Moreira Marta, Castro Olga, Palmieri Melissa, Efklidou Sofia, Castagna Stefano, Hoet Bernard
a GSK Vaccines , Global Medical affairs , Wavre , Belgium.
b GSK, Medical Affairs Vaccines , Algés , Portugal.
Hum Vaccin Immunother. 2017 Jun 3;13(6):1-12. doi: 10.1080/21645515.2016.1263409. Epub 2016 Dec 20.
Higher-valent pneumococcal conjugate vaccines (PCVs) were licensed from 2009 in Europe; similar worldwide clinical effectiveness was observed for PCVs in routine use. Despite a proven medical need, PCV vaccination in Southern Europe remained suboptimal until 2015/16. We searched PubMed for manuscripts published between 2009 and mid-2016. Included manuscripts had to contain data about invasive pneumococcal disease (IPD) incidence, or vaccination coverage with higher-valent PCVs. This review represents the first analysis of vaccination coverage and impact of higher-valent PCVs on overall IPD in Southern European countries (Portugal, Spain, Italy, Greece, Cyprus). Vaccination coverage in the Portuguese private market peaked around 2008 at 75% (children ≤ 2 years) but declined to 63% in 2012. In Madrid, coverage was 95% (2007-2012) but dropped to 67% (2013/14; children ≤ 2 years) after funding termination in May 2012. PCVs were recently introduced in the national immunisation program (NIP) of Portugal (2015) and Spain (2015/16). In Italy, coverage for the complete PCV schedule (children ≤ 2 years) was 88% in 2013, although highly variable between regions (45-99%). In Greece, in 2013, 82.3% had received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months. Overall IPD (net benefit: effect on vaccine types, vaccine-related types, and non-vaccine types) has decreased; in Greece, pneumococcal meningitis incidence remained stable. Continued IPD surveillance or national registers using ICD-10 codes of clinically suspected IPD are necessary, with timely publicly available reports and adequate national vaccination registers to assess trends in vaccination coverage, allowing evaluation of PCVs in NIPs.
更高价的肺炎球菌结合疫苗（PCV）于2009年在欧洲获得许可；常规使用的PCV在全球范围内观察到了相似的临床效果。尽管有已证实的医疗需求，但直到2015/16年，南欧的PCV疫苗接种情况仍不理想。我们在PubMed上搜索了2009年至2016年年中发表的手稿。纳入的手稿必须包含侵袭性肺炎球菌疾病（IPD）发病率或更高价PCV疫苗接种覆盖率的数据。本综述是对南欧国家（葡萄牙、西班牙、意大利、希腊、塞浦路斯）疫苗接种覆盖率以及更高价PCV对总体IPD影响的首次分析。葡萄牙私人市场的疫苗接种覆盖率在2008年左右达到峰值，为75%（2岁及以下儿童），但在2012年降至63%。在马德里，覆盖率在2007 - 2012年为95%，但在2012年5月资金终止后，降至67%（2013/14年；2岁及以下儿童）。PCV最近被引入葡萄牙（2015年）和西班牙（2015/16年）的国家免疫规划（NIP）。在意大利，2013年完整PCV接种程序（2岁及以下儿童）的覆盖率为88%，尽管各地区差异很大（45% - 99%）。在希腊，2013年，82.3%的儿童在12个月时接种了3剂PCV，而62.3%的儿童在24个月时接种了第4剂。总体IPD（净效益：对疫苗型、疫苗相关型和非疫苗型的影响）有所下降；在希腊，肺炎球菌脑膜炎发病率保持稳定。有必要继续使用临床疑似IPD的ICD - 10编码进行IPD监测或建立国家登记册，并及时公开报告，同时要有完善的国家疫苗接种登记册来评估疫苗接种覆盖率的趋势，以便对国家免疫规划中的PCV进行评估。
