|dc.identifier.citation||TY - JOUR AU - Abu Seir, Rania AU - Azmi, Kifaya AU - Hamdan, Ayob AU - Namouz, Hanan AU - Jaar, Fuad AU - Jaber, Hanaa AU - Rubin, Carmit AU - Doron, Dafna AU - Rahav, Galia AU - Abdeen, Ziad AU - Regev-Yochay, Gili PY - 2018/11/12 SP - e0206927 T1 - Comparison of early effects of pneumococcal conjugate vaccines: PCV7, PCV10 and PCV13 on Streptococcus pneumoniae nasopharyngeal carriage in a population based study; The Palestinian-Israeli Collaborative Research (PICR) VL - 13 DO - 10.1371/journal.pone.0206927 JO - PLOS ONE ER -||en_US
Pneumococcal conjugate vaccines (PCVs), PCV10 and PCV13, are currently used in different
countries. We have previously reported the effectiveness of PCV7, following its introduction
in Israel and before PCVs were introduced in Palestine. Here, we extended the study
and compared the initial impact of PCV10 to that of PCV7/13.
Four cross-sectional surveys of S. pneumoniae carriage among children <5y through 2009–
2014 were preformed among two proximate populations, living under two distinct health
authorities, with different vaccination policies. In East-Jerusalem (EJ), PCV7 was implemented
in 2009 and replaced by PCV13 in late 2010, while in Palestine (PA), PCV10 was
implemented in 2011.
A total of 1267 and 2414 children from EJ and PA were screened. In 2014, S. pneumoniae
was detected in 30.7% and 28.6% of the children in EJ and PA respectively Implementation
of both PCV7 (in EJ) and PCV10 (in PA) did not affect overall S. pneumoniae carriage, but
resulted in a significant decrease in the prevalence of vaccine-type strains. In the pre-vaccine
era, VT7/VT13 strains consisted 47.0%/62.0% and 41.2%/54.8% of pneumococci in EJ
and PA, respectively. A 48.6% and 53.9% decrease in VT7 strains was observed within 3
years of PCV7 implementation in EJ (p = 0.001) and PCV10 in PA (p<0.0001), respectively.
These vaccination policies also resulted in ~50% reduction in VT13-added serotypes especially
6A (from 11.0% to 0.0% (EJ) and 9.5% to 4.9% (PA)). Three years after PCV13 implementation
in EJ, an additional 67% decrease in VT13 strains was observed, yet an increase
in serotype 3 was observed (0.0% to 3.4%, p = 0.056). While the prevalence of VT13 strains
decreased significantly during the study period, the overall carriage rate didn’t change significantly
due to replacement with non-VT13 strains which comprised 89.8% and 70.7% of all
pneumococci, in EJ and in PA respectively in the last study year.
Within the first three years following PCV implementation, we observed similar reductions in
carriage of VT10 and VT13 strains with either vaccination policies, with no effect on overall
carriage. Further follow-up is needed to compare the long-term effects.||en_US