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Dominance of vaccine serotypes in pediatric invasive pneumococcal infections in Portugal (2012–2015)
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Advisor(s)
Abstract(s)
We evaluated the impact of continued 13-valent pneumococcal conjugate vaccine (PCV13) use in
the private market (uptake of 61%) in pediatric invasive pneumococcal disease (pIPD) in Portugal
(2012–2015). The most frequently detected serotypes were: 3 (n = 32, 13.8%), 14 (n = 23, 9.9%), 1
(n = 23, 9.9%), 7F (n = 15, 6.4%), 19A (n = 13, 5.6%), 6B and 15B/C (both n = 12, 5.2%), and 24F, 10A
and 12B (all with n = 10, 4.3%). Taken together, non-PCV13 serotypes were responsible for 42.2% of
pIPD with a known serotype. The use of PCR to detect and serotype pneumococci in both pleural and
cerebrospinal fluid samples contributed to 18.1% (n = 47) of all pIPD. Serotype 3 was mostly detected
by PCR (n = 21/32, 65.6%) and resulted from a relevant number of vaccine failures. The incidence of
pIPD varied in the different age groups but without a clear trend. There were no obvious declines of the
incidence of pIPD due to serotypes included in any of the PCVs, and PCV13 serotypes still accounted for
the majority of pIPD (57.8%). Our study indicates that a higher vaccination uptake may be necessary
to realize the full benefits of PCVs, even after 15 years of moderate use, and highlights the importance
of using molecular methods in pIPD surveillance, since these can lead to substantially increased case
ascertainment and identification of particular serotypes as causes of pIPD.
Description
Acknowledgements:
This work was partly supported by Fundação para a Ciência e a Tecnologia, Portugal (PTDC/DTPEPI/1555/2014), LISBOA-01-0145-EDER-007391, project cofunded by FEDER, through POR Lisboa 2020 - Programa Operacional Regional de Lisboa, PORTUGAL 2020 and Fundação para a Ciência e a Tecnologia, and an unrestricted Investigator initiated project from Pfzer. Te funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.