Exploring the evidence behind the comparable impact of the pneumococcal conjugate vaccines PHiD-CV and PCV13 on overall pneumococcal disease

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© 2021 GlaxoSmithKline Biologicals SA. Published with license by Taylor & Francis Group, LLC

Figure 1. Invasive pneumococcal disease incidence rates in children 0–2 y of age in PHiD-CV- or PCV13-using Swedish regions before PCV7 and before and after PHiD-CV or PCV13 implementation.

IRR, incidence rate ratio; PCV13, 13-valent pneumococcal conjugate vaccine; PCV7, 7-valent pneumococcal conjugate vaccine; PHiD-CV, pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine. Data from Naucler et al.¹³ IRRs (with 95% confidence intervals) compare the incidences of overall invasive pneumococcal disease after PHiD-CV or PCV13 implementation with those before PCV7 implementation.

Figure 2. Effectiveness of PCV13 and PHiD-CV against VT IPD in children.

FC, full cohort; IC, indirect cohort; m, months of age; MCC, matched case-control; PCV13, 13-valent pneumococcal conjugate vaccine; PHiD-CV, pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine; UCC, unmatched case-control; UK, United Kingdom (England, Wales and Northern Ireland in²³); US, United States; VE, vaccine effectiveness; VT IPD, vaccine-type invasive pneumococcal disease (see note ^b below); w, weeks of age; y, years of age. Error bars indicate 95% confidence or credible intervals (CIs). ^aEffectiveness estimates are for the indicated number of doses. Estimates for ≥1 dose were used where available. ^bFor PCV13 effectiveness estimates: IPD caused by PCV13 serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F and – for references^23,24 – vaccine-related 6C. For PHiD-CV estimates: IPD caused by PHiD-CV serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, 23F and – for reference¹⁴ – vaccine-related 6A. ^cNon-Aboriginal children only. ^dTwo different designs were used in this study to estimate VE against VT IPD: MCC: values in graph, and IC: VE was 76% (95% CI: 46–89). ^eInterquartile range for age of cases: 5.3–17.4 m, and controls: 4.8–15.3 m. ^fChildren not infected with human immunodeficiency virus only. ^g ≥2 doses before 12 m or 1 dose on or after 12 m. ^hActual age of included children was 2.6–53.1 m. ⁱThree different designs were used in this study: FC: values in graph, MCC: VE against VT IPD was 98% (95% CI: 90–100), and IC: VE against VT IPD was 100% (95% CI: 98–100).

Figure 3. Effectiveness of PCV13 and PHiD-CV against serotype-specific IPD in children.

FC, full cohort; IC, indirect cohort; IPD, invasive pneumococcal disease; m, months of age; MCC, matched case-control; PCV13, 13-valent pneumococcal conjugate vaccine; PHiD-CV, pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine; UCC, unmatched case-control; UK, United Kingdom (England, Wales and Northern Ireland for²³ and England for³⁵); US, United States; VE, vaccine effectiveness; w, weeks of age; y, years of age. Error bars indicate 95% confidence or credible intervals (CIs). ^aEffectiveness estimates are for the indicated number of doses. Estimates for ≥1 dose were used where available. ^bNon-Aboriginal children only. ^c ≥2 doses before 12 m or 1 dose on or after 12 m. ^dChildren not infected with human immunodeficiency virus only. ^e ≥1 dose with the first dose given before 2 y. ^fActual age of included children was 2.6–53.1 m. ^gNumber of doses was age-dependent: up to date for age for the recommended number of PHiD-CV doses. ^hThree different designs were used in this study: FC (values in graph), MCC: VE against 19A IPD was 45% (95% CI: −54–79) and IC: VE against 19A IPD was 66% (95% CI: −76–95).

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