Despite the introduction of pneumococcal conjugate vaccine (PCV) in the childhood immunization program in New Zealand, the incidence of invasive pneumococcal disease in neonates (<30 days old) remains relatively high at 6 per 100,000 (versus 2/100,000 in the U.S.). Out of 19 cases in infants <30 days old in this study, 9 (47%) occurred during the first 7 days of life and 6 within the first 48 hours. If proven effective, maternal vaccination would cover 74% to 84% of the serotypes that infected these infants, depending on the vaccine.
Pneumonia
Switching to PCV13 for infants reduced drug-resistant IPD by 78-96% in children under five
A large U.S. study of surveillance data examining the impact of switching from PCV7 to PCV13 for infants demonstrated how important vaccination is in combating antimicrobial resistance. While the incidence of antibiotic-resistant invasive pneumococcal disease (IPD) was increasing before the introduction of PCV13, drug resistant IPD declined 78-96% in children under five after the vaccine introduction.
Introduction of PCV-10 vaccines in Finland reduced invasive pneumococcal disease in unvaccinated children by 33-58%
The rate of invasive pneumococcal disease (IPD) in children too old to be vaccinated (≈1.5 – 10 years old) fell by 33% over a five-year period following the introduction of PCV-10 vaccines in Finland. The rate of IPD caused by serotypes in the vaccine fell by 58% in these children.
Immunization with PCV reduced the risk of pneumococcal pneumonia in HIV-positive adults in Kenya
Prior to the introduction of PCV, adults with HIV in a rural area of Kenya were nearly five times more likely to have pneumococcal pneumonia than non-infected adults, and the majority of cases with bacteremia (blood infection) occurred in HIV positive individuals.
PCV-10 vaccine reduced rates of pneumococcal pneumonia in adults in Kenya, including those with HIV
The introduction of PCV-10, along with a “catch-up” campaign for 1-4 year olds, led to dramatic reductions in the rates of pneumococcal pneumonia in adults (≥18 years old) in a rural area of Kenya with high rates of both adult pneumococcal pneumonia and HIV. Over five years following the vaccine introduction, the incidence rates among adults were 47-94% lower each year than in the pre-vaccine period, with similar declines for HIV-infected and HIV-uninfected adults.
Immunization with PCV in Portugal reduced hospitalization rates in older adults
Hospitalization rates for pneumococcal pneumonia in adults 65 and older in Portugal — which had been increasing on average by 16% per year before pneumococcal conjugate vaccines became available — began to reverse once PCVs became available for infants. The reduction in the elderly, over expected rates, was greatest after the introduction of PCV13.
Vaccination of infants against pneumonia greatly reduces hospitalizations, saving millions in healthcare costs
In a study using actual data on hospitalizations and costs before and after PCV-10 vaccine was introduced in Brazil, an estimated 463,000 hospitalizations from all causes of pneumonia were prevented in persons less than 65 years of age over 5 years following introduction of the vaccine — saving an estimated US$147 million in hospitalization costs. Half of the costs averted were due to fewer hospitalizations in children under five, who were targeted for the vaccine, while the remaining half were due to fewer hospitalizations in persons 5-49 years of age, as a result of herd protection.
Vaccinating infants with PCV also reduced disease and hospitalizations in older individuals
The cost-effectiveness of vaccinating infants with PCV-13 in China was estimated to be 21 times greater when the indirect effects of vaccination in reducing invasive pneumococcal disease and hospitalized cases of pneumonia in older (unvaccinated) individuals was taken into account — with costs per quality of life-year gained (QALY) of around US$564 (Y3,777) vs. $11,836 (Y79,204) when only the direct impact on vaccinated children is considered.
Vaccinating infants significantly reduces hospitalizations from pneumonia
According to a study using local epidemiological data in China, vaccinating infants with pneumococcal conjugate vaccine (PCV-13), using a 3+1 schedule, would prevent more than 10 times as many deaths from invasive pneumococcal disease and pneumonia in unvaccinated individuals (147,500 per year) than it would prevent directly in those vaccinated (12,800 per year). This would be due mainly to a reduction in hospitalizations for pneumonia.
Immunization with PCV reduced antibiotic prescriptions for children and slowed antibiotic resistance
In Iceland, a study of all children born over an 11-year period, before and after the introduction of pneumococcal conjugate vaccine (PCV) into the national immunization program, found a 6% decrease in all antibiotic prescriptions for children during their first four years of life and a 22% reduction in prescriptions for otitis media after the vaccine was introduced. Thus, in addition to reducing the burden of pneumococcal disease, PCV may also slow the spread of antibiotic resistance.