Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya
Abstract Background The World Health Organisation recommends the use of catch-up campaigns as part of the introduction of pneumococcal conjugate vaccines (PCVs) to accelerate herd protection and hence PCV impact. The value of a catch-up campaign is a trade-off between the costs of vaccinating additi...
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| Format: | Article |
| Language: | English |
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BMC
2017-06-01
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| Series: | BMC Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12916-017-0882-9 |
| _version_ | 1828852436402438144 |
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| author | Stefan Flasche John Ojal Olivier Le Polain de Waroux Mark Otiende Katherine L. O’Brien Moses Kiti D. James Nokes W John Edmunds J. Anthony G. Scott |
| author_facet | Stefan Flasche John Ojal Olivier Le Polain de Waroux Mark Otiende Katherine L. O’Brien Moses Kiti D. James Nokes W John Edmunds J. Anthony G. Scott |
| author_sort | Stefan Flasche |
| collection | DOAJ |
| description | Abstract Background The World Health Organisation recommends the use of catch-up campaigns as part of the introduction of pneumococcal conjugate vaccines (PCVs) to accelerate herd protection and hence PCV impact. The value of a catch-up campaign is a trade-off between the costs of vaccinating additional age groups and the benefit of additional direct and indirect protection. There is a paucity of observational data, particularly from low- and middle-income countries, to quantify the optimal breadth of such catch-up campaigns. Methods In Kilifi, Kenya, PCV10 was introduced in 2011 using the three-dose Expanded Programme on Immunisation infant schedule and a catch-up campaign in children <5 years old. We fitted a transmission dynamic model to detailed local data, including nasopharyngeal carriage and invasive pneumococcal disease (IPD), to infer the marginal impact of the PCV catch-up campaign over hypothetical routine cohort vaccination in that setting and to estimate the likely impact of alternative campaigns and their dose efficiency. Results We estimated that, within 10 years of introduction, the catch-up campaign among children <5 years old prevents an additional 65 (48–84) IPD cases across age groups, compared to PCV cohort introduction alone. Vaccination without any catch-up campaign prevented 155 (121–193) IPD cases and used 1321 (1058–1698) PCV doses per IPD case prevented. In the years after implementation, the PCV programme gradually accrues herd protection, and hence its dose efficiency increases: 10 years after the start of cohort vaccination alone the programme used 910 (732–1184) doses per IPD case averted. We estimated that a two-dose catch-up among children <1 year old uses an additional 910 (732–1184) doses per additional IPD case averted. Furthermore, by extending a single-dose catch-up campaign to children aged 1 to <2 years and subsequently to those aged 2 to <5 years, the campaign uses an additional 412 (296–606) and 543 (403–763) doses per additional IPD case averted. These results were not sensitive to vaccine coverage, serotype competition, the duration of vaccine protection or the relative protection of infants. Conclusions We find that catch-up campaigns are a highly dose-efficient way to accelerate population protection against pneumococcal disease. |
| first_indexed | 2024-12-12T23:53:05Z |
| format | Article |
| id | doaj.art-f0ecf686d1264c84a8db1d5798c69e2b |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-12T23:53:05Z |
| publishDate | 2017-06-01 |
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| series | BMC Medicine |
| spelling | doaj.art-f0ecf686d1264c84a8db1d5798c69e2b2022-12-22T00:06:39ZengBMCBMC Medicine1741-70152017-06-0115111010.1186/s12916-017-0882-9Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, KenyaStefan Flasche0John Ojal1Olivier Le Polain de Waroux2Mark Otiende3Katherine L. O’Brien4Moses Kiti5D. James Nokes6W John Edmunds7J. Anthony G. Scott8Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineKenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-CoastInternational Vaccine Access Center, Johns Hopkins Bloomberg School of Public HealthKenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-CoastKenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-CoastDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineAbstract Background The World Health Organisation recommends the use of catch-up campaigns as part of the introduction of pneumococcal conjugate vaccines (PCVs) to accelerate herd protection and hence PCV impact. The value of a catch-up campaign is a trade-off between the costs of vaccinating additional age groups and the benefit of additional direct and indirect protection. There is a paucity of observational data, particularly from low- and middle-income countries, to quantify the optimal breadth of such catch-up campaigns. Methods In Kilifi, Kenya, PCV10 was introduced in 2011 using the three-dose Expanded Programme on Immunisation infant schedule and a catch-up campaign in children <5 years old. We fitted a transmission dynamic model to detailed local data, including nasopharyngeal carriage and invasive pneumococcal disease (IPD), to infer the marginal impact of the PCV catch-up campaign over hypothetical routine cohort vaccination in that setting and to estimate the likely impact of alternative campaigns and their dose efficiency. Results We estimated that, within 10 years of introduction, the catch-up campaign among children <5 years old prevents an additional 65 (48–84) IPD cases across age groups, compared to PCV cohort introduction alone. Vaccination without any catch-up campaign prevented 155 (121–193) IPD cases and used 1321 (1058–1698) PCV doses per IPD case prevented. In the years after implementation, the PCV programme gradually accrues herd protection, and hence its dose efficiency increases: 10 years after the start of cohort vaccination alone the programme used 910 (732–1184) doses per IPD case averted. We estimated that a two-dose catch-up among children <1 year old uses an additional 910 (732–1184) doses per additional IPD case averted. Furthermore, by extending a single-dose catch-up campaign to children aged 1 to <2 years and subsequently to those aged 2 to <5 years, the campaign uses an additional 412 (296–606) and 543 (403–763) doses per additional IPD case averted. These results were not sensitive to vaccine coverage, serotype competition, the duration of vaccine protection or the relative protection of infants. Conclusions We find that catch-up campaigns are a highly dose-efficient way to accelerate population protection against pneumococcal disease.http://link.springer.com/article/10.1186/s12916-017-0882-9PneumococcusCatch-upVaccinationPCVDose efficiencyImpact |
| spellingShingle | Stefan Flasche John Ojal Olivier Le Polain de Waroux Mark Otiende Katherine L. O’Brien Moses Kiti D. James Nokes W John Edmunds J. Anthony G. Scott Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya BMC Medicine Pneumococcus Catch-up Vaccination PCV Dose efficiency Impact |
| title | Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya |
| title_full | Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya |
| title_fullStr | Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya |
| title_full_unstemmed | Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya |
| title_short | Assessing the efficiency of catch-up campaigns for the introduction of pneumococcal conjugate vaccine: a modelling study based on data from PCV10 introduction in Kilifi, Kenya |
| title_sort | assessing the efficiency of catch up campaigns for the introduction of pneumococcal conjugate vaccine a modelling study based on data from pcv10 introduction in kilifi kenya |
| topic | Pneumococcus Catch-up Vaccination PCV Dose efficiency Impact |
| url | http://link.springer.com/article/10.1186/s12916-017-0882-9 |
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