Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study

Christopher C Blyth; Kathryn J Britton; Cattram D Nguyen; Joycelyn Sapura; John Kave; Birunu Nivio; Jocelyn Chan; Catherine Satzke; Rebecca Ford; Wendy Kirarock; Deborah Lehmann; William Pomat; Fiona M Russell

The Lancet Regional Health. Western Pacific (May 2022)

Effectiveness of 13-valent pneumococcal conjugate vaccine against hypoxic pneumonia and hospitalisation in Eastern Highlands Province, Papua New Guinea: An observational cohort study

Christopher C Blyth,
Kathryn J Britton,
Cattram D Nguyen,
Joycelyn Sapura,
John Kave,
Birunu Nivio,
Jocelyn Chan,
Catherine Satzke,
Rebecca Ford,
Wendy Kirarock,
Deborah Lehmann,
William Pomat,
Fiona M Russell

Affiliations

Christopher C Blyth: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute and School of Medicine, The University of Western Australia, Nedlands, WA, Australia; Department of Infectious Diseases, Perth Children's Hospital, Nedlands, WA, Australia; Department of Microbiology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands WA, Australia; Corresponding author: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute and School of Medicine, The University of Western Australia, Nedlands, WA, Australia.
Kathryn J Britton: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute and School of Medicine, The University of Western Australia, Nedlands, WA, Australia
Cattram D Nguyen: Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
Joycelyn Sapura: Infection and Immunity Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
John Kave: Infection and Immunity Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
Birunu Nivio: Infection and Immunity Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
Jocelyn Chan: Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
Catherine Satzke: Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
Rebecca Ford: Infection and Immunity Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
Wendy Kirarock: Infection and Immunity Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
Deborah Lehmann: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute and School of Medicine, The University of Western Australia, Nedlands, WA, Australia
William Pomat: Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute and School of Medicine, The University of Western Australia, Nedlands, WA, Australia; Infection and Immunity Unit, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
Fiona M Russell: Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia

Journal volume & issue: Vol. 22
p. 100432

Abstract

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Summary: Background: Pneumonia is a leading cause of childhood mortality with Streptococcus pneumoniae a major contributor. Pneumococcal conjugate vaccines (PCVs) have been introduced into immunisation programs in many low- to middle-income countries (LMICs) yet there is a paucity of data evaluating the effectiveness in these settings. We assess the effectiveness of 13-valent PCV (13vPCV) against hypoxic pneumonia, hospitalisation and other clinical endpoints in children <5 years living in Eastern Highlands Province, Papua New Guinea (PNG). Methods: Data from two consecutive prospective observational studies (2013–2019) enrolling children <60 months presenting with pneumonia were included. Hypoxic pneumonia was defined as oxygen saturations <90%. Outcomes included hospitalisation, severe clinical pneumonia and death. 13vPCV status was determined using written records. Logistic regression models were used to estimate the odds ratios of key outcomes by 13vPCV vaccination status adjusted for confounders using inverse probability of treatment weighting. Findings: Data from 2067 children (median age; 9 months [IQR: 5–11]) were included. 739 children (36.1%) were hypoxic and 623 (30.4%) hospitalised. Twelve children (0.6% of total cohort) died in hospital. 670 children (32.7%) were fully 13vPCV-vaccinated. 13vPCV vaccination was associated with a 28.7% reduction (95% confidence interval [CI]: 9.9; 43.6%) in hypoxic pneumonia and a 57.4% reduction (38.0; 70.7%) in pneumonia hospitalisation. Interpretation: 13vPCV vaccination is effective against hypoxic pneumonia and pneumonia hospitalisation in PNG children. Strategies to improve access to and coverage of 13vPCV in PNG and other similar LMICs are urgently required. Funding: Funded by Pfizer Global and the Bill & Melinda Gates Foundation.

Published in The Lancet Regional Health. Western Pacific

ISSN: 2666-6065 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanwpc/home

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