Lapidot Rotem, Shea Kimberly M, Yildirim Inci, Cabral Howard J, Pelton Stephen I, Department Of Public Health The Massachusetts
Division of Pediatric Infectious Diseases, Boston Medical Center, Boston, MA 02118, USA.
Boston University Schools of Medicine, Boston, MA 02118, USA.
Pathogens. 2020 May 21;9(5):396. doi: 10.3390/pathogens9050396.
Although a substantial decline in vaccine-serotype invasive pneumococcal disease (IPD) incidence was observed following the introduction of pneumococcal conjugate vaccines (PCV), the estimated range of thirteen-valent conjugate vaccine (PCV13) effectiveness for serotype 3 disease is wide and includes zero. We assessed the impact of PCV13 on serotype 3 IPD incidence and disease characteristics in Massachusetts' children.
Serotype 3 IPD cases in children <18 years old were identified via enhanced passive surveillance system in Massachusetts. We compared incidence rates and characteristics of IPD cases before and after PCV13.
A total of 47 serotype 3 IPD cases were identified from 2002 to 2017; incidence of serotype 3 IPD in the years following PCV13 was 0.19 per 100,000 children compared to 0.21 before PCV 13, incidence rate ratio (IRR) = 0.86 (95% CI 0.47-1.57). The majority (78%) of post-PCV13 serotype 3 IPD cases occurred among fully vaccinated children. Age distribution, clinical syndrome and presence of comorbidities among serotype 3 IPD cases were similar before and after PCV13 introduction. There was no association between the date of the last PCV13 dose and time to IPD to suggest waning of immunity.
seven years following PCV 13 we found no significant changes in serotype 3 IPD incidence or disease characteristics in children in Massachusetts.
尽管在引入肺炎球菌结合疫苗（PCV）后，疫苗血清型侵袭性肺炎球菌疾病（IPD）的发病率大幅下降，但13价结合疫苗（PCV13）对3型疾病的有效性估计范围很广，包括零。我们评估了PCV13对马萨诸塞州儿童3型IPD发病率和疾病特征的影响。
通过马萨诸塞州的强化被动监测系统识别18岁以下儿童的3型IPD病例。我们比较了PCV13前后IPD病例的发病率和特征。
2002年至2017年共识别出47例3型IPD病例；PCV13接种后几年中3型IPD的发病率为每10万名儿童0.19例，而PCV13接种前为0.21例，发病率比（IRR）=0.86（95%CI 0.47-1.57）。大多数（78%）PCV13接种后的3型IPD病例发生在完全接种疫苗的儿童中。在引入PCV13前后，3型IPD病例的年龄分布、临床综合征和合并症情况相似。最后一剂PCV13接种日期与IPD发病时间之间没有关联，表明免疫力没有减弱。
在PCV13接种7年后，我们发现马萨诸塞州儿童的3型IPD发病率或疾病特征没有显著变化。
