Carlos III Health Institute ISCIII CNE

Madrid, Spain

Carlos III Health Institute ISCIII CNE

Madrid, Spain
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Garrido-Estepa M.,Carlos III Health Institute ISCIII CNE | Nunez O.G.,Carlos III Health Institute ISCIII CNE | Leon-Gomez I.,Carlos III Health Institute ISCIII CNE | Cano R.,Carlos III Health Institute ISCIII CNE | Herruzo R.,Autonomous University of Madrid
Vaccine | Year: 2015

Introduction: Although different epidemiological studies have assessed meningococcal C conjugate vaccine effectiveness within 1 and >1 year since vaccination, none of them evaluated long-term effectiveness. In order to assess if epidemiological data correlates with the findings described in seroprevalence studies we evaluated long-term vaccine effectiveness over time, up to 10 years since vaccination. Methods: Cases targeted by vaccination programs and notified to the Spanish Surveillance System between 2001 and 2013 were included in the study. Vaccine effectiveness was estimated using the screening method. Relationship between vaccine effectiveness and time since vaccination was explored using point estimates, simple logistic regression or restricted cubic splines logistic regression model for all and for those vaccinated at <1, 1-11 and at 12-19 years of age. Results: From 345 confirmed cases reported in the period and targeted by vaccination programs, 125 (36.23%) were vaccine failures. Proportion of vaccine failures decreased with age of vaccination: 63.97% at <1 year; 36.84% at 1-11 years; and 3.88% at 12-19 years. Using the best model for each group, vaccine effectiveness decreased from 99.12% to 90.85% (%change = -8.3%) for all; from 99.04% to 48.60% (%change = -50.9%) for those vaccinated at <1 years and from 99.45% to 90.18% (%change = -9.3%) for those vaccinated at 1-11 years after 10 years since vaccination. For those vaccinated at 12-19 years no changes were observed in vaccine effectiveness after 10 years (p= 0.968). Conclusions: After 10 years, vaccine effectiveness decreased by 50% in those vaccinated at <1 year, while those vaccinated with one dose at 12-19 years showed no changes. Vaccine failures occurred early after vaccination and more frequently in those vaccinated at younger ages. Vaccination at ≥12 years seems to be related to a low number of vaccine failures and a higher and endurable protection over time. © 2015 Elsevier Ltd.


PubMed | Autonomous University of Madrid and Carlos III Health Institute ISCIII CNE
Type: Journal Article | Journal: Vaccine | Year: 2015

Although different epidemiological studies have assessed meningococcal C conjugate vaccine effectiveness within 1 and >1 year since vaccination, none of them evaluated long-term effectiveness. In order to assess if epidemiological data correlates with the findings described in seroprevalence studies we evaluated long-term vaccine effectiveness over time, up to 10 years since vaccination.Cases targeted by vaccination programs and notified to the Spanish Surveillance System between 2001 and 2013 were included in the study. Vaccine effectiveness was estimated using the screening method. Relationship between vaccine effectiveness and time since vaccination was explored using point estimates, simple logistic regression or restricted cubic splines logistic regression model for all and for those vaccinated at <1, 1-11 and at 12-19 years of age.From 345 confirmed cases reported in the period and targeted by vaccination programs, 125 (36.23%) were vaccine failures. Proportion of vaccine failures decreased with age of vaccination: 63.97% at <1 year; 36.84% at 1-11 years; and 3.88% at 12-19 years. Using the best model for each group, vaccine effectiveness decreased from 99.12% to 90.85% (%change=-8.3%) for all; from 99.04% to 48.60% (%change=-50.9%) for those vaccinated at <1 years and from 99.45% to 90.18% (%change=-9.3%) for those vaccinated at 1-11 years after 10 years since vaccination. For those vaccinated at 12-19 years no changes were observed in vaccine effectiveness after 10 years (p=0.968).After 10 years, vaccine effectiveness decreased by 50% in those vaccinated at <1 year, while those vaccinated with one dose at 12-19 years showed no changes. Vaccine failures occurred early after vaccination and more frequently in those vaccinated at younger ages. Vaccination at 12 years seems to be related to a low number of vaccine failures and a higher and endurable protection over time.


PubMed | Carlos III Health Institute ISCIII CNE
Type: | Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology | Year: 2016

In Spain, anti-pneumococcal vaccination is recommended for all children under 2years old, high-risk groups and adults 65years old. However, it is not funded in most autonomous communities. This study aims to compare pneumococcal disease hospitalisation rates between Period 1 (2007-2009), when 7-valent (PCV7) vaccine was available, and Period 2 (2011-2013), after the change to 13-valent (PCV13) vaccine in Spain. Data on hospitalisations were obtained from the National Registry of Hospitalisations. We calculated hospitalisation rates (HRs) and hospitalisation rate ratios (HRRs) among periods by age group and autonomous community, for all and by clinical presentation. From 138,361 patients hospitalised, 83,528 (60.4 %) were males. The median age was 73.8years. The most common clinical presentation was pneumonia (133,204 hospitalisations; 96.3 %), followed by septicaemia (7053 hospitalisations; 5.1 %) and meningitis (3182 hospitalisations; 2.3 %). In Period 2, hospitalisations among children <5years old decreased for pneumonia [HRR: 0.37; 95 % confidence interval (95 % CI): 0.35 to 0.39] and meningitis (HRR: 0.53; 95 % CI: 0.44 to 0.65). For adults 65years old, pneumonia (HRR: 0.49; 95 % CI: 0.49 to 0.50) and peritonitis (HRR: 0.34; 95 % CI: 0.19 to 0.63) hospitalisations decreased and septicaemia hospitalisations (HRR: 1.27; 95 % CI: 1.18 to 1.36) increased. Significant changes in HRs for pneumococcal disease were observed even without an integrated and continuous vaccination programme after the introduction of PCV13, especially in children <5years old and for pneumonia. The impact of the PCV13 adult vaccination new recommendations on the septicaemia increase reported should be evaluated in the future.

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