The introduction of the 13-valent pneumococcal conjugate vaccine has led to a significant decrease in the incidence of invasive pneumococcal disease in the general pediatric population but with a trend toward increasing incidence, particularly of nonvaccine serotypes, among children with comorbidities.
A study of Massachusetts public health surveillance data from before and after the introduction of the 13-valent vaccine (PCV13) showed a 49% decrease (168 vs. 85) in the absolute number of invasive pneumococcal disease cases in children aged under 5 years but a 17% increase in the proportion of cases in children with comorbidities such as chronic lung disease, malignancy, or immunosuppressive therapy. These changes are not considered statistically significant.
Dr. Pui-Ying Iroh Tam
"Routine vaccination with PCV13 may not be sufficient to reduce the risk of invasive disease in patients with comorbidity, and administering 23-valent pneumococcal polysaccharide vaccine to all children with comorbidity at the earliest acceptable age should be considered," wrote Dr. Pui-Ying Iroh Tam of the University of Minnesota Children’s Hospital, Minneapolis, and colleagues.
The prevalence of vaccine serotypes declined significantly (18%) in the first 2 years after introduction of PCV13, although serotype 19A remained the most common serotype even after the introduction of the vaccine, despite a significant decline in its prevalence, as reported online in the July 7 edition of Pediatrics (Pediatrics 2014 July 7 [doi: 10.1542/peds.2014-0473]).
The study was funded by the National Institutes of Health. One author received investigator-initiated grants from Pfizer for the study, while another author declared honoraria and grants from various pharmaceutical companies.