Observed differences in invasive pneumococcal disease epidemiology after routine infant vaccination

Abstract

Healthcare decisions on vaccination programs mainly rely on the direct burden of illness and related costs of the disease. Next to the expected direct beneficial effect of pediatric immunization programs against Streptococcus pneumoniae, worldwide implementation of these programs has also been driven by the indirect beneficial impact as observed among various nontargeted age groups in Northern America. In this article, we provide a descriptive overview of the post-marketing surveillance and show that there are large differences in the observed disease epidemiology after implementation of pediatric pneumococcal immunization programs across countries. Possible factors responsible for these differences may include vaccine-serotype coverage, implemented vaccination schedules, antibiotic resistance rates and pneumococcal disease incidence prior to vaccination. A potential limitation can be found in the installation or enhancement of existing surveillance systems as well as other potential confounding bias, which may have influenced observed disease rates in the included observational studies. We conclude that the health and economic impact should be addressed in light of the country specific pneumoccocal disease epidemiology to support decisions on immunization programs.

Keywords::

• cost–effectiveness
• epidemiology
• herd protection
• immunization
• invasive pneumococcal disease
• nonvaccine serotype
• pneumococcal conjugated vaccine
• serotype replacement
• Streptococcus pneumoniae
• vaccination
• vaccine serotype

Financial & competing interests disclosure

Mark H Rozenbaum was funded by an unrestricted grant from Wyeth (now part of Pfizer Inc.). Cornelis Boersma received an unrestricted grant from GlaxoSmithKline. All authors received grants and/or honoraria from various vaccine producers, inclusive of both pneumococcal vaccines. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.