Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.

<h4>Overview</h4>The protective effect of infant pneumococcal conjugate vaccine (PCV) recommendation can be seen in Germany as a whole and in smaller regional groups. Comparisons between population-normalized geographic regions of Germany show different serotype distributions after progr...

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Main Authors: Stephanie Perniciaro, Matthias Imöhl, Christina Fitzner, Mark van der Linden
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0210278
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author Stephanie Perniciaro
Matthias Imöhl
Christina Fitzner
Mark van der Linden
author_facet Stephanie Perniciaro
Matthias Imöhl
Christina Fitzner
Mark van der Linden
author_sort Stephanie Perniciaro
collection DOAJ
description <h4>Overview</h4>The protective effect of infant pneumococcal conjugate vaccine (PCV) recommendation can be seen in Germany as a whole and in smaller regional groups. Comparisons between population-normalized geographic regions of Germany show different serotype distributions after program implementation, particularly in non-vaccine serotypes. The prior distinct differences in serotype distribution in children between the former East and former West German federal states have vanished. Children under six remain a vulnerable group, but the occurrence of vaccine-type (VT) invasive pneumococcal disease (IPD) in children correctly vaccinated (using a three-dose primary series plus one booster dose) with PCV13 was low (9 out of 374 cases, 2.4%). However, only 18.4% of children in Germany with IPD were correctly vaccinated with PCV13 according to the recommended schedule. Continued surveillance and better schedule adherence are essential to definitively establish the most effective PCV administration schedule.<h4>Vaccination effects</h4>For all PCV products used in Germany (PCV7, PCV10, and PCV13), vaccination status was the most common statistically significant predictor of infection with a particular serotype: Unvaccinated children old enough to have received at least one dose of vaccine in the PCV7 group had significantly higher odds (OR: 6.84, 95%CI: 2.66-22.06, adjusted for per capita income and residence in the northeastern federal states) of contracting VT IPD. In the PCV10 group, VT IPD had an OR of 4.52 (95% CI: 1.60-15.62, adjusted for year of infection, median household size, and residence in the southern federal states) in unvaccinated children, and in the PCV13 group, unvaccinated children continued to have higher odds (OR: 6.21, 95%CI: 3.45-11.36, adjusted for year of infection, age of child, per capita income, residence in the southern federal states, and percentage of children using public daycare) of getting vaccine-type IPD. Being unvaccinated was the most frequent significant indicator for infection with vaccine-type serotypes for each analysis group, while geographic groupings showed more limited potential to predict serotype of infection in early childhood IPD in Germany.
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spelling doaj.art-33e2287c0d98429e86b58d8d3218f9f92022-12-21T23:10:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01141e021027810.1371/journal.pone.0210278Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.Stephanie PerniciaroMatthias ImöhlChristina FitznerMark van der Linden<h4>Overview</h4>The protective effect of infant pneumococcal conjugate vaccine (PCV) recommendation can be seen in Germany as a whole and in smaller regional groups. Comparisons between population-normalized geographic regions of Germany show different serotype distributions after program implementation, particularly in non-vaccine serotypes. The prior distinct differences in serotype distribution in children between the former East and former West German federal states have vanished. Children under six remain a vulnerable group, but the occurrence of vaccine-type (VT) invasive pneumococcal disease (IPD) in children correctly vaccinated (using a three-dose primary series plus one booster dose) with PCV13 was low (9 out of 374 cases, 2.4%). However, only 18.4% of children in Germany with IPD were correctly vaccinated with PCV13 according to the recommended schedule. Continued surveillance and better schedule adherence are essential to definitively establish the most effective PCV administration schedule.<h4>Vaccination effects</h4>For all PCV products used in Germany (PCV7, PCV10, and PCV13), vaccination status was the most common statistically significant predictor of infection with a particular serotype: Unvaccinated children old enough to have received at least one dose of vaccine in the PCV7 group had significantly higher odds (OR: 6.84, 95%CI: 2.66-22.06, adjusted for per capita income and residence in the northeastern federal states) of contracting VT IPD. In the PCV10 group, VT IPD had an OR of 4.52 (95% CI: 1.60-15.62, adjusted for year of infection, median household size, and residence in the southern federal states) in unvaccinated children, and in the PCV13 group, unvaccinated children continued to have higher odds (OR: 6.21, 95%CI: 3.45-11.36, adjusted for year of infection, age of child, per capita income, residence in the southern federal states, and percentage of children using public daycare) of getting vaccine-type IPD. Being unvaccinated was the most frequent significant indicator for infection with vaccine-type serotypes for each analysis group, while geographic groupings showed more limited potential to predict serotype of infection in early childhood IPD in Germany.https://doi.org/10.1371/journal.pone.0210278
spellingShingle Stephanie Perniciaro
Matthias Imöhl
Christina Fitzner
Mark van der Linden
Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.
PLoS ONE
title Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.
title_full Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.
title_fullStr Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.
title_full_unstemmed Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.
title_short Regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in Germany.
title_sort regional variations in serotype distribution and vaccination status in children under six years of age with invasive pneumococcal disease in germany
url https://doi.org/10.1371/journal.pone.0210278
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