Global impact of 10- and 13-valent pneumococcal conjugate vaccines on pneumococcal meningitis in all ages: The PSERENADE project
Yang, Yangyupei; Knoll, Maria Deloria; Herbert, Carly; Bennett, Julia C; Feikin, Daniel R; Garcia Quesada, Maria; Hetrich, Marissa K; Zeger, Scott L; Kagucia, Eunice W; Xiao, Melody; Cohen, Adam L; van der Linden, Mark; du Plessis, Mignon; Yildirim, Inci; Winje, Brita A; Varon, Emmanuelle; Valenzuela, Maria Teresa; Valentiner-Branth, Palle; Steens, Anneke; Scott, J Anthony; Savrasova, Larisa; Sanz, Juan Carlos; Khan, Aalisha Sahu; Oishi, Kazunori; Nzoyikorera, Néhémie; Nuorti, J Pekka; Mereckiene, Jolita; McMahon, Kimberley; McGeer, Allison; Mackenzie, Grant A; MacDonald, Laura; Ladhani, Shamez N; Kristinsson, Karl G; Kleynhans, Jackie; Kellner, James D; Jayasinghe, Sanjay; Ho, Pak-Leung; Hilty, Markus; Hammitt, Laura L; Guevara, Marcela; Gilkison, Charlotte; Gierke, Ryan; Desmet, Stefanie; De Wals, Philippe; Dagan, Ron; Colzani, Edoardo; Ciruela, Pilar; Chuluunbat, Urtnasan; Chan, Guanhao; Camilli, Romina; Bruce, Michael G; Brandileone, Maria-Cristina C; Ampofo, Krow; O'Brien, Katherine L; Hayford, Kyla
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date
2025-01-27
Research Projects
Organizational Units
Journal Issue
Title
Global impact of 10- and 13-valent pneumococcal conjugate vaccines on pneumococcal meningitis in all ages: The PSERENADE project
Translated Title
Published in
J Infect 2025; 90(3):106426
Abstract
Pneumococcal conjugate vaccines (PCVs) introduced in childhood national immunization programs lowered vaccine-type invasive pneumococcal disease (IPD), but replacement with non-vaccine-types persisted throughout the PCV10/13 follow-up period. We assessed PCV10/13 impact on pneumococcal meningitis incidence globally.
The number of cases with serotyped pneumococci detected in cerebrospinal fluid and population denominators were obtained from surveillance sites globally. Site-specific meningitis incidence rate ratios (IRRs) comparing pre-PCV incidence to each year post-PCV10/13 were estimated by age (<5, 5-17 and ≥18 years) using Bayesian multi-level mixed effects Poisson regression, accounting for pre-PCV trends. All-site weighted average IRRs were estimated using linear mixed-effects regression stratified by age, product (PCV10 or PCV13) and prior PCV7 impact (none, moderate, or substantial). Changes in pneumococcal meningitis incidence were estimated overall and for product-specific vaccine-types and non-PCV13-types.
Analyses included 10,168 cases <5 y from PCV13 sites and 2849 from PCV10 sites, 3711 and 1549 for 5-17 y and 29,187 and 5653 for ≥18 y from 42 surveillance sites (30 PCV13, 12 PCV10, 2 PCV10/13) in 30 countries, primarily high-income (84%). Six years after PCV10/PCV13 introduction, pneumococcal meningitis declined 48-74% across products and PCV7 impact strata for children <5 y, 35-62% for 5-17 y and 0-36% for ≥18 y. Impact against PCV10-types at PCV10 sites, and PCV13-types at PCV13 sites was high for all age groups (<5 y: 96-100%; 5-17 y: 77-85%; ≥18 y: 73-85%). After switching from PCV7 to PCV10/13, increases in non-PCV13-types were generally low to none for all age groups.
Pneumococcal meningitis declined in all age groups following PCV10/PCV13 introduction. Plateaus in non-PCV13-type meningitis suggest less replacement than for all IPD. Data from meningitis belt and high-burden settings were limited.
The number of cases with serotyped pneumococci detected in cerebrospinal fluid and population denominators were obtained from surveillance sites globally. Site-specific meningitis incidence rate ratios (IRRs) comparing pre-PCV incidence to each year post-PCV10/13 were estimated by age (<5, 5-17 and ≥18 years) using Bayesian multi-level mixed effects Poisson regression, accounting for pre-PCV trends. All-site weighted average IRRs were estimated using linear mixed-effects regression stratified by age, product (PCV10 or PCV13) and prior PCV7 impact (none, moderate, or substantial). Changes in pneumococcal meningitis incidence were estimated overall and for product-specific vaccine-types and non-PCV13-types.
Analyses included 10,168 cases <5 y from PCV13 sites and 2849 from PCV10 sites, 3711 and 1549 for 5-17 y and 29,187 and 5653 for ≥18 y from 42 surveillance sites (30 PCV13, 12 PCV10, 2 PCV10/13) in 30 countries, primarily high-income (84%). Six years after PCV10/PCV13 introduction, pneumococcal meningitis declined 48-74% across products and PCV7 impact strata for children <5 y, 35-62% for 5-17 y and 0-36% for ≥18 y. Impact against PCV10-types at PCV10 sites, and PCV13-types at PCV13 sites was high for all age groups (<5 y: 96-100%; 5-17 y: 77-85%; ≥18 y: 73-85%). After switching from PCV7 to PCV10/13, increases in non-PCV13-types were generally low to none for all age groups.
Pneumococcal meningitis declined in all age groups following PCV10/PCV13 introduction. Plateaus in non-PCV13-type meningitis suggest less replacement than for all IPD. Data from meningitis belt and high-burden settings were limited.