Effectiveness of Tick-borne Encephalitis Vaccines in Children, Latvia, 2018-2020.
Journal
The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858
Informations de publication
Date de publication:
01 10 2023
01 10 2023
Historique:
medline:
22
9
2023
pubmed:
5
7
2023
entrez:
5
7
2023
Statut:
ppublish
Résumé
Tick-borne encephalitis (TBE) is an infection by the tick-borne encephalitis virus (TBEV) with symptoms of central nervous system inflammation. TBE is endemic in Latvia and other parts of Europe. TBE vaccination is recommended for children in Latvia. TBE vaccine effectiveness (VE) was estimated in Latvia, a country with high TBE incidence, providing the first VE estimates against a range of TBEV infection outcomes in children 1-15 years-of-age. Rīga Stradinš University conducted nationwide surveillance for suspected TBE cases. Serum and cerebrospinal fluid were ELISA tested for TBEV-specific IgG and IgM antibodies. A fully vaccinated child was an individual who had received the 3-dose primary series and appropriately timed boosters. The proportion of laboratory-confirmed TBE cases fully vaccinated (PCV) was determined from interviews and medical records. The proportion of the general population fully vaccinated (PPV) was determined from national surveys conducted in 2019 and 2020. TBE VE in children 1-15 years-of-age was estimated using the screening method: VE = 1 - [PCV/(1 - PCV)/PPV/(1 - PPV)]. From 2018 to 2020, surveillance identified 36 TBE cases in children 1-15 years-of-age; all were hospitalized, 5 (13.9%) for >12 days. Of the TBE cases, 94.4% (34/36) were unvaccinated compared with 43.8% of children in the general population. VE against TBE hospitalization in children 1-15 years-of-age was 94.9% (95% confidence interval 63.1-99.3). In 2018-2020, vaccination in children 1-15 years-of-age averted 39 hospitalized TBE cases. Pediatric TBE vaccines were highly effective in preventing TBE in children. Increasing TBE vaccine uptake in children is essential to maximize the public health impact of TBE vaccination.
Sections du résumé
BACKGROUND
Tick-borne encephalitis (TBE) is an infection by the tick-borne encephalitis virus (TBEV) with symptoms of central nervous system inflammation. TBE is endemic in Latvia and other parts of Europe. TBE vaccination is recommended for children in Latvia. TBE vaccine effectiveness (VE) was estimated in Latvia, a country with high TBE incidence, providing the first VE estimates against a range of TBEV infection outcomes in children 1-15 years-of-age.
METHODS
Rīga Stradinš University conducted nationwide surveillance for suspected TBE cases. Serum and cerebrospinal fluid were ELISA tested for TBEV-specific IgG and IgM antibodies. A fully vaccinated child was an individual who had received the 3-dose primary series and appropriately timed boosters. The proportion of laboratory-confirmed TBE cases fully vaccinated (PCV) was determined from interviews and medical records. The proportion of the general population fully vaccinated (PPV) was determined from national surveys conducted in 2019 and 2020. TBE VE in children 1-15 years-of-age was estimated using the screening method: VE = 1 - [PCV/(1 - PCV)/PPV/(1 - PPV)].
RESULTS
From 2018 to 2020, surveillance identified 36 TBE cases in children 1-15 years-of-age; all were hospitalized, 5 (13.9%) for >12 days. Of the TBE cases, 94.4% (34/36) were unvaccinated compared with 43.8% of children in the general population. VE against TBE hospitalization in children 1-15 years-of-age was 94.9% (95% confidence interval 63.1-99.3). In 2018-2020, vaccination in children 1-15 years-of-age averted 39 hospitalized TBE cases.
CONCLUSION
Pediatric TBE vaccines were highly effective in preventing TBE in children. Increasing TBE vaccine uptake in children is essential to maximize the public health impact of TBE vaccination.
Identifiants
pubmed: 37406220
doi: 10.1097/INF.0000000000004034
pii: 00006454-202310000-00021
doi:
Substances chimiques
Vaccines
0
Viral Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
927-931Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
D.Z. declares a research grant within the Research Collaboration to Rīga Stradinš University (employer) from Pfizer Vaccines. Z.F. declares editorial support for the manuscript by Pfizer. L.R.H., C.B., P.Z., F.J.A., W.E., A.G., J.C.M., and L.J. are employees of Pfizer Inc. and hold stock and stock options in Pfizer Inc. The other authors have no conflicts of interest to disclose.
Références
Lindquist L, Vapalahti O. Tick-borne encephalitis. Lancet. 2008;371:1861–1871.
Süss J. Tick-borne encephalitis 2010: epidemiology, risk areas, and virus strains in Europe and Asia—an overview. Ticks Tick Borne Dis. 2011;2:2–15.
European Centre for Disease Prevention and Control (ECDC) Surveillance Report. Tick-borne encephalitis annual epidemiological report for 2020. Available at: https://www.ecdc.europa.eu/sites/default/files/documents/Tick-borne-encephalitis-annual-epidemiological-report-2022.pdf . Accessed May 31, 2023.
European Centre for Disease Prevention and Control (ECDC) Surveillance Report. Tick-borne encephalitis annual epidemiological report for 2015. Available at: https://www.ecdc.europa.eu/sites/default/files/documents/AER_for_2015-tick-borne-encephalitis.pdf . Accessed May 31, 2023.
Zavadska D, Odzelevica Z, Karelis G, et al. Tick-borne encephalitis: a 43-year summary of epidemiological and clinical data from Latvia (1973 to 2016). PLoS One. 2018;13:e0204844.
Rostasy K. Tick-borne encephalitis in children. Wien Med Wochenschr. 2012;162:244–247.
von Stülpnagel C, Winkler P, Koch J, et al. MRI-imaging and clinical findings of eleven children with tick-borne encephalitis and review of the literature. Eur J Paediatr Neurol. 2016;20:45–52.
Cizman M, Rakar R, Zakotnik B, et al. Severe forms of tick-borne encephalitis in children. Wien Klin Wochenschr. 1999;111:484–487.
Lesnicar G, Poljak M, Seme K, et al. Pediatric tick-borne encephalitis in 371 cases from an endemic region in Slovenia, 1959 to 2000. Pediatr Infect Dis J. 2003;22:612–617.
Logar M, Arnez M, Kolbl J, et al. Comparison of the epidemiological and clinical features of tick-borne encephalitis in children and adults. Infection. 2000;28:74–77.
Fowler A, Forsman L, Eriksson M, et al. Tick-borne encephalitis carries a high risk of incomplete recovery in children. J Pediatr. 2013;163:555–560.
Parfut A, Laugel E, Baer S, et al. Tick-borne encephalitis in pediatrics: an often overlooked diagnosis. Infect Dis Now. 2023;53:104645.
Riccardi N, Antonello RM, Luzzati R, et al. Tick-borne encephalitis in Europe: a brief update on epidemiology, diagnosis, prevention, and treatment. Eur J Intern Med. 2019;62:1–6.
Lundkvist K, Vene S, Golovljova I, et al. Characterization of tick-borne encephalitis virus from Latvia: evidence for co-circulation of three distinct subtypes. J Med Virol. 2001;65:730–735.
World Health Organization (WHO). Vaccines against tick-borne encephalitis: WHO position paper—recommendations. Vaccine. 2011;29:8769–8770.
Holzmann H, Vorobyova MS, Ladyzhenskaya IP, et al. Molecular epidemiology of tick-borne encephalitis virus: cross-protection between European and Far Eastern subtypes. Vaccine. 1992;10:345–349.
Hayasaka D, Goto A, Yoshii K, et al. Evaluation of European tick-borne encephalitis virus vaccine against recent Siberian and far-eastern subtype strains. Vaccine. 2001;19:4774–4779.
Republic of Latvia. Vaccination regulations: cabinet regulation no. 330 adopted on September 26, 2000 [in Latvian]. Available at: http://likumi.lv/doc.php?id=11215 . Accessed May 31, 2023.
Zavadska D, Anca I, André F, et al. Recommendations for tick-borne encephalitis vaccination from the Central European Vaccination Awareness Group (CEVAG). Hum Vaccin Immunother. 2013;9:362–374.
Center for Disease Control and Prevention of Latvia. Government reimbursed vaccination against tickborne encephalitis for children. Available at: https://spkc.gov.lv/lv/tavai-veselibai/infekcijas-slimibas/vakcinacija/pret-ercu-encefalitu-berniem . [in Latvian] Accessed May 31, 2023.
Kunz C. TBE vaccination and the Austrian experience. Vaccine. 2003;21(Suppl 1):S50–S55.
Santonja I, Stiasny K, Essl A, et al. Tick-borne encephalitis in vaccinated patients: a retrospective case-control study and analysis of vaccination field effectiveness in Austria from 2000 to 2018. J Infect Dis. 2023;227:512–521. doi:10.1093/infdis/jiac075.
doi: 10.1093/infdis/jiac075
Nygren TM, Pilic A, Böhmer MM, et al. Tick-borne encephalitis vaccine effectiveness and barriers to vaccination in Germany. Sci Rep. 2022;12:11706.
Erber W, Khan F, Zavadska D, et al. Effectiveness of TBE vaccination in southern Germany and Latvia. Vaccine. 2022;40:819–825.
Zens KD, Haile SR, Schmidt AJ, et al. Retrospective, matched case-control analysis of tickborne encephalitis vaccine effectiveness by booster interval, Switzerland 2006-2020. BMJ Open. 2022;12:e061228.
Republic of Latvia. Procedures for registration of infectious diseases: cabinet regulation no. 7 adopted on January 5, 1999 (Prot. No. 1 § 13) [in Latvian]. Available at: https://likumi.lv/ta/id/20667-infekcijas-slimibu-registracijas-kartiba . Accessed May 31, 2023.
Günther G, Haglund M, Lindquist L, et al. Tick-bone encephalitis in Sweden in relation to aseptic meningo-encephalitis of other etiology: a prospective study of clinical course and outcome. J Neurol. 1997;244:230–238.
European Centre for Disease Prevention and Control (ECDC). EU case definitions: European Commission; 2018. Available at: https://ecdc.europa.eu/en/surveillance-and-disease-data/eu-case-definitions . Accessed May 31, 2023.
Erber W, Schmitt HJ. Self-reported tick-borne encephalitis (TBE) vaccination coverage in Europe: results from a cross-sectional study. Ticks Tick Borne Dis. 2018;9:768–777.
Pilz A, Erber W, Schmitt HJ. Vaccine uptake in 20 countries in Europe 2020: focus on tick-borne encephalitis (TBE). Ticks Tick Borne Dis. 2023;14:102059.
Farrington CP. Estimation of vaccine effectiveness using the screening method. Int J Epidemiol. 1993;22:742–746.