Abstract
Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon.
Highlights
Streptococcus pneumoniae is an important cause of morbidity and mortality globally, in both children and adults [1,2]
All available serotype-specific invasive pneumococcal disease (IPD) surveillance data in countries using PCV10/13 were identified and characterized to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome
IPD surveillance is recommended by the World Health Organization (WHO) [4] and nearly 80% of countries using pneumococcal conjugate vaccines (PCV) in 2018 had an active IPD surveillance system
Summary
Streptococcus pneumoniae is an important cause of morbidity and mortality globally, in both children and adults [1,2]. In 2007, the World Health Organization (WHO) first recommended including pneumococcal conjugate vaccines (PCV) in childhood immunization programs worldwide to prevent pneumococcal disease. In 2019, WHO expanded IPD surveillance recommendations to encourage high-quality sentinel surveillance to monitor the distribution of serotypes causing IPD and ideally population-based surveillance for evaluating PCV impact on IPD incidence and serotype replacement disease [4]. By 2020, 145 countries, including countries from all regions of the world, had introduced PCV into infant immunization programs [5], many of which have IPD surveillance systems [6,7,8,9,10]. Multisite analyses lead to greater understanding of pneumococcal epidemiology and PCV impact around the world, and where there is heterogeneity, to greater understanding of the factors driving it, e.g., differences in local epidemiology versus PCV use
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