Vaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in Iceland

The introduction of pneumococcal conjugate vaccines (PCVs) into childhood vaccination programs has reduced carriage of vaccine serotypes and pneumococcal disease. The 10-valent PCV was introduced in Iceland in 2011. The aim of this study was to determine PCV impact on the prevalence of serotypes, ge...

תיאור מלא

מידע ביבליוגרפי
Main Authors: Quirk, S, Haraldsson, G, Hjálmarsdóttir, M, Van Tonder, A, Hrafnkelsson, B, Bentley, S, Haraldsson, Á, Erlendsdóttir, H, Brueggemann, A, Kristinsson, K
פורמט: Journal article
שפה:English
יצא לאור: American Society for Microbiology 2019
_version_ 1826290311002849280
author Quirk, S
Haraldsson, G
Hjálmarsdóttir, M
Van Tonder, A
Hrafnkelsson, B
Bentley, S
Haraldsson, Á
Erlendsdóttir, H
Brueggemann, A
Kristinsson, K
author_facet Quirk, S
Haraldsson, G
Hjálmarsdóttir, M
Van Tonder, A
Hrafnkelsson, B
Bentley, S
Haraldsson, Á
Erlendsdóttir, H
Brueggemann, A
Kristinsson, K
author_sort Quirk, S
collection OXFORD
description The introduction of pneumococcal conjugate vaccines (PCVs) into childhood vaccination programs has reduced carriage of vaccine serotypes and pneumococcal disease. The 10-valent PCV was introduced in Iceland in 2011. The aim of this study was to determine PCV impact on the prevalence of serotypes, genetic lineages, and antimicrobial-resistant pneumococci isolated from the lower respiratory tract (LRT) of adults. Pneumococci isolated between 2009 and 2017 at the Landspitali University Hospital were included (n = 797). The hospital serves almost three-quarters of the Icelandic population. Isolates were serotyped and tested for antimicrobial susceptibility, and the genome of every other isolate collected between 2009 and 2014 was sequenced (n = 275). Serotypes and multilocus sequence types (STs) were extracted from the genome data. Three study periods were defined, 2009 to 2011 (PreVac), 2012 to 2014 (PostVac-I), and 2015 to 2017 (PostVac-II). The total number of isolates and vaccine-type (VT) pneumococci decreased from PreVac to PostVac-II (n = 314 versus n = 230 [p = 0.002] and n = 170 versus n = 33 [p < 0.001], respectively), but non-vaccine-type (NVT) pneumococci increased among adults 18 to 64 years old (n = 56 versus n = 114 [p = 0.008]). Serotype 19F decreased in the PostVac-II period; these isolates were all multidrug resistant (MDR) and were members of the Taiwan19F-14 PMEN lineage. Serotype 6A decreased among adults ≥65 years old in the PostVac-II period (p = 0.037), while serotype 6C increased (p = 0.021) and most serotype 6C isolates were MDR. Nonencapsulated Streptococcus pneumoniae (NESp) isolates increased among adults 18 to 64 years old in the PostVac-II period, and the majority were MDR (p = 0.028). An overall reduction in the number of LRT samples and pneumococcus-positive cultures and significant changes in the serotype distribution became evident within 4 years, thereby demonstrating a significant herd effect.
first_indexed 2024-03-07T02:42:14Z
format Journal article
id oxford-uuid:aad89132-3762-4d5c-8dd6-eb137e202bdf
institution University of Oxford
language English
last_indexed 2024-03-07T02:42:14Z
publishDate 2019
publisher American Society for Microbiology
record_format dspace
spelling oxford-uuid:aad89132-3762-4d5c-8dd6-eb137e202bdf2022-03-27T03:17:54ZVaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in IcelandJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:aad89132-3762-4d5c-8dd6-eb137e202bdfEnglishSymplectic Elements at OxfordAmerican Society for Microbiology2019Quirk, SHaraldsson, GHjálmarsdóttir, MVan Tonder, AHrafnkelsson, BBentley, SHaraldsson, ÁErlendsdóttir, HBrueggemann, AKristinsson, KThe introduction of pneumococcal conjugate vaccines (PCVs) into childhood vaccination programs has reduced carriage of vaccine serotypes and pneumococcal disease. The 10-valent PCV was introduced in Iceland in 2011. The aim of this study was to determine PCV impact on the prevalence of serotypes, genetic lineages, and antimicrobial-resistant pneumococci isolated from the lower respiratory tract (LRT) of adults. Pneumococci isolated between 2009 and 2017 at the Landspitali University Hospital were included (n = 797). The hospital serves almost three-quarters of the Icelandic population. Isolates were serotyped and tested for antimicrobial susceptibility, and the genome of every other isolate collected between 2009 and 2014 was sequenced (n = 275). Serotypes and multilocus sequence types (STs) were extracted from the genome data. Three study periods were defined, 2009 to 2011 (PreVac), 2012 to 2014 (PostVac-I), and 2015 to 2017 (PostVac-II). The total number of isolates and vaccine-type (VT) pneumococci decreased from PreVac to PostVac-II (n = 314 versus n = 230 [p = 0.002] and n = 170 versus n = 33 [p < 0.001], respectively), but non-vaccine-type (NVT) pneumococci increased among adults 18 to 64 years old (n = 56 versus n = 114 [p = 0.008]). Serotype 19F decreased in the PostVac-II period; these isolates were all multidrug resistant (MDR) and were members of the Taiwan19F-14 PMEN lineage. Serotype 6A decreased among adults ≥65 years old in the PostVac-II period (p = 0.037), while serotype 6C increased (p = 0.021) and most serotype 6C isolates were MDR. Nonencapsulated Streptococcus pneumoniae (NESp) isolates increased among adults 18 to 64 years old in the PostVac-II period, and the majority were MDR (p = 0.028). An overall reduction in the number of LRT samples and pneumococcus-positive cultures and significant changes in the serotype distribution became evident within 4 years, thereby demonstrating a significant herd effect.
spellingShingle Quirk, S
Haraldsson, G
Hjálmarsdóttir, M
Van Tonder, A
Hrafnkelsson, B
Bentley, S
Haraldsson, Á
Erlendsdóttir, H
Brueggemann, A
Kristinsson, K
Vaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in Iceland
title Vaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in Iceland
title_full Vaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in Iceland
title_fullStr Vaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in Iceland
title_full_unstemmed Vaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in Iceland
title_short Vaccination of Icelandic children with the 10-valent pneumococcal vaccine leads to a significant herd effect among adults in Iceland
title_sort vaccination of icelandic children with the 10 valent pneumococcal vaccine leads to a significant herd effect among adults in iceland
work_keys_str_mv AT quirks vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT haraldssong vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT hjalmarsdottirm vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT vantondera vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT hrafnkelssonb vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT bentleys vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT haraldssona vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT erlendsdottirh vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT brueggemanna vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland
AT kristinssonk vaccinationoficelandicchildrenwiththe10valentpneumococcalvaccineleadstoasignificantherdeffectamongadultsiniceland