2010 年至 2019 年美国儿童中 13 价肺炎球菌结合疫苗预防侵袭性肺炎球菌病的效果：一项间接队列研究。
Effectiveness of 13-valent pneumococcal conjugate vaccine for prevention of invasive pneumococcal disease among children in the United States between 2010 and 2019: An indirect cohort study.
机构信息
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
出版信息
Vaccine. 2024 Jun 11;42(16):3555-3563. doi: 10.1016/j.vaccine.2024.04.061. Epub 2024 May 3.
BACKGROUND
A U.S. case-control study (2010-2014) demonstrated vaccine effectiveness (VE) for ≥ 1 dose of the thirteen-valent pneumococcal conjugate vaccine (PCV13) against vaccine-type (VT) invasive pneumococcal disease (IPD) at 86 %; however, it lacked statistical power to examine VE by number of doses and against individual serotypes.
METHODS
We used the indirect cohort method to estimate PCV13 VE against VT-IPD among children aged < 5 years in the United States from May 1, 2010 through December 31, 2019 using cases from CDC's Active Bacterial Core surveillance, including cases enrolled in a matched case-control study (2010-2014). Cases and controls were defined as individuals with VT-IPD and non-PCV13-type-IPD (NVT-IPD), respectively. We estimated absolute VE using the adjusted odds ratio of prior PCV13 receipt (1-aOR x 100 %).
RESULTS
Among 1,161 IPD cases, 223 (19.2 %) were VT cases and 938 (80.8 %) were NVT controls. Of those, 108 cases (48.4 %; 108/223) and 600 controls (64.0 %; 600/938) had received > 3 PCV13 doses; 23 cases (17.6 %) and 15 controls (2.4 %) had received no PCV doses. VE ≥ 3 PCV13 doses against VT-IPD was 90.2 % (95 % Confidence Interval75.4-96.1 %), respectively. Among the most commonly circulating VT-IPD serotypes, VE of ≥ 3 PCV13 doses was 86.8 % (73.7-93.3 %), 50.2 % (28.4-80.5 %), and 93.8 % (69.8-98.8 %) against serotypes 19A, 3, and 19F, respectively.
CONCLUSIONS
At least three doses of PCV13 continue to be effective in preventing VT-IPD among children aged < 5 years in the US. PCV13 was protective against serotypes 19A and 19F IPD; protection against serotype 3 IPD did not reach statistical significance.
背景
美国的一项病例对照研究（2010-2014 年）表明，13 价肺炎球菌结合疫苗（PCV13）对≥1 剂疫苗的有效性（VE）为 86%，可预防疫苗型（VT）侵袭性肺炎球菌病（IPD）；然而，该研究缺乏统计能力来根据接种剂次和血清型检验 VE。
方法
我们使用间接队列法，通过美国疾病控制与预防中心（CDC）的主动细菌性核心监测中的病例（包括 2010-2014 年参加匹配病例对照研究的病例），估计 2010 年 5 月 1 日至 2019 年 12 月 31 日期间，5 岁以下儿童中 PCV13 对 VT-IPD 的 VE。病例和对照定义为分别患有 VT-IPD 和非 PCV13 型 IPD（NVT-IPD）的个体。我们使用既往 PCV13 接种的调整比值比（1-aOR×100%）估计绝对 VE。
结果
在 1161 例 IPD 病例中，223 例（19.2%）为 VT 病例，938 例（80.8%）为 NVT 对照。其中，108 例（48.4%；108/223）和 600 例（64.0%；600/938）接受了>3 剂 PCV13；23 例（17.6%）和 15 例（2.4%）未接受任何 PCV 剂量。3 剂及以上 PCV13 对 VT-IPD 的 VE 分别为 90.2%（95%置信区间 75.4%-96.1%）。在最常见的循环 VT-IPD 血清型中，3 剂及以上 PCV13 对血清型 19A、3 和 19F IPD 的 VE 分别为 86.8%（73.7%-93.3%）、50.2%（28.4%-80.5%）和 93.8%（69.8%-98.8%）。
结论
至少 3 剂 PCV13 继续有效预防美国<5 岁儿童的 VT-IPD。PCV13 对血清型 19A 和 19F IPD 有保护作用；对血清型 3 IPD 的保护作用未达到统计学意义。
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