title: A reflection on invasive pneumococcal disease and pneumococcal conjugate vaccination coverage in children in Southern Europe (2009-2016).
abstract: Higher-valent pneumococcal conjugate vaccines (PCVs) were licensed from 2009 in Europe; similar worldwide clinical effectiveness was observed for PCVs in routine use. Despite a proven medical need, PCV vaccination in Southern Europe remained suboptimal until 2015/16. We searched PubMed for manuscripts published between 2009 and mid-2016. Included manuscripts had to contain data about invasive pneumococcal disease (IPD) incidence, or vaccination coverage with higher-valent PCVs. This review represents the first analysis of vaccination coverage and impact of higher-valent PCVs on overall IPD in Southern European countries (Portugal, Spain, Italy, Greece, Cyprus). Vaccination coverage in the Portuguese private market peaked around 2008 at 75% (children ≤ 2 years) but declined to 63% in 2012. In Madrid, coverage was 95% (2007-2012) but dropped to 67% (2013/14; children ≤ 2 years) after funding termination in May 2012. PCVs were recently introduced in the national immunisation program (NIP) of Portugal (2015) and Spain (2015/16). In Italy, coverage for the complete PCV schedule (children ≤ 2 years) was 88% in 2013, although highly variable between regions (45-99%). In Greece, in 2013, 82.3% had received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months. Overall IPD (net benefit: effect on vaccine types, vaccine-related types, and non-vaccine types) has decreased; in Greece, pneumococcal meningitis incidence remained stable. Continued IPD surveillance or national registers using ICD-10 codes of clinically suspected IPD are necessary, with timely publicly available reports and adequate national vaccination registers to assess trends in vaccination coverage, allowing evaluation of PCVs in NIPs.
authors.affiliation: a GSK Vaccines , Global Medical affairs , Wavre , Belgium.
authors.forename: Marta
authors.initials: M
authors.lastname: Moreira
authors.affiliation: b GSK, Medical Affairs Vaccines , Algés , Portugal.
authors.forename: Olga
authors.initials: O
authors.lastname: Castro
authors.affiliation: c GSK, Medical Affairs Vaccines , Madrid , Spain.
authors.forename: Melissa
authors.initials: M
authors.lastname: Palmieri
authors.affiliation: d GSK, Medical Affairs Vaccines , Athens , Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Efklidou
authors.affiliation: e GSK, Medical Affairs Vaccines , Verona , Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Castagna
authors.affiliation: a GSK Vaccines , Global Medical affairs , Wavre , Belgium.
authors.forename: Bernard
authors.initials: B
authors.lastname: Hoet
mesh_terms: D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D011008:Pneumococcal Infections / Q000453:epidemiology*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D000073887:Vaccination Coverage
chemical_list: D022242:Pneumococcal Vaccines
keywords: Southern Europe; invasive pneumococcal disease; national immunisation programmes; pneumococcal conjugate vaccine; vaccination coverage