Five winters of pneumococcal serotype replacement in UK carriage following PCV introduction.

Abstract:

:The seven-valent pneumococcal conjugate vaccine (PCV7) was added to the UK national immunisation programme in September 2006. PCV13 replaced PCV7 in April 2010. As carriage precedes disease cases this study collected carried pneumococci from children each winter from 2006/7 to 2010/11 over PCV introduction. Conventional microbiology and whole genome sequencing were utilised to characterise pneumococcal strains. Overall prevalence of pneumococcal carriage remained stable. Vaccine serotypes (VT) decreased (p<0.0001) with concomitant increases in non-vaccine serotypes (NVT). In winter 2010/11 only one isolate of PCV7 VT was observed (6B). PCV13 unique VTs decreased between winters immediately preceding and following PCV13 introduction (p=0.04). Significant decreases for VTs 6B, 19F, 23F (PCV7) and 6A (PCV13) and increases for NVT 21, 23B, 33F and 35F were detected. The serotype replacement was accompanied by parallel changes in genotype prevalence for associated sequence types with clonal expansion contributing to replacement. By winter 2010/11, serotype coverage of PCV7 and PCV13 was 1% and 11% respectively. VT replacement was observed for PCV7 and PCV13 serotypes. Conjugate vaccine design and use requires continuous monitoring and revision.

journal_name

Vaccine

journal_title

Vaccine

authors

Gladstone RA,Jefferies JM,Tocheva AS,Beard KR,Garley D,Chong WW,Bentley SD,Faust SN,Clarke SC

doi

10.1016/j.vaccine.2015.03.012

subject

Has Abstract

pub_date

2015-04-21 00:00:00

pages

2015-21

issue

17

eissn

0264-410X

issn

1873-2518

pii

S0264-410X(15)00300-X

journal_volume

33

pub_type

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