Abstract
Background
Pneumococcal conjugate vaccines (PCVs) generate herd protection by reducing nasopharyngeal (NP) carriage. Two PCVs, PCV10 and PCV13, have been in use for over a decade, yet there are few data comparing their impact on carriage. Here we report their effect on carriage in a 2+1 schedule, compared with each other and with unvaccinated controls.
Methods Data from four groups within a parallel, open-label randomised controlled trial in Ho Chi Minh City contribute to this article. Three groups were randomised to receive a 2+1 schedule of PCV10 (n = 250), a 2+1 schedule of PCV13 (n = 251), or two doses of PCV10 at 18 and 24 months (controls, n = 197). An additional group (n = 199) was recruited at 18 months to serve as controls from 18 to 24 months. NP swabs collected at 2, 6, 9, 12, 18, and 24 months were analysed (blinded) for pneumococcal carriage. This study aimed to determine if PCV10 and PCV13 have a differential effect on pneumococcal carriage, a secondary outcome of the trial. We also describe the serotype distribution among unvaccinated participants. Trial registration: ClinicalTrials.gov NCT01953510.
Findings Compared with unvaccinated controls, a 2+1 schedule of PCV10 reduced PCV10-type carriage by 45–62% from pre-booster through to 24 months of age, and a 2+1 schedule of PCV13 reduced PCV13-type carriage by 36–49% at 12 and 18 months of age. Compared directly with each other, there were few differences between the vaccines in their impact on carriage. Vaccine serotypes accounted for the majority of carriage in unvaccinated participants.
Interpretation Both PCV10 and PCV13 reduce the carriage of pneumococcal vaccine serotypes. The introduction of either vaccine would have the potential to generate significant herd protection in this population.
Pneumococcal conjugate vaccines (PCVs) generate herd protection by reducing nasopharyngeal (NP) carriage. Two PCVs, PCV10 and PCV13, have been in use for over a decade, yet there are few data comparing their impact on carriage. Here we report their effect on carriage in a 2+1 schedule, compared with each other and with unvaccinated controls.
Methods Data from four groups within a parallel, open-label randomised controlled trial in Ho Chi Minh City contribute to this article. Three groups were randomised to receive a 2+1 schedule of PCV10 (n = 250), a 2+1 schedule of PCV13 (n = 251), or two doses of PCV10 at 18 and 24 months (controls, n = 197). An additional group (n = 199) was recruited at 18 months to serve as controls from 18 to 24 months. NP swabs collected at 2, 6, 9, 12, 18, and 24 months were analysed (blinded) for pneumococcal carriage. This study aimed to determine if PCV10 and PCV13 have a differential effect on pneumococcal carriage, a secondary outcome of the trial. We also describe the serotype distribution among unvaccinated participants. Trial registration: ClinicalTrials.gov NCT01953510.
Findings Compared with unvaccinated controls, a 2+1 schedule of PCV10 reduced PCV10-type carriage by 45–62% from pre-booster through to 24 months of age, and a 2+1 schedule of PCV13 reduced PCV13-type carriage by 36–49% at 12 and 18 months of age. Compared directly with each other, there were few differences between the vaccines in their impact on carriage. Vaccine serotypes accounted for the majority of carriage in unvaccinated participants.
Interpretation Both PCV10 and PCV13 reduce the carriage of pneumococcal vaccine serotypes. The introduction of either vaccine would have the potential to generate significant herd protection in this population.
| Original language | English |
|---|---|
| Pages (from-to) | 2303-2310 |
| Number of pages | 8 |
| Journal | Vaccine |
| Volume | 39 |
| Issue number | 16 |
| DOIs | |
| Publication status | Published - 15 Apr 2021 |
Bibliographical note
Funding Information:We thank the study participants and their families, the study staff, and the laboratory staff from the Pasteur Institute of Ho Chi Minh City, the Menzies Child Health team, and the MCRI Translational Microbiology group. We acknowledge the contributions of Dang Duc Anh, Nguyen Thi Hien Anh, Dorota Borys, Jonathan Carapetis, Nguyen Thi Kieu Chinh, Nguyen Le Dang, Lam Trung Duc, Katherine Gould, Ahsan Habib, William Hausdorff, Bernard Hoet, Nguyen Huu Hung, Vu Thi Que Huong (deceased), Phan Trong Lan, Tran Thi Kim Ngan, Vo Thuy Ngoc, Peter Paradiso, Nguyen Thi Minh Phuong (deceased), Nguyen Ngo Quang, Fiona Russell, Hoang Hoa Son, and Lay Myint Yoshida. This work was supported by the National Health and Medical Research Council of Australia (grant number 566792) and the Bill & Melinda Gates Foundation (grant number OPP1116833). CS is the recipient of a NHMRC Career Development Fellowship (1087957) and a Veski Inspiring Women Fellowship. GlaxoSmithKline Biological SA donated the doses of PCV10. We also acknowledge the Victorian Government's Operational Infrastructure Support Program.
Publisher Copyright:
© 2021 The Author(s)
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.