Article
Author: Glikman, Danny ; Kasis, Imad ; Viener-Well, Yonit ; Finn, Talia ; Khoury-Assi, Camellia ; Weber, Gabriel ; Bar-Yochai, Avihu ; Zbriger, Alvira ; Korenman, Zina ; Barkai, Galia ; Ben-Zvi, Haim ; Bachinski, Ahuva ; Amir, Jacob ; Sari, Mandelbaum ; Kennes, Yoram ; Glikman, Daniel ; Freimann, Sarit ; Paran, Yael ; Averbuch, Diana ; Smollan, Gill ; Gottesman, Giora ; Ephros, Moshe ; Regev-Yochay, Gili ; Grisaru-Soen, Galia ; Guri, Alex ; Rahav, Galia ; Geffen, Yuval ; Strahilevitz, Jacob ; Dagan, Ron ; Engelhard, Dan ; Temper, Violetta ; Megged, Orli ; Peretz, Avi ; Hershman, Mirit ; Mor, Meirav ; Brosh-Nissimov, Tal ; Zucker, Miriam ; Rubinstein, Uri ; Elias, Nael ; Katzir, Michal ; Reisenberg, Klaris ; Bernstein, Rita ; Maor, Yasmin ; Miron, Dan ; Assous, Marc ; Paitan, Yosi ; Embon, Alicia ; Cohen-Poradosu, Ronit ; Khakshoor, Shirley ; van der Beek, Bart Adriaan ; Schlesinger, Yechiel ; Srugo, Itzhak ; Zimchony, Oren ; Schwartz, Orna ; Miron, Danny ; Ofir-Mintzer, Hana ; Istomin, Valery ; Ben-Shimol, Shalom ; Sheindler, Yehudit ; Bar-Meir, Maskit ; Brik, Larissa ; Aviner, Shraga ; Keller, Nathan ; Stein, Michal ; Sverdlob, Olga ; Schwartz, David ; Shalit, Itamar ; Rechnitzer, Hagai ; Shaked-Mishan, Pninit ; Ztibba, Yevgenia ; Givon-Lavi, Noga ; Chowers, Michal ; Asher Kuperman, Amir ; Srugo, Isaac ; Oren, Ilana ; Weinberger, Miriam ; Benedikt, Ilana ; Bardenstein, Rita ; Chazan, Bibiana ; Sela, Shifra ; Bishara, Jihad ; Somekh, Eli ; Potasman, Israel
Background:Following 13-valent pneumococcal conjugate vaccine (PCV13) implementation in infants worldwide, overall and vaccine-type invasive pneumococcal disease (IPD) rates declined in children, with variable indirect impact on adults.
Methods:A population-based, prospective, nationwide active surveillance of IPD in Israel, 2004–2019 (for adults ≥18 years, 2009–2019). The 7-valent PCV (PCV7)/PCV13 were implemented in Israel in July 2009/November 2010, respectively, with >90% uptake in children <2 years. The 23-valent pneumococcal polysaccharide vaccine (PPV-23) uptake among those >65 years was ~75%. For pre-PCV episodes with missing serotype, extrapolations were applied. Overall, PCV13 serotypes (VT13) and non-VT13 (NVT) incidence rate ratios (IRRs) comparing pre-PCV (2004–2008), early-PCV (2009–2011), and late-PCV13 (2016–2019) periods were calculated for different age groups.
Results:Overall, 8614 IPD cases were recorded. IPD rates declined by 67% in children <5 and 5–17 years, comparing late-PCV13 versus pre-PCV periods (IRR [95% CI]: .33 [.27–.40] and .33 [.21–.50], respectively). For adults, comparing late-PCV13 with early-PCV periods, rates significantly declined by 53% in those aged 18–44, while rates did not decline significantly in other age groups. VT13 rates significantly declined in all ages, with decline rates ranging between 94% in children <5 years and 60% in adults ≥85 years. NVT rates significantly increased in <5-, 50–64-, and ≥65-year age groups. In the late-PCV13 period, serotypes 3, 14, and 19A remained the predominant VT13, while serotypes 8 and 12F emerged as predominant NVTs.
Conclusions:Continuous monitoring of circulating serotypes in all ages demonstrated direct and indirect PCV effects, which are essential for the development of new vaccination strategies.