2728. Proportion of Invasive Pneumococcal Disease Potentially Covered by Current and Next-Generation of Higher-Valency Pneumococcal Conjugate Vaccines in Canada, 2010–2016

Abstract

BackgroundIn Canada, routine pediatric immunization with 7-valent pneumococcal conjugate vaccine (PCV7) was introduced between 2002 and 2006. Two of ten provinces transitioned to PCV10 in 2009; by mid-2011, following a national preferential recommendation, PCV13 replaced PCV7/PCV10 across Canada. PCV13 also has been recommended for immunocompromised adults since 2013, and immunocompetent adults aged ≥65 years on an individual basis since 2016. Immunization with 23-valent polysaccharide vaccine (PPV23) is recommended in adults with certain comorbidities, and routinely in those aged ≥65 years. Two higher-valency PCVs, PCV15, and PCV20 are currently under development.MethodsCase counts of invasive pneumococcal disease (IPD) by serotype and age group were obtained from published annual reports of passive laboratory-based national IPD surveillance conducted by the National Microbiology Laboratory (NML) since April 2010.ResultsIn all ages, the proportion of IPD due to PCV13 serotypes declined from 55% in 2010 to 31% in 2016 (Figure 1); in children age < 5 years, from 66% to 19%; in adults age 50–64 years, from 52% to 34%, and in adults age > 65 years from 51% to 25%. While most age groups have experienced declines in the proportion of PCV13-type IPD, this proportion has plateaued since 2014 in all age groups except 2–4 years old. During 2016, among all ages, the proportions of IPD due to PCV13, PCV15, and PCV20 types were 31%, 43%, and 58%, respectively; among children age < 5 years 19%, 35%, and 50%, respectively, among adults 50–64 years, 34%, 47%, and 61%, respectively, and among adults age ≥65 years, 25%, 38%, and 53%, respectively.ConclusionThe proportion of PCV13-type IPD has declined across all ages since the introduction of PCV13 in children. The plateau in this proportion observed across most age groups since 2014 suggests that herd effect may have been maximized, and additional reductions could be expected primarily from direct PCV13 adult immunization. PCV20 could potentially protect against a large proportion of the remaining IPD burden in Canada. Disclosures All authors: No reported disclosures.