Impact of pneumococcal vaccination in children in the distribution of serotypes in bacteriemic pneumococcal pneumonia in adults

Abstract

Introduction: Pneumococcal conjugated vaccination (PCV) is recommended in children, adults≥65 years and ≤65 years with comorbidities. PCV13 was introduced for children in 2010 in Spain with a coverage of 61%. Objectives: Evaluation of distribution of serotypes in bacteriemic pneumococcal pneumonia (BPP) in adults, dependant on age and comorbidities after implementation of PCV in children. Methodology Prospective observational study performed in immunocompetent adult patientes admitted with BPP in 2 Spanish hospitals between 2001-2014. Evolution of serotypes, and distribution based on comorbidities and age were examined. Sample was divided in 3 periods: 2001-2005, 2006-2010, 2011-2014. Serotypes were classified in 3 groups: PCV7(7serotypes in PCV7), PCV13-PCV7(6 serotypes added in PCV13) and no-PCV13(not included in PCV13). Age was divided in 3 groups:18-49, 50-64, ≥65. Patients were classified in 3 groups:healthy adults, risk factor adults and adults with comorbidities. Results: 451 patients were included. Most prevalent serotypes were 3, 7F and 19A. A significant decrease of serotypes included in PCV7 was observed in 3 periods. An increase of PCV13-7 serotypes was noted. Serotype distribution based on comorbidities and age is shown in Tables1&2. Conclusions: After PCV7 vaccine was implemented, a decrease of BPP caused by these serotypes was noted. Despite the implementation of PCV13 in children in 2010, PCV13-7 serotypes increased in 3 periods of study, being statistically significant in adults ≥65 y.o and adults with comorbidities. Thus, PCV13 vaccination should include not only children but also adults with comorbidities.