Abstract

Global impact of 10- and 13-valent pneumococcal conjugate vaccines on pneumococcal meningitis in all ages: the PSERENADE project

Yang Y, Knoll MD, Herbert C, Bennett JC, Feikin DR, Quesada MG, Hetrich MK, Zeger SL, Kagucia EW, Xiao M, Cohen AL, van der Linden M, du Plessis M, Yildirim I, Winje BA, Varon E, Valenzuela MT, Valentiner-Branth P, Steens A, Scott JA, Savrasova L, Sanz JC, Khan AS, Oishi K, Nzoyikorera N, Nuorti JP, Mereckiene J, McMahon K, McGeer A, Mackenzie GA, MacDonald L, Ladhani SN, Kristinsson KG, Kleynhans J, Kellner JD, Jayasinghe S, Ho PL, Hilty M, Hammitt LL, Guevara M, Gilkison C, Gierke R, Desmet S, De Wals P, Dagan R, Colzani E, Ciruela P, Chuluunbat U, Chan G, Camilli R, Bruce MG, Brandileone MC, Ampofo K, O'Brien KL, Hayford K
J Infect. 2025;90

Permenent descriptor

BACKGROUND: Pneumococcal conjugate vaccines (PCVs) introduced in childhood national immunization programs lowered vaccine-type invasive pneumococcal disease (IPD), but replacement with non-vaccine-types persisted throughout the PCV10/13 follow-up period. We assessed PCV10/13 impact on pneumococcal meningitis incidence globally. METHODS: The number of cases with serotyped pneumococci detected in cerebrospinal fluid and population denominators were obtained from surveillance sites globally. Site-specific meningitis incidence rate ratios (IRRs) comparing pre-PCV incidence to each year post-PCV10/13 were estimated by age (<5, 5-17 and ≥18 years) using Bayesian multi-level mixed effects Poisson regression, accounting for pre-PCV trends. All-site weighted average IRRs were estimated using linear mixed-effects regression stratified by age, product (PCV10 or PCV13) and prior PCV7 impact (none, moderate, or substantial). Changes in pneumococcal meningitis incidence were estimated overall and for product-specific vaccine-types and non-PCV13-types. RESULTS: Analyses included 10,168 cases <5y from PCV13 sites and 2,849 from PCV10 sites, 3,711 and 1,549 for 5-17y and 29,187 and 5,653 for ≥18y from 42 surveillance sites (30 PCV13, 12 PCV10, 2 PCV10/13) in 30 countries, primarily high-income (84%). Six years after PCV10/PCV13 introduction, pneumococcal meningitis declined 4874% across products and PCV7 impact strata for children <5y, 3562% for 5-17y and 036% for ≥18y. Impact against PCV10-types at PCV10 sites, and PCV13-types at PCV13 sites was high for all age groups (<5y: 96100%; 5-17y: 7785%; ≥18y: 7385%). After switching from PCV7 to PCV10/13, increases in non-PCV13-types were generally low to none for all age groups. CONCLUSION: Pneumococcal meningitis declined in all age groups following PCV10/PCV13 introduction. Plateaus in non-PCV13-type meningitis suggest less replacement than for all IPD. Data from meningitis belt and high-burden settings were limited.