title: Effectiveness of three pneumococcal conjugate vaccines to prevent invasive pneumococcal disease in Quebec, Canada.
abstract: BACKGROUND
  In Quebec, a pneumococcal conjugate vaccine (PCV) program was implemented in December 2004. The recommended schedule is 2+1 doses for low-risk infants. PCV-7 was first used (including catch-up for children <5 years of age), replaced by PCV10 in June 2009, and by PCV13 in January 2011 (no catch-up in both instances). From the beginning, >90% of children received the recommended number of doses.
  
  
  OBJECTIVE
  To assess the effectiveness of the three PCVs sequentially used to prevent invasive infectious disease (IPD).
  
  
  METHODS
  IPD cases in children 2-59 months during the years 2005-2013 were eligible. Controls were randomly identified in the provincial health insurance registry. Parents were interviewed and immunization records reviewed. Vaccine effectiveness (VE) was computed using multivariate logistic regression models.
  
  
  RESULTS
  Out of 889 IPD cases reported, full participation was obtained for 516 cases (58%) and for 1767 controls. Against vaccine-type IPD, VE (≥1 dose) was 90% (82-95%) for PCV7, 97% (84-99%) for PCV10 and 86% (62-95%) for PCV13. Against 19A IPD, VE was, respectively, 42% (-9% to 69%), 71% (24-89%), and 74% (11-92%). VE (≥2 doses) against PCV13-type IPD was 85% for PCV10 (66-94%), 85% for PCV13 (55-94%), and 89% (58-97%) for a mixed PCV10+PCV13 schedule.
  
  
  CONCLUSIONS
  All three PCV vaccines showed high level of protection against IPD caused by serotypes included in their formulation and there was a high level of cross-protection against 19A for PCV10. No substantial difference was seen between PCV10, PCV13, or a mixed PCV10+PCV13 schedule.
authors.affiliation: Quebec University Hospital Research Centre, Quebec City, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Deceuninck
authors.affiliation: Quebec University Hospital Research Centre, Quebec City, Canada; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec City, Canada; Department of Social and Preventive Medicine, Laval University, Quebec City, Canada.
authors.forename: Gaston
authors.initials: G
authors.lastname: De Serres
authors.affiliation: Quebec University Hospital Research Centre, Quebec City, Canada; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec City, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Boulianne
authors.affiliation: Laboratoire de Santé publique du Québec, Institut national de santé publique du Québec, Ste-Anne-de-Bellevue, Canada.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Lefebvre
authors.affiliation: Quebec University Hospital Research Centre, Quebec City, Canada; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec City, Canada; Department of Social and Preventive Medicine, Laval University, Quebec City, Canada. Electronic address: philippe.dewals@criucpq.ulaval.ca.
authors.forename: Philippe
authors.initials: P
authors.lastname: De Wals
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000517:prevention & control*; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000517:prevention & control*; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011792:Quebec / Q000453:epidemiology; D016896:Treatment Outcome; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Case–control study; Effectiveness; Invasive pneumococcal disease; Pneumococcal conjugate vaccine