Elsevier

Vaccine

Volume 34, Issue 25, 27 May 2016, Pages 2766-2778
Vaccine

Review
Impact of the introduction of the pneumococcal conjugate vaccine in the Brazilian routine childhood national immunization program

https://doi.org/10.1016/j.vaccine.2016.04.006Get rights and content
Under a Creative Commons license
open access

Abstract

Brazil introduced the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix™, GSK Vaccines) in the routine childhood immunization program in 2010 with a 3 + 1 schedule (with catch-up for children <2 years-old). This review represents the first analysis of the overall impact of a second-generation pneumococcal conjugate vaccine on nasopharyngeal carriage and all the major pneumococcal disease manifestations in a single, pneumococcal conjugate vaccine-naïve, developing country. A total of 15 published articles and 13 congress abstracts were included in the analysis. In children <5 years-old, studies showed a positive impact of PHiD-CV on the incidence of vaccine-type and any-type invasive pneumococcal disease (including decreases in pneumococcal meningitis morbidity and mortality), on pneumonia incidence and mortality, and on otitis media. Nasopharyngeal carriage of vaccine-type and any-type pneumococci decreased after the primary doses, with no early signs of replacement with other pathogens. Finally, herd protection against vaccine-type invasive pneumococcal disease and pneumonia in unvaccinated subjects was shown in some studies for some age groups. In conclusion, pneumococcal disease decreased after the introduction of PHiD-CV into the Brazilian national immunization program. Further follow-up is needed to evaluate the long-term overall impact of PHiD-CV in the Brazilian population.

Abbreviations

AOM
acute otitis media
CI
confidence interval
CVE
Centro de Vigilância Epidemiológica
IAL
Instituto Adolfo Lutz
IPD
invasive pneumococcal disease
NS
statistically non-significant
NTHi
non-typeable Haemophilus influenzae
NVT
non-vaccine type
PCV
pneumococcal conjugate vaccine
PHiD-CV
pneumococcal Haemophilus influenzae protein D conjugate vaccine
PM
pneumococcal meningitis
RCTs
randomized controlled trials
SINAN
Notifiable Diseases Information System
VE
vaccine effectiveness
VT
vaccine-type

Keywords

Streptococcus pneumoniae
Brazil
Invasive pneumococcal disease
Pneumonia
Acute otitis media
Nasopharyngeal carriage

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Trademarks: Synflorix is a trademark of the GSK group of companies. Prevenar/Prevnar is a trademark of Pfizer/Wyeth LLC.