Invasive pneumococcal disease incidence in children and adults in France during the pneumococcal conjugate vaccine era: an interrupted time-series analysis of data from a 17-year national prospective surveillance study

Study (75,903 cases of pneumococcal disease) found that implementation of the 13 valent vaccine (PCV13) led to a major reduction in the incidence of disease. However, a rebound in cases, driven by several emerging non-PCV13 serotypes, jeopardises long-term benefits.

SPS commentary:

A commentary on this study states that, these data, together with similar data from the UK, Germany, and Sweden, are in contrast to a stable incidence of invasive pneumococcal disease caused by non-vaccine serotypes in the USA but in aggregate suggest that efforts to reduce invasive pneumococcal disease continue to be compromised by serotype replacement.

None of the third-generation vaccines in development will address serotype 24F, which caused only 5·0% of invasive pneumococcal disease in all ages in this study but was the leading cause in children younger than 2 years, in whom this serotype caused almost a quarter of the cases. In 2013–14, serotype 24F was the most common cause of non-PCV13 invasive pneumococcal disease in children younger than 5 years in the UK and the only replacement serotype that showed significant increases in both children and adults compared with the period before the introduction of PCV13. Subsequently, serotype 24F spontaneously decreased in the UK, although it continued to be over-represented among cases of pneumococcal meningitis.

Continued high-quality surveillance, as per this study, is essential for planning a third generation of PCVs that will undoubtedly be needed to outpace Streptococcus pneumoniae invasive disease while  awaiting a non-serotype vaccine approach.


The Lancet Infectious Diseases

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