High residual carriage of vaccine-serotype Streptococcus pneumoniae after introduction of pneumococcal conjugate vaccine in Malawi.
Adolescent
Adult
Child
Child, Preschool
Cross-Sectional Studies
Demography
Female
HIV Infections
Humans
Infant
Malawi
Male
Nasopharynx
/ immunology
Pneumococcal Vaccines
/ administration & dosage
Prevalence
Prospective Studies
Serogroup
Streptococcus pneumoniae
/ immunology
Time Factors
Vaccination
Vaccines, Conjugate
/ administration & dosage
Journal
Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555
Informations de publication
Date de publication:
06 05 2020
06 05 2020
Historique:
received:
20
06
2019
accepted:
28
03
2020
entrez:
8
5
2020
pubmed:
8
5
2020
medline:
15
8
2020
Statut:
epublish
Résumé
There are concerns that pneumococcal conjugate vaccines (PCVs) in sub-Saharan Africa sub-optimally interrupt Streptococcus pneumoniae vaccine-serotype (VT) carriage and transmission. Here we assess PCV carriage using rolling, prospective nasopharyngeal carriage surveys between 2015 and 2018, 3.6-7.1 years after Malawi's 2011 PCV13 introduction. Carriage decay rate is analysed using non-linear regression. Despite evidence of reduction in VT carriage over the study period, there is high persistent residual carriage. This includes among PCV-vaccinated children 3-5-year-old (16.1% relative reduction from 19.9% to 16.7%); PCV-unvaccinated children 6-8-year-old (40.5% reduction from 26.4% to 15.7%); HIV-infected adults 18-40-years-old on antiretroviral therapy (41.4% reduction from 15.2% to 8.9%). VT carriage prevalence half-life is similar among PCV-vaccinated and PCV-unvaccinated children (3.26 and 3.34 years, respectively). Compared with high-income settings, there is high residual VT carriage 3.6-7.1 years after PCV introduction. Rigorous evaluation of strategies to augment vaccine-induced control of carriage, including alternative schedules and catch-up campaigns, is required.
Identifiants
pubmed: 32376860
doi: 10.1038/s41467-020-15786-9
pii: 10.1038/s41467-020-15786-9
pmc: PMC7203201
doi:
Substances chimiques
Pneumococcal Vaccines
0
Vaccines, Conjugate
0
Banques de données
figshare
['10.6084/m9.figshare.11985255']
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2222Subventions
Organisme : Department of Health
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N023129/1
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 106846/Z/15/Z
Pays : United Kingdom
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