Smith-Vaughan, H;
Temple, B;
Trang Dai, VT;
Hoan, PT;
Loc Thuy, HN;
Phan, TV;
Bright, K;
Toan, NT;
Uyen, DY;
Nguyen, CD;
et al.
Smith-Vaughan, H; Temple, B; Trang Dai, VT; Hoan, PT; Loc Thuy, HN; Phan, TV; Bright, K; Toan, NT; Uyen, DY; Nguyen, CD; Beissbarth, J; Ortika, BD; Nation, ML; Dunne, EM; Hinds, J; Lai, J; Satzke, C; Huu, TN; Mulholland, K
(2023)
Effect of different schedules of ten-valent pneumococcal conjugate vaccine on pneumococcal carriage in Vietnamese infants: results from a randomised controlled trial.
Lancet Reg Health West Pac, 32.
p. 100651.
ISSN 2666-6065
https://doi.org/10.1016/j.lanwpc.2022.100651
SGUL Authors: Hinds, Jason
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Abstract
BACKGROUND: WHO recommends a three-dose infant pneumococcal conjugate vaccine (PCV) schedule administered as a two-dose primary series with booster (2 + 1) or a three-dose primary series (3 + 0). Data on carriage impacts of these and further reduced PCV schedules are needed to inform PCV strategies. Here we evaluate the efficacy against carriage of four different PCV10 schedules. METHODS: Participants within an open-label, randomised controlled trial in Ho Chi Minh City, Vietnam, were allocated to receive PCV10 in a 3 + 1 (2,3,4,9 months, n = 152), 3 + 0 (2,3,4 months, n = 149), 2 + 1 (2,4,9.5 months, n = 250) or novel two-dose (2,6 months, n = 202) schedule, or no infant doses of PCV (two control groups, n = 197 and n = 199). Nasopharyngeal swabs collected between 2 and 24 months were analysed (blinded) for pneumococcal carriage and serotypes. Trial registration: ClinicalTrials.gov NCT01953510. FINDINGS: Pneumococcal carriage prevalence was low (10.6-14.1% for vaccine-type (VT) at 12-24 months in unvaccinated controls). All four PCV10 schedules reduced VT carriage compared with controls (the 2 + 1 schedule at 12, 18, and 24 months; the 3 + 1 and two-dose schedules at 18 months; and the 3 + 0 schedule at 24 months), with maximum reductions of 40.1%-64.5%. There were no differences in VT carriage prevalence at 6 or 9 months comparing three-dose and two-dose primary series, and no differences at 12, 18, or 24 months when comparing schedules with and without a booster dose. INTERPRETATION: In Vietnamese children with a relatively low pneumococcal carriage prevalence, 3 + 1, 2 + 1, 3 + 0 and two-dose PCV10 schedules were effective in reducing VT carriage. There were no discernible differences in the effect on carriage of the WHO-recommended 2 + 1 and 3 + 0 schedules during the first two years of life. Together with the previously reported immunogenicity data, this trial suggests that a range of PCV schedules are likely to generate significant direct and indirect protection. FUNDING: NHMRC, BMGF.
Item Type: | Article | |||||||||
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Additional Information: | Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). | |||||||||
Keywords: | Pneumococcal carriage, Pneumococcal conjugate vaccine, Vaccine schedules | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | |||||||||
Journal or Publication Title: | Lancet Reg Health West Pac | |||||||||
ISSN: | 2666-6065 | |||||||||
Language: | eng | |||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution 4.0 | |||||||||
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PubMed ID: | 36785850 | |||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/115222 | |||||||||
Publisher's version: | https://doi.org/10.1016/j.lanwpc.2022.100651 |
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