Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.
Pfizer Pharma GmbH, Berlin, Germany.
PLoS One. 2023 Feb 15;18(2):e0281261. doi: 10.1371/journal.pone.0281261. eCollection 2023.
Two next-generation pneumococcal conjugate vaccines (PCVs), a 15- and a 20-valent PCV (PCV15 and PCV20), have recently been licensed for use in adults, and PCV15 has also been licensed in children. We developed a dynamic transmission model specific for Germany, with the aim to predict carriage prevalence and invasive pneumococcal disease (IPD) burden for serotypes included in these vaccines.
The model allows to follow serotype distributions longitudinally both in the absence and presence of PCV vaccinations. We considered eight age cohorts and seven serotype groups according to the composition of different pneumococcal vaccines. This comprises the additional serotypes contained in PCV15 and PCV20 but not in PCV13.
The model predicted that by continuing the current vaccine policy (standard vaccination with PCV13 in children and with PPSV23 in adults) until 2031, IPD case counts due to any serotype in children <2 years of age will remain unchanged. There will be a continuous decrease of IPD cases in adults aged 16-59y, but a 20% increase in adults ≥60y. Furthermore, there will be a steady decrease of the proportion of carriage and IPD due to serotypes included in PCV7 and PCV13 over the model horizon and a steady rise of non-PCV13 serotypes in carriage and IPD. The highest increase for both pneumococcal carriage and absolute IPD case counts was predicted for serotypes 22F and 33F (included in both PCV15 and PCV20) and serotypes 8, 10A, 11A, 12F, and 15B (included in PCV20 only), particularly in older adults. Between 2022 and 2031, serotypes included in PCV20 only are expected to cause 19.7-25.3% of IPD cases in adults ≥60y.
We conclude that introduction of next-generation PCVs for adults may prevent a substantial and increasing proportion of adult IPDs, with PCV20 having the potential to provide the broadest protection against pneumococcal disease.
两种新一代肺炎球菌结合疫苗（PCV），即 15 价和 20 价 PCV（PCV15 和 PCV20），最近已获准在成人中使用，PCV15 也已获准在儿童中使用。我们开发了一种针对德国的动态传播模型，旨在预测这些疫苗包含的血清型的携带率和侵袭性肺炎球菌病（IPD）负担。
该模型允许在没有和存在 PCV 疫苗接种的情况下对血清型分布进行纵向跟踪。我们根据不同肺炎球菌疫苗的组成考虑了八个年龄组和七个血清型组。这包括 PCV15 和 PCV20 中包含的但 PCV13 中不包含的额外血清型。
该模型预测，如果继续执行当前的疫苗政策（儿童接种 PCV13 和成人接种 PPSV23）到 2031 年，2 岁以下儿童中任何血清型引起的 IPD 病例数将保持不变。16-59 岁成人的 IPD 病例数将持续减少，但 60 岁以上成人的 IPD 病例数将增加 20%。此外，在模型预测期间，PCV7 和 PCV13 中包含的血清型的携带率和 IPD 将持续下降，而非 PCV13 血清型的携带率和 IPD 将持续上升。对于携带和绝对 IPD 病例数的增加，预测最高的是血清型 22F 和 33F（均包含在 PCV15 和 PCV20 中）以及血清型 8、10A、11A、12F 和 15B（仅包含在 PCV20 中），尤其是在老年人群中。2022 年至 2031 年期间，预计仅包含在 PCV20 中的血清型将导致 60 岁以上成人 IPD 病例的 19.7-25.3%。
我们得出的结论是，为成人引入新一代 PCV 可能会预防相当大比例且不断增加的成人 IPD，PCV20 有可能提供最广泛的肺炎球菌疾病保护。
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