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Pneumokokkirokotteen epäsuora vaikutus vakavaan pneumokokkitautiin rokottamattomilla lapsilla
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Pneumokokkirokotteen epäsuora vaikutus vakavaan pneumokokkitautiin rokottamattomilla lapsilla

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Pneumokokkikonjugaattirokotteen epäsuora laumavaikutus vakavan pneumokokkitaudin ilmaantuvuuteen rokottamattomilla lapsilla Suomen kansallisessa rokotusohjelmassa. Esitys Euroopan lasten …

Pneumokokkikonjugaattirokotteen epäsuora laumavaikutus vakavan pneumokokkitaudin ilmaantuvuuteen rokottamattomilla lapsilla Suomen kansallisessa rokotusohjelmassa. Esitys Euroopan lasten infektiotautijärjestön (ESPID) kokouksessa Milanossa 30.5.2013

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  • 1. INDIRECT IMPACT OF10-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV10)AGAINST INVASIVE PNEUMOCOCCAL DISEASE (IPD)AMONG CHILDREN IN FINLANDJukka Jokinen1, Hanna Rinta-Kokko1, Lotta Siira2, Arto Palmu3, MikkoVirtanen2, Hanna Nohynek1, Anni Virolainen-Julkunen4, Pekka Nuorti2,51Department of Vaccination and Immune Protection, 2Department of Infectious DiseaseSurveillance and Control, National Institute for Health and Welfare, Helsinki, 3Departmentof Vaccination and Immune Protection, National Institute for Health and Welfare (THL),Tampere, 4Ministry for Social Affairs and Health, Helsinki, 5University of TampereMedical School, Tampere, FinlandMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 1
  • 2. Disclosure•  J.Jokinen is a co-investigator in the effectiveness study of the10-valent pneumococcal conjugate vaccine (FinIP) funded byGlaxoSmithKline Biologicals SA and National Institute forHealth and Welfare (THL)May 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 2
  • 3. Background•  Finland: population 5,4 million, annual birth cohort of 60,000•  10-valent pneumococcal conjugate vaccine (PCV10) wasintroduced into the Finnish National Vaccination Programme(NVP) in September 2010•  Eligible children born after June 1, 2010•  Nordic schedule 2+1: vaccination at 3, 5 and 12 months of age•  Estimated uptake: <1% prior and ~95% after NVP introduction•  Impact in the vaccinated: Rinta-Kokko, Hall A, Thu at 17:04Question: After NVP introduction, does PCV10 provide protectionagainst invasive pneumococcal disease (IPD) also for theunvaccinated? (Indirect vaccine impact; herd protection)May 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 3
  • 4. Background: PCV uptake before NVP -PCV10-trial (FinIP) 2009-2010•  Community-randomised double-blinded trial of PCV10•  Recruitment period–  Feb 2009 to Aug 2010.•  Conducted in 80% of public healthcare centers–  Over 47 000 participants–  2/3 of clusters PCV10, 1/3 control•  PCV10-vaccinated participating toFinIP excluded from NVP impactanalyses (n =30,625)May 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 4Palmu et al. Lancet 2013
  • 5. Methods: unvaccinated cohorts for comparisonMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 5
  • 6. May 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 6
  • 7. Methods: unvaccinated cohorts for comparisonMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 7
  • 8. Methods: unvaccinated cohorts for comparisonMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 8
  • 9. Methods: unvaccinated cohorts for comparisonMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 9
  • 10. Methods: unvaccinated cohorts for comparisonMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 10
  • 11. Methods: unvaccinated cohorts for comparisonMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 11
  • 12. Results: incidence rates/100 000 person-yearsof IPD in target and reference cohortsMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 12Cohort ReferencecohortJan’02-May’04(N=135,837)ReferencecohortJan’04-May’06(N=139,767)TargetCohortJan’08- May’10(N=114,912)Ratereduction(95%CI):Target vs.ref. cohortscombinedRatereduction(95%CI):Target vs.ref. cohortscombinedYear ofobser-vation2005(Aged1-4 yrs)2006(Aged2-5 yrs)2007(Aged1-4 yrs)2008(Aged2-5 yrs)2011(Aged1-4 yrs)2012(Aged2-5 yrs)2011 versus2005 &20072012 versus2006 &2008All IPD 45.621.352.223.642.611.313(-20, 38)50(12, 74)PCV10serotypes36.116.242.217.930.59.622(-13,48)44(-4, 72)PCV10related*5.94.48.62.17.01.74(-110,60)47(-107, 92)* PCV10-related types: serotypes belonging to the same serogroup as PCV10-types
  • 13. Conclusions•  By 2012, IPD rates were significantly lower amongunvaccinated children (2 to 5 years of age) compared toreference cohorts prior to pneumococcal NVP introduction•  Results suggest herd protection against IPD amongunvaccinated children•  Results consistent with indirect impact of PCV10 againstcarriage in unvaccinated children, see Poster discussion 12:Hall I, Fri May 31 at 14:07–  INDIRECT EFFECTIVENESS OF THE TEN-VALENTPNEUMOCOCCAL HAEMOPHILUS INFLUENZAE PROTEIN DCONJUGATE VACCINE (PHID-CV10) AGAINST NASOPHARYNGEALCARRIAGE: FINIP INDIRECT CARRIAGE STUDYMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 13
  • 14. BackupMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 14
  • 15. BackupMay 2013 PCV10 indirect impact on IPD in Finland, Jokinen et. al. ESPID 2013 15