Oct 4;193(7):392-6. doi: 10.5694/j.1326-5377.2010.tb03965.x.
To compare trends in invasive pneumococcal disease (IPD) in non-Indigenous people in north Queensland before and after the introduction of funded pneumococcal vaccines, and to examine the proportion of cases that occurred after vaccine roll-out that could be vaccine-preventable.
DESIGN, SETTING AND PARTICIPANTS: In 2005, a 7-valent pneumococcal conjugate vaccine (7vPCV) for non-Indigenous children and a 23-valent pneumococcal polysaccharide vaccine (23vPPV) for non-Indigenous adults aged ≥ 65 years were made freely available. Trends in IPD in the non-Indigenous estimated resident population in north Queensland (about 581 850 in 2006) were compared between the 4 years before (2001-2004) and after (2006-2009) the vaccines were rolled out.
Incidences and serotypes of IPD in non-Indigenous people.
After the introduction of the vaccines, there were significant declines for all ages in the average annual incidence of IPD (- 34%; P < 0.05) and 7vPCV serotype IPD (- 77%; P < 0.05). In children aged < 5 years, there was a 91% decline in the incidence of 7vPCV serotype IPD (P < 0.05); in adults aged 15-64 years and ≥ 65 years there were 62% and 77% declines, respectively, in 7vPCV and 23vPPV common-serotype IPD (P < 0.05). There was a 188% increase in 23vPPV-only serotype IPD in adults aged 15-64 years (P < 0.05), whereas there was no significant change in adults aged ≥ 65 years. Serotype 19A was the most frequently identified serotype in 2006-2009, causing 19% of all IPD in those 4 years.
There is circumstantial evidence that 7vPCV has had a powerful indirect effect in preventing IPD in adults in north Queensland; 23vPPV may have had a direct effect in adults aged ≥ 65 years. It is likely that with combined direct and indirect effects, newer conjugate vaccines could prevent more IPD than could be prevented with the two current vaccines.
比较北昆士兰州非原住民人群在引入肺炎球菌疫苗前后侵袭性肺炎球菌病（IPD）的趋势，并研究疫苗推出后可预防的病例比例。
设计、地点和参与者：2005 年，为非原住民儿童提供了 7 价肺炎球菌结合疫苗（7vPCV），为≥65 岁的非原住民成年人提供了 23 价肺炎球菌多糖疫苗（23vPPV）。比较了 2006 年（疫苗推出前）和 2006-2009 年（疫苗推出后）这 4 年北昆士兰州非原住民估计常住人口（2006 年约为 581850 人）中 IPD 的发病率和血清型。
非原住民人群的 IPD 发病率和血清型。
疫苗推出后，所有年龄段的 IPD 平均年发病率（-34%；P<0.05）和 7vPCV 血清型 IPD（-77%；P<0.05）均显著下降。5 岁以下儿童 7vPCV 血清型 IPD 的发病率下降了 91%（P<0.05）；15-64 岁和≥65 岁的成年人中，7vPCV 和 23vPPV 常见血清型 IPD 分别下降了 62%和 77%（P<0.05）。15-64 岁成年人中，23vPPV 单一血清型 IPD 增加了 188%（P<0.05），而≥65 岁的成年人则没有显著变化。血清型 19A 是 2006-2009 年最常见的血清型，占这 4 年所有 IPD 的 19%。
有间接证据表明，7vPCV 对北昆士兰州成年人的 IPD 具有强大的间接影响；23vPPV 可能对≥65 岁的成年人具有直接影响。很可能由于直接和间接作用的综合影响，新型结合疫苗预防的 IPD 病例可能比目前使用的两种疫苗更多。
