Effectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in South African children : a case-control study

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dc.contributor.authorCohen, Cherylen_ZA
dc.contributor.authorVon Mollendorf, Claireen_ZA
dc.contributor.authorDe Gouveia, Lindaen_ZA
dc.contributor.authorLengana, Saronaen_ZA
dc.contributor.authorMeiring, Susanen_ZA
dc.contributor.authorQuan, Vanessaen_ZA
dc.contributor.authorNguweneza, Arthermonen_ZA
dc.contributor.authorMoore, David P.en_ZA
dc.contributor.authorReubenson, Garyen_ZA
dc.contributor.authorMoshe, Mamokgethien_ZA
dc.contributor.authorMadhi, Shabir A.en_ZA
dc.contributor.authorEley, Brianen_ZA
dc.contributor.authorHallbauer, Uteen_ZA
dc.contributor.authorFinlayson, Heatheren_ZA
dc.contributor.authorVarughese, Sheebaen_ZA
dc.contributor.authorO'Brien, Katherine L.en_ZA
dc.contributor.authorZell, Elizabeth R.en_ZA
dc.contributor.authorKlugman, Keith P.en_ZA
dc.contributor.authorWhitney, Cynthia G.en_ZA
dc.contributor.authorVon Gottberg, Anneen_ZA
dc.date.accessioned2018-10-25T08:21:58Z
dc.date.available2018-10-25T08:21:58Z
dc.date.issued2017-01-27
dc.descriptionCITATION: Cohen, C., et al. 2017. Effectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in South African children : a case-control study. Lancet Global Health, 5(3):e359-e369, doi:10.1016/S2214-109X(17)30043-8.
dc.descriptionThe original publication is available at http://www.thelancet.com/journals/langlo
dc.description.abstractBackground: The 13-valent pneumococcal conjugate vaccine (PCV13) was designed to include disease-causing serotypes that are important in low-income and middle-income countries. Vaccine eff ectiveness estimates are scarce in these settings. South Africa replaced PCV7 with PCV13 in 2011 using a 2 + 1 schedule. We aimed to assess the eff ectiveness of two or more doses of PCV13 against invasive pneumococcal disease in children with HIV infection and in those not infected with HIV. Methods: Cases of invasive pneumococcal disease in children aged 5 years or younger were identifi ed through national laboratory-based surveillance. Isolates were serotyped with the Quellung reaction or PCR. We sought in-hospital controls for every case, matched for age, HIV status, and study site. We aimed to enrol four controls for every case not infected with HIV and six controls for every case with HIV infection (case-control sets). With conditional logistic regression, we calculated vaccine eff ectiveness as a percentage, with the equation 1 – [adjusted odds ratio for vaccination] × 100. We included data from an earlier investigation of PCV7 to assess vaccine eff ectiveness in children exposed to but not infected with HIV and in malnourished children not infected with HIV. Findings: Between January, 2012, and December, 2014, we enrolled children aged 16 weeks or older to our study: 240 were cases not infected with HIV, 75 were cases with HIV infection, 1118 were controls not infected with HIV, and 283 were controls with HIV infection. The eff ectiveness of two or more doses of PCV13 against PCV13-serotype invasive pneumococcal disease was 85% (95% CI 37 to 96) among 11 case-control sets of children not infected with HIV and 91% (–35 to 100) among three case-control sets of children with HIV infection. PCV13 eff ectiveness among 26 case-control sets of children not infected with HIV was 52% (95% CI –12 to 79) against all-serotype invasive pneumococcal disease and 94% (44 to 100) for serotype 19A. Vaccine eff ectiveness against PCV7-serotype invasive pneumococcal disease was 87% (95% CI 38 to 97) in children exposed to HIV but uninfected and 90% (53 to 98) in malnourished children not infected with HIV. Interpretation: Our results indicate that PCV13 in a 2 + 1 schedule is eff ective for preventing vaccine-type pneumococcal infections in young children not infected with HIV, including those who are malnourished or who have been exposed to HIV. Although the point estimate for PCV13 vaccine eff ectiveness in children infected with HIV was high, it did not reach signifi cance, possibly because of the small sample size. These fi ndings support recommendations for widespread use of pneumococcal conjugate vaccine in low-income and middle-income countries.en_ZA
dc.description.urihttps://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30043-8/fulltext#%20
dc.description.versionPublisher's version
dc.format.extent11 pagesen_ZA
dc.identifier.citationCohen, C., et al. 2017. Effectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in South African children : a case-control study. Lancet Global Health, 5(3):e359-e369, doi:10.1016/S2214-109X(17)30043-8
dc.identifier.issn2214-109X (online)
dc.identifier.otherdoi:10.1016/S2214-109X(17)30043-8
dc.identifier.urihttp://hdl.handle.net/10019.1/104608
dc.language.isoen_ZAen_ZA
dc.publisherElsevieren_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectPneumococcal vaccineen_ZA
dc.subjectPneumonia, Pneumococcalen_ZA
dc.subjectVaccination of childrenen_ZA
dc.subjectHIV infections -- Complicationsen_ZA
dc.subjectHIV-positive childrenen_ZA
dc.titleEffectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in South African children : a case-control studyen_ZA
dc.typeArticleen_ZA
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