Invasive Pneumococcal Disease in the Setting of the 13-Valent Pneumococcal Conjugate Vaccine :

In 2010, we began using the 13-valent (rather than 7-valent) pneumococcal conjugate vaccine (PCV) with the hope that we would continue to reduce the incidence of invasive pneumococcal disease in children who were vaccinated. So how did we do? Kaplan et al. (10.1542/peds.2019-0567), in a study being early released this week in our journal, investigated this question by studying the prevalence of invasive pneumococcal disease (IPD) at 8 children’s hospitals from 2014 to 2017 and examine the serotypes associated with IPD cases.  The authors found 482 patients with IPD and 23.9% of these cases (115 children) had a serotype found in the vaccine.  Sadly, 30 of these children with PCV13 serotypes had not received the vaccine when 22 were at an age when they should have already received 2 doses, and 14 additional children had only received one dose prior to developing IPD. The majority of children (54.5%) with non-PCV13 serotypes had an underlying condition compared to those vaccinated with PCV13 (23.5%).  The authors noted that an immune workup was done on 28 of 61 children who had received at least 2 doses of PCV13 and were PCV13 serotype positive, of which only one child had an immunodeficiency.  There is a lot more interesting data in this study suggesting that while the PCV13 vaccine is not 100% effective, it is doing a great job reducing the incidence and in turn the prevalence of IPD to the serotypes in this vaccine—but there is more work to be done to make this vaccine even more effective. Inject some time into reading the findings in this interesting study, and then use it to educate families who may want to better understand just how important it is for their children to receive this and all other recommended vaccines.