2001-2012 年法国肺炎球菌结合疫苗对侵袭性肺炎球菌病的影响。

Impact of the pneumococcal conjugate vaccines on invasive pneumococcal disease in France, 2001-2012.

机构信息

Département des maladies infectieuses, Institut de Veille Sanitaire, Saint Maurice, France.

Centre National de Référence des Pneumocoques, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.

出版信息

Vaccine. 2015 Jan 3;33(2):359-66. doi: 10.1016/j.vaccine.2014.11.011. Epub 2014 Nov 20.

DOI:10.1016/j.vaccine.2014.11.011

PMID:25448105

Abstract

CONTEXT AND AIMS

Vaccination with the 7-valent pneumococcal conjugate vaccine (PCV7) was recommended in France in 2003 for children <2 years. The 13-valent conjugate vaccine (PCV13) replaced PCV7 in 2010. We assessed the impact of PCVs vaccination on the incidence of invasive pneumococcal diseases (IPD) in French children (0-15 years) and adults (>15 years).

METHODS

IPD rates were calculated using cases reported from 2001 to 2012 to Epibac, a laboratory network. The distribution of serotypes was assessed from invasive isolates serotyped at the National reference Centre for Pneumococci. IPD incidence rates were compared between the pre-PCV7 (2001-2002), late PCV7 (2008-2009) and post PCV13 (2012) periods.

RESULTS

The PCVs coverage increased from 56% in the 2004 birth-cohort to 94% in the 2008 and following birth-cohorts. Following PCV7 introduction, IPD incidence decreased by 19% between 2001-2002 and 2008-2009 in children <2 years, but increased in children aged 2-15 years and adults, despite a sharp decline in PCV7-IPD in all age-groups. After PCV13 introduction, IPD incidence decreased by 34% in children <5 years, by 50% in those aged 5-15 years and 15% in adults from 2008-2009 to 2012. The incidence of PCV13-Non PCV7-IPD decreased by 74% in children <5 years and by 60% in those aged 5-15 years.

CONCLUSIONS

Vaccination with PCV13 was rapidly followed by a decrease in the incidence of all-type IPD in children, in relation with a sharp decrease in the incidence of PCV13-Non PCV7-IPD. Moreover, all-type IPD decreased after PCV13 introduction in older non-vaccinated age-groups, with a shift in the distribution of serotypes. Considering the whole 2001-2012 period, the vaccination with PCV7 and PCV13 resulted in a decline in the incidence of IPD in children up to the age of 5 but not in older children and adults.

摘要

背景和目的

2003 年，法国开始推荐为 2 岁以下儿童接种 7 价肺炎球菌结合疫苗（PCV7）。2010 年，13 价肺炎球菌结合疫苗（PCV13）取代了 PCV7。本研究评估了肺炎球菌疫苗接种对法国儿童（0-15 岁）和成人（＞15 岁）侵袭性肺炎球菌病（IPD）发病率的影响。

方法

通过实验室网络 Epibac 报告的 2001 年至 2012 年期间的病例，计算 IPD 发病率。通过国家肺炎球菌参考中心对侵袭性分离株进行血清分型，评估血清型分布。比较 PCV7 接种前（2001-2002 年）、PCV7 后期（2008-2009 年）和 PCV13 接种后（2012 年）期间的 IPD 发病率。

结果

2004 年出生队列中 PCV 覆盖率为 56%，2008 年及之后的出生队列中 PCV 覆盖率达到 94%。PCV7 引入后，2001-2002 年和 2008-2009 年，＜2 岁儿童的 IPD 发病率下降了 19%，但 2-15 岁儿童和成人的 IPD 发病率却上升了，尽管所有年龄组的 PCV7-IPD 急剧下降。PCV13 引入后，＜5 岁儿童的 IPD 发病率下降了 34%，5-15 岁儿童下降了 50%，成人下降了 15%，从 2008-2009 年到 2012 年。＜5 岁儿童的 PCV13-非 PCV7-IPD 发病率下降了 74%，5-15 岁儿童下降了 60%。

结论

PCV13 接种后，与 PCV13-非 PCV7-IPD 发病率的急剧下降相关，所有类型的 IPD 发病率在儿童中迅速下降。此外，在未接种疫苗的大龄儿童和成人中，PCV13 引入后所有类型的 IPD 发病率均下降，血清型分布也发生了变化。考虑到整个 2001-2012 年期间，PCV7 和 PCV13 的接种导致 5 岁以下儿童的 IPD 发病率下降，但在年龄较大的儿童和成人中没有下降。