- Title
- Lack of effectiveness of 13-valent pneumococcal conjugate vaccination against pneumococcal carriage density in Papua New Guinean infants
- Creator
- Britton, Kathryn; Pickering, Janessa; Pomat, William; de Gier, Camilla; Greenhill, Andrew
- Date
- 2021
- Type
- Text; Journal article
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/179570
- Identifier
- vital:15610
- Identifier
-
https://doi.org/10.1016/j.vaccine.2021.07.085
- Identifier
- ISBN:0264-410X (ISSN)
- Abstract
- Background: Papua New Guinea (PNG) introduced the 13-valent pneumococcal conjugate vaccine (PCV13) in 2014, with administration at 1, 2, and 3 months of age. PCV13 has reduced or eliminated carriage of vaccine types in populations with low pneumococcal carriage prevalence, carriage density and serotype diversity. This study investigated PCV13 impact on serotype-specific pneumococcal carriage prevalence, density, and serotype diversity in PNG infants, who have some of the highest reported rates of pneumococcal carriage and disease in the world. Methods: Nasopharyngeal swabs were collected at 1, 4 and 9 months of age from PCV13-vaccinated infants (n = 57) and age-/season-matched, unvaccinated infants (at approximately 1 month, n = 53; 4 months, n = 57; 9 months, n = 52). Serotype-specific pneumococcal carriage density and antimicrobial resistance genes were identified by qPCR and microarray. Results: Pneumococci were present in 89% of swabs, with 60 different serotypes and four non-encapsulated variants detected. Multiple serotype carriage was common (47% of swabs). Vaccine type carriage prevalence was similar between PCV13-vaccinated and unvaccinated infants at 4 and 9 months of age. The prevalence of non-vaccine type carriage was also similar between cohorts, with non-vaccine types present in three-quarters of samples (from both vaccinated and unvaccinated infants) by 4 months of age. The median pneumococcal carriage density was high and similar at each age group (~7.0 log10 genome equivalents/mL). PCV13 had no effect on overall pneumococcal carriage density, vaccine type density, non-vaccine type density, or the prevalence of antimicrobial resistance genes. Conclusion: PNG infants experience dense and diverse pneumococcal colonisation with concurrent serotypes from 1 month of age. PCV13 had no impact on pneumococcal carriage density, even for vaccine serotypes. The low prevalence of vaccine serotypes, high pneumococcal carriage density and abundance of non-vaccine serotypes likely contribute to the lack of PCV13 impact on carriage in PNG infants. Indirect effects of the infant PCV programs are likely to be limited in PNG. Alternative vaccines with broader coverage should be considered. © 2021 The Authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Andrew Greenhill" is provided in this record**
- Publisher
- Elsevier Ltd
- Relation
- Vaccine Vol. 39, no. 38 (2021), p. 5401-5409
- Rights
- All metadata describing materials held in, or linked to, the repository is freely available under a CC0 licence
- Rights
- http://creativecommons.org/licenses/by/4.0/
- Rights
- Copyright © 2021 The Authors. Published by Elsevier Ltd.
- Rights
- Open Access
- Subject
- 06 Biological Sciences; 07 Agricultural and Veterinary Sciences; 11 Medical and Health Sciences; Carriage; Microarray; Papua New Guinea; Pneumococcal conjugate vaccine; Serotype; Streptococcus pneumoniae
- Full Text
- Reviewed
- Funder
- This study was funded by a Robert Austrian Research Award in Pneumococcal Vaccinology, supported by Pfizer, that was awarded to Dr Lea-Ann Kirkham at the 11 th International Symposium in Pneumococci and Pneumococcal Disease (ISPPD-11) in 2018. Ms Kathryn Britton is supported by an Australian Government Research Training Program Scholarship at The University of Western Australia and a PhD top-up scholarship from the Wesfarmers Centre of Vaccines and Infectious Diseases at the Telethon Kids Institute. A/Prof Chris Blyth is supported by NHMRC investigator grant #1173163.
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