After PCV13, Non-Vaccine Type Pneumococcal Infections Increase Among Older Adults

While the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) has aided in a significant decrease in the occurrence of invasive pneumococcal disease (IPD) among adults, the patient population—especially those older than 65 years—has also experienced a significant increase in non-vaccine type IPDs, according to new research.

The researchers identified all randomized, controlled trials and observational studies from January 1946 to May 2017 that had recorded the incidence of IPD, non-invasive pneumococcal disease, hospitalizations, and mortality in adults. The researchers then used this information to assess how the 2010 introduction of the PCV13 in pediatric immunization programs impacted the incidence of IPD in adults.

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In all, the researchers analyzed 3306 records that included 29 observational studies and 2,033,961 cases.

After PCV13 was introduced, a significant decrease in IPD rates among adults of all ages was noted. Similar to what was observed with PCV7 serotypes, lower rates of IPD were measured with PCV13 serotypes.

The researchers also determined that the incidence rate ratio was significantly higher for non-vaccine serotypes (1.10)—especially among adults who were aged 65 years or older (1.20).

“PCV13 use in children had a moderate impact on reducing the overall and vaccine-type IPDs, but there was a significant increase in non-vaccine type IPDs among adults, especially in those over 65 years,” the researchers concluded.

—Colleen Murphy

Reference:

Vadlamudi NK, Chen A, Marra F. Impact of the 13-valent pneumococcal conjugate vaccine among adults: a systematic review and meta-analysis. Clin Infect Dis. 2019;69(1):34-49. https://doi.org/10.1093/cid/ciy872.