agir au mieux pour prévenir les infections...
TRANSCRIPT
1
Agir au mieux pour preacutevenir les
infections pneumococciques
Tour drsquohorizon agrave travers le Monde
et Perspectives
ACPP- Infovac-Maroc
Pr Robert COHEN
2
Fardeau des infections pneumococciques chez
les enfants Seacuteveacuteriteacute de la maladie
Inva
sive
N
on
inva
sive
Preacutevalence Pour chaque cas de
meacuteningite il yrsquoa
approximativement Meacuteningites
Bacteacuterieacutemies
Pneumonies
Otites moyennes aiguecircs gtX 2000
X 200
X 20
Adapted from Pneumococcal Disease CDC Website httpwwwcdcgovvaccinespubspinkbookdownloadspneumopdf Accessed April 11 2011
Note Based on surveillance before the Introduction of PCV
3
La niche eacutecologique du pneumocoque
Le microbiome rhino-pharyngeacute
3
4
Incidence des IIP USA (1997 agrave 2011)
Active Bacterial Core Surveillance CDC Website httpwwwcdcgovabcsreports-findingssurv-reportshtml Updated January 28 2014 Accessed April 15 2014
Enfants de 1 agrave 2 ans
0
50
100
150
200
250 Pre-PCV7
Introduction
PCV7
Introduction
Post-PCV7
Introduction PCV13
Introduction
2000 2010
PCV7 PCV13
5
Preacutevention du nombre de cas drsquoIIP et de deacutecegraves dus agrave la maladie
pneumococcique invasive apregraves introduction du PCV7 et PCV13 chez les
enfants lt et ge 5 ans aux USA
5
Moore M et al Lancet 2015
Aux USA
En 2000 -gt PCV7
En 2010 -gt PCV13
3 ans apregraves lrsquointroduction du PCV13
Preacutevention de ~30 000 cas drsquoIIP
Preacutevention de ~3000 deacutecegraves
De 2001 agrave 2012 PCV7 suivi de PCV13
Preacutevention de ~ 400 000 cas drsquoIIP
Preacutevention de ~ 30 000 deacutecegraves
2000 2010
PCV7 PCV13
6
Angleterre et Pays de Galle Incidence des IIP
2000-2014
Waight PA Andrews NJ Ladhani SN et al Lancet Infect Dis 2015 Published Online March 20 2015 httpdxdoiorg101016 S1473-
3099(15)70044-7
7
Taux de visites pour OMA par enfant anneacutee chez des enfants de
le 6 ans chez des enfants lt 2 ans aux USA
Tal Marom et al JAMA Pediatr 2014 168(1)68-75
2000 2010
PCV7 PCV13
Enfants le 6 ans Enfants lt 2 ans
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
2
Fardeau des infections pneumococciques chez
les enfants Seacuteveacuteriteacute de la maladie
Inva
sive
N
on
inva
sive
Preacutevalence Pour chaque cas de
meacuteningite il yrsquoa
approximativement Meacuteningites
Bacteacuterieacutemies
Pneumonies
Otites moyennes aiguecircs gtX 2000
X 200
X 20
Adapted from Pneumococcal Disease CDC Website httpwwwcdcgovvaccinespubspinkbookdownloadspneumopdf Accessed April 11 2011
Note Based on surveillance before the Introduction of PCV
3
La niche eacutecologique du pneumocoque
Le microbiome rhino-pharyngeacute
3
4
Incidence des IIP USA (1997 agrave 2011)
Active Bacterial Core Surveillance CDC Website httpwwwcdcgovabcsreports-findingssurv-reportshtml Updated January 28 2014 Accessed April 15 2014
Enfants de 1 agrave 2 ans
0
50
100
150
200
250 Pre-PCV7
Introduction
PCV7
Introduction
Post-PCV7
Introduction PCV13
Introduction
2000 2010
PCV7 PCV13
5
Preacutevention du nombre de cas drsquoIIP et de deacutecegraves dus agrave la maladie
pneumococcique invasive apregraves introduction du PCV7 et PCV13 chez les
enfants lt et ge 5 ans aux USA
5
Moore M et al Lancet 2015
Aux USA
En 2000 -gt PCV7
En 2010 -gt PCV13
3 ans apregraves lrsquointroduction du PCV13
Preacutevention de ~30 000 cas drsquoIIP
Preacutevention de ~3000 deacutecegraves
De 2001 agrave 2012 PCV7 suivi de PCV13
Preacutevention de ~ 400 000 cas drsquoIIP
Preacutevention de ~ 30 000 deacutecegraves
2000 2010
PCV7 PCV13
6
Angleterre et Pays de Galle Incidence des IIP
2000-2014
Waight PA Andrews NJ Ladhani SN et al Lancet Infect Dis 2015 Published Online March 20 2015 httpdxdoiorg101016 S1473-
3099(15)70044-7
7
Taux de visites pour OMA par enfant anneacutee chez des enfants de
le 6 ans chez des enfants lt 2 ans aux USA
Tal Marom et al JAMA Pediatr 2014 168(1)68-75
2000 2010
PCV7 PCV13
Enfants le 6 ans Enfants lt 2 ans
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
3
La niche eacutecologique du pneumocoque
Le microbiome rhino-pharyngeacute
3
4
Incidence des IIP USA (1997 agrave 2011)
Active Bacterial Core Surveillance CDC Website httpwwwcdcgovabcsreports-findingssurv-reportshtml Updated January 28 2014 Accessed April 15 2014
Enfants de 1 agrave 2 ans
0
50
100
150
200
250 Pre-PCV7
Introduction
PCV7
Introduction
Post-PCV7
Introduction PCV13
Introduction
2000 2010
PCV7 PCV13
5
Preacutevention du nombre de cas drsquoIIP et de deacutecegraves dus agrave la maladie
pneumococcique invasive apregraves introduction du PCV7 et PCV13 chez les
enfants lt et ge 5 ans aux USA
5
Moore M et al Lancet 2015
Aux USA
En 2000 -gt PCV7
En 2010 -gt PCV13
3 ans apregraves lrsquointroduction du PCV13
Preacutevention de ~30 000 cas drsquoIIP
Preacutevention de ~3000 deacutecegraves
De 2001 agrave 2012 PCV7 suivi de PCV13
Preacutevention de ~ 400 000 cas drsquoIIP
Preacutevention de ~ 30 000 deacutecegraves
2000 2010
PCV7 PCV13
6
Angleterre et Pays de Galle Incidence des IIP
2000-2014
Waight PA Andrews NJ Ladhani SN et al Lancet Infect Dis 2015 Published Online March 20 2015 httpdxdoiorg101016 S1473-
3099(15)70044-7
7
Taux de visites pour OMA par enfant anneacutee chez des enfants de
le 6 ans chez des enfants lt 2 ans aux USA
Tal Marom et al JAMA Pediatr 2014 168(1)68-75
2000 2010
PCV7 PCV13
Enfants le 6 ans Enfants lt 2 ans
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
4
Incidence des IIP USA (1997 agrave 2011)
Active Bacterial Core Surveillance CDC Website httpwwwcdcgovabcsreports-findingssurv-reportshtml Updated January 28 2014 Accessed April 15 2014
Enfants de 1 agrave 2 ans
0
50
100
150
200
250 Pre-PCV7
Introduction
PCV7
Introduction
Post-PCV7
Introduction PCV13
Introduction
2000 2010
PCV7 PCV13
5
Preacutevention du nombre de cas drsquoIIP et de deacutecegraves dus agrave la maladie
pneumococcique invasive apregraves introduction du PCV7 et PCV13 chez les
enfants lt et ge 5 ans aux USA
5
Moore M et al Lancet 2015
Aux USA
En 2000 -gt PCV7
En 2010 -gt PCV13
3 ans apregraves lrsquointroduction du PCV13
Preacutevention de ~30 000 cas drsquoIIP
Preacutevention de ~3000 deacutecegraves
De 2001 agrave 2012 PCV7 suivi de PCV13
Preacutevention de ~ 400 000 cas drsquoIIP
Preacutevention de ~ 30 000 deacutecegraves
2000 2010
PCV7 PCV13
6
Angleterre et Pays de Galle Incidence des IIP
2000-2014
Waight PA Andrews NJ Ladhani SN et al Lancet Infect Dis 2015 Published Online March 20 2015 httpdxdoiorg101016 S1473-
3099(15)70044-7
7
Taux de visites pour OMA par enfant anneacutee chez des enfants de
le 6 ans chez des enfants lt 2 ans aux USA
Tal Marom et al JAMA Pediatr 2014 168(1)68-75
2000 2010
PCV7 PCV13
Enfants le 6 ans Enfants lt 2 ans
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
5
Preacutevention du nombre de cas drsquoIIP et de deacutecegraves dus agrave la maladie
pneumococcique invasive apregraves introduction du PCV7 et PCV13 chez les
enfants lt et ge 5 ans aux USA
5
Moore M et al Lancet 2015
Aux USA
En 2000 -gt PCV7
En 2010 -gt PCV13
3 ans apregraves lrsquointroduction du PCV13
Preacutevention de ~30 000 cas drsquoIIP
Preacutevention de ~3000 deacutecegraves
De 2001 agrave 2012 PCV7 suivi de PCV13
Preacutevention de ~ 400 000 cas drsquoIIP
Preacutevention de ~ 30 000 deacutecegraves
2000 2010
PCV7 PCV13
6
Angleterre et Pays de Galle Incidence des IIP
2000-2014
Waight PA Andrews NJ Ladhani SN et al Lancet Infect Dis 2015 Published Online March 20 2015 httpdxdoiorg101016 S1473-
3099(15)70044-7
7
Taux de visites pour OMA par enfant anneacutee chez des enfants de
le 6 ans chez des enfants lt 2 ans aux USA
Tal Marom et al JAMA Pediatr 2014 168(1)68-75
2000 2010
PCV7 PCV13
Enfants le 6 ans Enfants lt 2 ans
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
6
Angleterre et Pays de Galle Incidence des IIP
2000-2014
Waight PA Andrews NJ Ladhani SN et al Lancet Infect Dis 2015 Published Online March 20 2015 httpdxdoiorg101016 S1473-
3099(15)70044-7
7
Taux de visites pour OMA par enfant anneacutee chez des enfants de
le 6 ans chez des enfants lt 2 ans aux USA
Tal Marom et al JAMA Pediatr 2014 168(1)68-75
2000 2010
PCV7 PCV13
Enfants le 6 ans Enfants lt 2 ans
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
7
Taux de visites pour OMA par enfant anneacutee chez des enfants de
le 6 ans chez des enfants lt 2 ans aux USA
Tal Marom et al JAMA Pediatr 2014 168(1)68-75
2000 2010
PCV7 PCV13
Enfants le 6 ans Enfants lt 2 ans
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
8
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
9
0
2
4
6
8
10
12
14
16
18
20
1(n=663) 2(n=573) 3(n=658) 4(n=622) 5(n=750) 6(n=645) 7(n=530) 8(n=600) 9(n=601) 10(n=598) 11(n=582) 12(n=591) 13(n=578) 14(n=582)
ST19A Lineacuteaire(ST19A)
Trend test from year
1 to 9
Trend test from year
10 to 14
PCV13
implementation
plt0001
plt0001
Serotype 19A AOM feverplusmn otalgia 8573 children 14 years
86
29
Study Years (Year 1 Oct 2001June 2002 Year 14 Oct 2014 March 2015)
n=41
n=16
n=7
n=17
Cohen Vaccine 2015 Sep 2233(39)5118-26
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
10
Number of Sp meningitis
Age distribution for IPD Sp meningitis and Sp carriage
Number of IPD
Sp carriage (healthy)
0
10
20
30
40
50
60
70
80
90
100
0
100
200
300
400
500
600
700
800
900
le12m 18 m 24 m 30 m 36 m 42 m 48 m 54 m 60 m
10
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
11
Variation of IPD profiles according to serotypes
Levy C et al CID 2015
594 children with IPD recorded after PCV13 implementation from 2011 to 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
12
PCV10 ou PCV13
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
13
Both PCVs are availablereimbursed in the NIP or the NIP consists of different PCVs by region
Programme national dimmunisation avec
le PCV agrave travers le monde1-2
1 Gavi Alliance Progress Report 2013 httpwwwgaviallianceorgresultsgavi-progress-reports 2 Data on file Pfizer
PCV13
PCV13 amp PCV10
PCV10
PCV13 NIP Announced
PCV10 NIP Announced
Mise agrave jour mars 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
14
bull Il srsquoagit de 2 bons vaccins preacutevenant bien les
infections invasives agrave pneumocoques
bull Avantages theacuteoriques du PCV13 sont
ndash 3 valences suppleacutementaires
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
15
bull 3 valences suppleacutementaires
bull 19A
ndash Seacuterotype majeur impliqueacute dans toutes les pathologies
ndash Reacutesistance aux antibiotiques
Le 10 valent exerce probablement un effet protecteur
contre les infections invasives agrave 19 A
bull 3 ndash Seacuterotype important
ndash Activiteacute du PCV13 moins bien deacutemontreacute
bull 6A ndash Protection croiseacutee 6B (PCV7 et PCV10)
ndash 6AProtegravege contre le 6C
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
16
ndash Une meilleure immunogeacuteniciteacute sur la tregraves grande
majoriteacute des seacuterotypes et notamment le 19A
bull Les deux vaccins suscitent des taux drsquoanticorps
protecteurs contre les infections invasives
bull Par contre les taux drsquoanticorps plus eacuteleveacutes du
PCV13 Impact plus grand sur le portage
bull 2 conseacutequences ndash Pas drsquoeffet troupeau du 1O Valent sur le 19A
ndash Echecs de vaccinations vont probablement persister
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
17
PCV10 Impact on Carriage of Serotype 19A
bull Carriage data from PCV10 clinical trials
ndash COMPAS (Panama) Finland Netherlands
bull Only one time point (out of 15 points measured in 3 clinical trials) shows any reduction in 19A carriage
ndash In a 3+1 schedule (not in a 2+1 schedule)
Mrkvan T et al Serotype 19A and PHiD-CV Lessons learned to date Adapted from poster presentation 31st Annual Meeting of the European Society for
Paediatric Infectious Diseases ESPID May 30 2013 Milan Italy
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
18
PCV10 Kilifi Kenya
Nasopharyngeal Carriage
PCV10 demonstrated no effect on NPC prevalence for serotypes 19A or 6A
Difference in NPC prevalence between baseline amp vaccine periods was statistically significant for only serotypes 6B and 19F
Serotype-specific carriage prevalence of Streptococcus pneumoniae among children younger
than 5 years within the Kilifi Health and Demographic Surveillance System (KHDSS) where an
additional catch-up campaign provided up to two doses of PCV10 to children aged 12mdash59 months
p=0middot0003 daggerp=0middot002
Hammitt LL et al Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of
Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi Kenya findings from cross-sectional
carriage studies The Lancet Global Health 28 May 2014 DOI 101016S2214-109X(14)70224-4
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
19
19A IPD cases in New Zealand
PCV10 officially replaced PCV7 on the childhood NIP schedule from July 2011 but PCV7 continued to be used until late 2011
PCV13 officially replaced PCV10 on the childhood NIP schedule from July 2014 but PCV10 continued to be used until late 2014
Source New Zealand Public Health Surveillance institute of Environmental Science and Research Ltd (ESR) Accessed
13Feb2015 from httpssurvesrcrinzsurveillanceIPDphp
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
20
Serotype 19A IPD Cases By Age Group
US and Finland National Surveillance
1 Moore MR Link-Gelles R Schaffner W et al Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the US
analysis of multisite population-based surveillance Lancet Infect Dis Published online 02Feb 2015 DOI httpdxdoiorg101016S1473-3099(14)71081-3
2 Finland Institute for Health and Welfare (THL) httpwwwthlfienwebthlfi-entopicsinformation-packagesincidence-of-invasive-pneumococcal-disease-in-finland
lt5 y 5ndash17 y 18ndash49 y 50ndash64 y 65+ y
PCV13
Mar 2010
PCV10
Sep 2010
US ndash Serotype 19A IPD1
Finland ndash Serotype 19A IPD2
Case
s
Case
s
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
21
Prochains vaccins pneumococciques
conjugueacutes
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
22
PCV20
bull 9N possible protection croiseacutee pour le 9V
bull ^6A protection croiseacutee pour le 6C
bull 15B possible protection croiseacutee pour le 15C
1 2 3 4 5 6A 6B 7F 8 9N 9V 10A 11A 12F 14 15B 17F 18C 19A 19F 20 22F 23F 33F
Prevnar
13 ^
PCV15
^
20v
PnC
^
PPSV23
A 20 valent conjugates composition comprising glycoconjugates from S pneumoniae serotypes 1 3 4 5 6A 6B 7F 8 9V 10A 11A 12F 14
15B 18C 19A 19F 22F 23F and 33F (20vPnC) all individually conjugated to CRMsub197
httpappftusptogovnetacginph-
ParserSect1=PTO1ampSect2=HITOFFampd=PG01ampp=1ampu=2Fnetahtml2FPTO2Fsrchnumhtmlampr=1ampf=Gampl=50amps1=222015020230922PGN
RampOS=DN20150202309ampRS=DN20150202309
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
23
Clinical Burden of Additional 7
Serotypes Contained in PCV20 ST Profile
Serotype 8 Invasive low carriage123
Serotype 10A Invasive moderate carriage12
Serotype 11A Non Invasive high carriage123 multidrug resistant23
Serotype 12F Invasive low carriage234 AOM4
Serotype 15B Non Invasive moderate carriage12 3 multidrug resistant23
Serotype 22F Invasive moderate carriage123
Serotype 33F Invasive low carriage123
IPD invasive pneumococcal disease pneumococcal conjugate vaccine
1 Van Hoek AJ et al PLoS One 20127(7)e39150
2 Varon CNRP 2014
3 Cohen et al Vaccine 2015
4 Azzari PIDJ 2014
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
24
Back-Up
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
25
Hi+Sp
associated ST - Among Sp carriers Hi association =48
0
10
20
30
40
50
60
70
80
90
100
7F 3 6A 25A 6B 12F 9N 31 19F 16F 19A 20 29 NT 34 10A 35F 15BC 35B 15F
25
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
26
Distribution of main serotypes overall IPD by period
26
ST
20082009
N=388 ()
20122013
N=181 ()
P
Evolution of the rank
19A 128 (33) 16 (9) 0000 1 2
7F 53 (14) 0 0000 2
1 30 (8) 0 0000 3
24F 25 (6) 36 (20) 0000 4 1
3 18 (5) 5 (3) 5 10
15BC 17 (4) 15 (8) 0077 6 4
25A 15 (4) 0 0004 7
19F 10 (3) 7 (4) 8 8
12F 9 (2) 16 (9) 0001 9 2
10A 7 (2) 14 (8) 0001 10 5
15A 6 (1) 13 (7) 0002 11 6
22F 6 (1) 9 (5) 0024 11 7
33F 5 (1) 6 (3) 14 9
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
27
Distribution of main serotypes meningitis by period
27
ST
20082009
N=102 ()
20122013
N=64 ()
P
Evolution of the rank
19A 33 (32) 6 (9) 0001 1 3
7F 12 (12) 0 0004 2
24F 11 (11) 17 (27) 0011 3 1
15BC 7 (7) 4 (6) 4 5
10A 5 (5) 6 (9) 5 3
15A 4 (4) 4 (6) 6 5
22F 3 (3) 1 (2) 7 12
25A 3 (3) 0 7
17F 3 (3) 0 7
1 2 (2) 0 10
3 2 (2) 1 (2) 10 12
12F 1 (1) 8 (13) 0002 15 2
19F 1 (1) 3 (5) 15 7
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015
28
Distribution of main serotypes pneumonia by period
28
ST
20082009
N=85()
20122013
N=29()
P
Evolution of the rank
19A 28 (33) 5 (17) 1 2
7F 12 (14) 0 0035 2
1 8 (9) 0 3
3 7 (8) 0 4
25A 4 (5) 0 5
19F 4 (5) 1 (4) 5 8
12F 4 (5) 2 (7) 5 5
14 3 (4) 0 8
5 2 (2) 0 9
24F 1 (1) 8 (28) 0000 11 1
15BC 1 (1) 3 (10) 0050 11 3
15A 1 (1) 3 (10) 0050 11 3
33F 0 2 (7) 5
Varon et al Vaccine 2015