Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries: A protocol for a prospective observational study

Jocelyn Chan, Cattram D. Nguyen, Jana Y.R. Lai, Eileen M. Dunne, Ross Andrews, Christopher C. Blyth, Siddhartha Datta, Kim Fox, Rebecca Ford, Jason Hinds, Sophie La Vincente, Deborah Lehmann, Ruth Lim, Tuya Mungun, Paul N. Newton, Rattanaphone Phetsouvanh, Willam S. Pomat, Anonh Xeuatvongsa, Claire Von Mollendorf, David A.B. DanceCatherine Satzke, Kim Muholland, Fiona M. Russell

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    Abstract

    Introduction Pneumococcal conjugate vaccines (PCVs) prevent disease through both direct protection of vaccinated individuals and indirect protection of unvaccinated individuals by reducing nasopharyngeal (NP) carriage and transmission of vaccine-type (VT) pneumococci. While the indirect effects of PCV vaccination are well described, the PCV coverage required to achieve the indirect effects is unknown. We will investigate the relationship between PCV coverage and VT carriage among undervaccinated children using hospital-based NP pneumococcal carriage surveillance at three sites in Asia and the Pacific. Methods and analysis We are recruiting cases, defined as children aged 2-59 months admitted to participating hospitals with acute respiratory infection in Lao People's Democratic Republic, Mongolia and Papua New Guinea. Thirteen-valent PCV status is obtained from written records. NP swabs are collected according to standard methods, screened using lytA qPCR and serotyped by microarray. Village-level vaccination coverage, for the resident communities of the recruited cases, is determined using administrative data or community survey. Our analysis will investigate the relationship between VT carriage among undervaccinated cases (indirect effects) and vaccine coverage using generalised estimating equations. Ethics and dissemination Ethical approval has been obtained from the relevant ethics committees at participating sites. The results are intended for publication in open-access peer-reviewed journals and will demonstrate methods suitable for low- and middle-income countries to monitor vaccine impact and inform vaccine policy makers about the PCV coverage required to achieve indirect protection.

    Original languageEnglish
    Article numbere021512
    JournalBMJ Open
    Volume8
    Issue number5
    DOIs
    Publication statusPublished - May 2018

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    Chan, J., Nguyen, C. D., Lai, J. Y. R., Dunne, E. M., Andrews, R., Blyth, C. C., Datta, S., Fox, K., Ford, R., Hinds, J., La Vincente, S., Lehmann, D., Lim, R., Mungun, T., Newton, P. N., Phetsouvanh, R., Pomat, W. S., Xeuatvongsa, A., Von Mollendorf, C., ... Russell, F. M. (2018). Determining the pneumococcal conjugate vaccine coverage required for indirect protection against vaccine-type pneumococcal carriage in low and middle-income countries: A protocol for a prospective observational study. BMJ Open, 8(5), [e021512]. https://doi.org/10.1136/bmjopen-2018-021512