What effect did the introduction of conjugate pneumococcal vaccines have on BC’s childhood immunization program?


A little boy gets a vaccination

In 2000, it was estimated that Streptococcus pneumoniae caused 826,000 deaths per year worldwide, mostly in children aged 5 and under. Deaths are caused by a number of the serotypes causing invasive pneumococcal disease (IPD) such as bacteremia, meningitis, bacteriemic pneumonia and sepsis, as well as non-invasive pneumococcal diseases (Non-IPD) such as lobar pneumonia and upper respiratory tract infections.

A pneumococcal conjugate vaccine covering 7 serotypes (PCV7) was introduced into European and North America in the early 2000’s, and incorporated into numerous national immunization programs as a routine childhood vaccine. Since then, many jurisdictions have reported on the vaccine’s effectiveness, however, these studies also showed increases in the non-PCV7 serotypes, some of which are known to cause multi-drug resistant invasive disease in a younger population.

By late 2010 the Canadian National Advisory Committee on Immunization suggested replacing PCV7 with PCV13, which covered additional serotypes. Data on the effectiveness of the newer PCV13 vaccine is just beginning to be published by European and USA agencies.

“From a Canadian perspective, we have limited information on non-invasive disease or outcomes and mortality associated with the current circulating pneumococcal strains,” says Dr. Fawziah Lalji, a Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia.

Data access has recently been approved for Dr. Lalji to conduct a population-based study to describe the effect of conjugate pneumococcal vaccines, PCV7 and PCV13, after their respective introduction into a universal childhood immunization program in British Columbia.

“We will determine the cost to the health care system of invasive pneumococcal disease and evaluate outcomes in terms of morbidity and mortality associated with both invasive- and non-invasive pneumococcal disease in children and adults. We will also explore changes in the incidence of specific serotypes in the post-PCV7 and PCV-13 eras.” 

Dr Lalji aims to develop knowledge translation and educational activities for health care professionals and the public to educate around pneumococcal vaccine, depending on the study findings.

PopData will link data from the BC Ministry of Health, the BC Vital Statistics Agency, the BC Centre for Disease Control, the Canadian Institute for Health Information and the 2006 Canadian Census.

This project is funded by Pfizer Canada*. 

 

*In accordance with policies for industry funding, the study is conducted at arm’s length from the industry sponsor and no industry sponsor employees, contractors or agents are part of the study team. The industry sponsor has no influence on study direction or analysis, and the industry sponsor has no access to data, other than final published results.