Impact of Pneumococcal Conjugate Vaccine 13 Introduction on Severe Lower Respiratory Tract Infections Associated with Respiratory Syncytial Virus or Influenza Virus in Hospitalized Children in Ulaanbaatar, Mongolia

Overview

Journal IJID Reg

Specialty Infectious Diseases

Date 2024 Apr 5

PMID 38577554

Authors

Lien Anh Ha Do

Naranzul Tsedenbal

Chimidregzen Khishigmunkh

Bazarkhuu Tserendulam

Lkhagvadorj Altanbumba

Dashtseren Luvsantseren

Munkhchuluun Ulziibayar

Bujinlkham Suuri

Dorj Narangerel

Bilegtsaikhan Tsolmon

Sodbayar Demberelsuren

Cattram Nguyen

Tuya Mungun

Claire von Mollendorf

Darmaa Badarch

Kim Mulholland

Affiliations

Soon will be listed here.

Abstract

Objectives: Limited data indicate a beneficial effect of pneumococcal conjugate vaccines (PCVs) on respiratory syncytial virus (RSV) and influenza infections in young children. We evaluated the impact of 13-valent PCV (PCV13) introduction on the incidence of severe lower respiratory tract infections (LRTIs) associated with RSV or influenza in hospitalized children.

Methods: Our study was restricted to children aged <2 years with arterial oxygen saturation <93% and children with radiologically confirmed pneumonia nested in a pneumonia surveillance project in four districts of Ulaanbaatar city, Mongolia. We tested nasopharyngeal swabs collected on admission for RSV and influenza using quantitative reverse transcription-polymerase chain reaction. The impact of PCV13 on the incidence of LRTI outcomes associated with RSV or with influenza for the period April 2015-March 2020 was estimated. Incidence rate ratios comparing pre- and post-vaccine periods were estimated for each outcome for each district using negative binomial models and for all districts combined with a mixed-effects negative binomial model. Adjusted models accounted for seasonality. Sensitivity analyses were conducted to assess the robustness of our findings.

Results: Among 5577 tested cases, the adjusted incidence rate ratios showed a trend toward a reduction in RSV-associated outcomes: all LRTIs (0.77, 95% confidence interval [CI] 0.44-1.36), severe LRTIs (0.88, 95% CI 0.48-1.62), very severe LRTIs (0.76, 95% CI 0.42-1.38), and radiologically confirmed pneumonia (0.66, 95% CI 0.32-1.38) but inconsistent trends in outcomes associated with influenza.

Conclusions: No significant reductions were observed in any outcomes associated with RSV and influenza after PCV introduction.

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