ABSTRACT

Introduction

Modeling analyses have attempted to quantify the global impact of pneumococcal conjugate vaccines (PCVs) on pneumococcal disease (PD), however these pediatric models face several challenges in obtaining comprehensive impact measurements.

Areas Covered

We present several measurement challenges and discuss examples from recently published pediatric modeling evaluations. Challenges include estimating the number of infants fully or partially vaccinated with PCVs, inclusion of indirect effects of vaccination, accounting for various dosing schedules, capturing effect of PCVs on nonspecific, noninvasive PD, and inclusion of adult PCV use.

Expert Opinion

The true impact of PCVs has been consistently underestimated in published analyses due to multiple measurement challenges. Nearly 100 million adults are estimated to have received PCV13 over the last decade globally, potentially preventing up to 662 thousand cases of PD. Approximately 4.1 million cases of invasive PD alone may have been averted through indirect protection. Estimates of PCV impact on noninvasive PD remain a challenge due to altered epidemiology. Program switches, incomplete vaccination, and private market uptake among children also confound PD impact estimates. Taken together, the number of averted PD cases from PCV use in the last ten years may be up to three times higher than estimated in previous studies.

中文翻译：

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肺炎球菌结合疫苗对公共卫生的影响：衡量挑战的回顾

摘要

介绍

建模分析试图量化肺炎球菌结合疫苗 (PCV) 对肺炎球菌疾病 (PD) 的全球影响，但这些儿科模型在获得综合影响测量方面面临着若干挑战。

涵盖的领域

我们提出了几个测量挑战，并讨论了最近发表的儿科建模评估的例子。挑战包括估计完全或部分接种 PCV 的婴儿数量、包括疫苗接种的间接影响、考虑各种给药方案、捕捉 PCV 对非特异性、非侵入性 PD 的影响，以及包括成人 PCV 的使用。

专家意见

由于多重测量挑战，PCV 的真正影响在已发表的分析中一直被低估。据估计，在过去十年中，全球有近 1 亿成年人接受了 PCV13，可能预防多达 66.2 万例 PD。仅通过间接保护就可能避免了大约 410 万例侵袭性 PD。由于流行病学的改变，估计 PCV 对无创 PD 的影响仍然是一个挑战。程序转换、疫苗接种不完整和儿童的私人市场吸收也混淆了对 PD 影响的估计。综上所述，过去十年因使用 PCV 而避免的 PD 病例数可能比先前研究估计的高出三倍。