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• W2837142584 abstract "We want to express major concerns about the assumed causal link that Stefanie Desmet and colleagues1Desmet S Verhaegen J Van Ranst M Peetermans WE Lagrou K Switch in a childhood pneumococcal vaccination program from PCV13 to PCV10: a defendable approach?.Lancet Infect Dis. 2018; (published online July 9.)http://dx.doi.org/10.1016/S1473-3099(18)30346-3Summary Full Text Full Text PDF PubMed Scopus (35) Google Scholar suggested between changes in the increased number of invasive pneumococcal disease isolates in Belgium and the switch from the 13-valent pneumococcal conjugate vaccine (PCV13) to pneuomococcal non-typeable haemophilius influenzae protein D conjugate vaccine (PHiD-CV [PCV10]), based on the 2017 passive laboratory surveillance report on invasive pneumococcal disease.2Scientific Institute of Public HealthSurveillance van de pneumokokkeninfecties in België. Verslag voor.https://nrchm.wiv-isp.be/nl/ref_centra_labo/streptococcus_pneumoniae_invasive/Rapporten/Streptococcus%20pneumoniae%202017.pdfDate: 2017Date accessed: May 30, 2018Google Scholar The authors' interpretation might cause unwarranted concern from a public health perspective regarding the switch in pneumococcal vaccine programmes. They based their assessment on single-year typing data, rather than a multi-year assessment with thorough epidemiological analyses, which is deemed crucial for assessing the success of vaccine programmes as emphasised by public health experts.3O'Brien KL PCV13 impact evaluations: the obvious and the unpredicted.Pediatr Infect Dis J. 2013; 32: 264-265Crossref PubMed Scopus (16) Google Scholar, 4WHOMeasuring impact of Streptococcus pneumoniae and Haemophilus influenzae type b conjugate vaccination. World Health Organization, Geneva2012Google Scholar Desmet and colleagues reported a sudden rise in invasive pneumococcal disease isolates due to any pneumococcal serotypes, including 19A, in children younger than 2 years (1 and 2 years after PHiD-CV replaced PCV13 in the Walloon and Flemish regions, respectively). However, the authors did not discuss the relevant observations reported, nor have they highlighted limitations of the Belgian surveillance report: they did not comment on a similar increase in invasive pneumococcal disease that was already reported between 2014 and 2015,1Desmet S Verhaegen J Van Ranst M Peetermans WE Lagrou K Switch in a childhood pneumococcal vaccination program from PCV13 to PCV10: a defendable approach?.Lancet Infect Dis. 2018; (published online July 9.)http://dx.doi.org/10.1016/S1473-3099(18)30346-3Summary Full Text Full Text PDF PubMed Scopus (35) Google Scholar, 2Scientific Institute of Public HealthSurveillance van de pneumokokkeninfecties in België. Verslag voor.https://nrchm.wiv-isp.be/nl/ref_centra_labo/streptococcus_pneumoniae_invasive/Rapporten/Streptococcus%20pneumoniae%202017.pdfDate: 2017Date accessed: May 30, 2018Google Scholar when most children received PCV13. Additionally, their Correspondence did not include a decrease in the prevalence of invasive pneumococcal disease in children younger than 1 year (from 57 to 34 isolates) between 2016 and 2017,1Desmet S Verhaegen J Van Ranst M Peetermans WE Lagrou K Switch in a childhood pneumococcal vaccination program from PCV13 to PCV10: a defendable approach?.Lancet Infect Dis. 2018; (published online July 9.)http://dx.doi.org/10.1016/S1473-3099(18)30346-3Summary Full Text Full Text PDF PubMed Scopus (35) Google Scholar which was evident in the surveillance report.2Scientific Institute of Public HealthSurveillance van de pneumokokkeninfecties in België. Verslag voor.https://nrchm.wiv-isp.be/nl/ref_centra_labo/streptococcus_pneumoniae_invasive/Rapporten/Streptococcus%20pneumoniae%202017.pdfDate: 2017Date accessed: May 30, 2018Google Scholar Notably, these children predominantly received PHiD-CV. Furthermore, the vaccination status of the reported cases are not available. Given the yet incomplete information in their Correspondence, a thorough assessment cannot be made and a causal conclusion should not be drawn. PHiD-CV is currently licensed for the prevention of 19A invasive pneumococcal disease in more than 100 countries, a decision based on independent, well designed studies showing its effectiveness against 19A invasive pneumococcal disease. By contrast with what Desmet and colleagues state, other countries and regions have switched from PCV13 to PHiD-CV, including New Zealand, Morocco, El Salvador, Quebec, and some regions in Sweden and Italy. Data from Casablanca, Morocco, revealed a significant reduction in the number of invasive pneumococcal disease isolates due to serotypes contained in PCV13 and PHiD-CV in children younger than 2 years. Furthermore, 2 years after switching to PHiD-CV, no cases of invasive pneumococcal disease due to serotype 19A were reported.5Diawara I Zerouali K Katfy K et al.Invasive pneumococcal disease among children younger than 5 years of age before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco.Int J Infect Dis. 2015; 40: 95-101Summary Full Text Full Text PDF PubMed Scopus (36) Google Scholar Passive surveillance data need to be analysed with caution, especially if the population denominator of the reported cases and changes over time are unknown, which seems to be the case from the Belgian report.6European Centre for Disease Prevention and ControlAnnual epidemiological report for 2015: invasive pneumococcal disease.https://ecdc.europa.eu/sites/portal/files/documents/AER_for_2015-pneumococcal-disease-invasive.pdfDate: 2017Date accessed: May 30, 2018Google Scholar As recommended by WHO,4WHOMeasuring impact of Streptococcus pneumoniae and Haemophilus influenzae type b conjugate vaccination. World Health Organization, Geneva2012Google Scholar epidemiological analysis based on incidence rates studied over multiple years of surveillance is integral to substantiate data interpretation. Pneumococcal vaccine programmes are not implemented to eliminate particular serotypes, but rather, to reduce the overall disease burden, which should be the primary measure to evaluate the successes of vaccination programmes. PI and TB are employed by and hold shares in the GlaxoSmithKline group of companies. Switch in a childhood pneumococcal vaccination programme from PCV13 to PCV10: a defendable approach?Pneumococcal vaccination is the cornerstone in the prevention of invasive pneumococcal disease. The use of the first pneumococcal conjugate vaccine in children, the 7-valent pneumococcal conjugate vaccine (PCV7), resulted in an important decline in vaccine serotype invasive pneumococcal disease.1 However, due to serotype replacement by serotypes not included in PCV7, the introduction of this vaccine was associated with a subsequent increase in non-vaccine serotypes.1–3 New conjugate vaccines were developed, including a 10-valent conjugate vaccine, PCV10 (including PCV7 serotypes plus ST1, ST5, ST7F), and a 13-valent vaccine, PCV13 (including PCV10 serotypes plus ST3, ST19A, ST6A). Full-Text PDF Switch in childhood pneumococcal vaccine in BelgiumWe read with interest Patricia Izurieta and Thomas Breuer's Correspondence1 about the switch from 13-valent pneumococcal conjugate vaccine (PCV13) to pneumococcal non-typeable Haemophilius influenzae protein D conjugate vaccine (PHiD-CV [PCV10]) in the childhood pneumococcal vaccination programme in Belgium. Full-Text PDF" @default.
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