title: Effect of the different 13-valent pneumococcal conjugate vaccination uptakes on the invasive pneumococcal disease in children: Analysis of a hospital-based and population-based surveillance study in Madrid, Spain, 2007-2015.
abstract: In the Community of Madrid, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced the 7-valent (PCV7) in the fully government-funded Regional Immunization Program (RIP) in May, 2010, but was later excluded in May, 2012, and included again in January, 2015. These unique changes allowed us to assess the impact of the different pneumococcal vaccination policies on PCV13 uptake in infants and on the incidence rate (IR) of invasive pneumococcal disease (IPD) in children <15 years old. In this prospective, active, surveillance study, we estimated PCV13 uptakes, IR and incidence rate ratios (IRR) for total IPD and for IPD caused by PCV13- and non-PCV13 serotypes in children <15 years, stratified by age, in four periods with different vaccination policies: fully government-funded PCV7 vaccination, fully government-funded PCV13, mixed public/private funding and only private funding. Vaccine uptakes reached 95% in periods with public-funded pneumococcal vaccination, but fell to 67% in the private funding period. Overall, IR of IPD decreased by 68% (p<0.001) in 2014-15, due to 93% reduction in the IR of PCV13-type IPD (p<0.001) without significant changes in non-PCV13-type IPD. A fully government-funded PCV13 vaccination program lead to high vaccine uptake and dramatic reductions in both overall and PCV13-type IPD IR. When this program was switched to private PCV13 vaccination, there was a fall in vaccine coverage and stagnation in the decline of PCV13-type IPD with data suggesting a weakening of herd immunity.
authors.affiliation: Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Picazo
authors.affiliation: Pediatric Department, Hospital Universitario 12 de Octubre, Madrid, Spain.|Pediatric Department, School of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Ruiz-Contreras
authors.affiliation: Pediatric ICU, Hospital Universitario Infantil Niño Jesús, Madrid, Spain.|Pediatric Department, School of Medicine, Universidad Autónoma, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Casado-Flores
authors.affiliation: Pediatric Department, Hospital Universitario 12 de Octubre, Madrid, Spain.|Pediatric Department, School of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: Sagrario
authors.initials: S
authors.lastname: Negreira
authors.affiliation: Pediatric Department, School of Medicine, Universidad Autónoma, Madrid, Spain.|Pediatric Department, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Baquero
authors.affiliation: Pediatric Department, School of Medicine, Universidad Complutense, Madrid, Spain.|Pediatric Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain and CIBER of Respiratory Diseases, CIBERES, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Hernández-Sampelayo
authors.affiliation: Pediatric Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Otheo
authors.affiliation: Medical Department, Pfizer SLU, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Méndez
mesh_terms: D002675:Child, Preschool; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage / Q000276:immunology; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D011446:Prospective Studies; D012703:Serotyping; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000302:isolation & purification; D013997:Time Factors
chemical_list: C538862:13-valent pneumococcal vaccine; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines