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

Yangyupei Yang ; Maria Deloria Knoll ; Carly Herbert ; Julia C Bennett ; Daniel R Feikin ; Maria Garcia Quesada ; Marissa K Hetrich ; Scott L Zeger ; Eunice W Kagucia ; Melody Xiao ; +46 more... Adam L Cohen ; Mark van der Linden ; Mignon du Plessis ; Inci Yildirim ; Brita A Winje ; Emmanuelle Varon ; Maria Teresa Valenzuela ; Palle Valentiner-Branth ; Anneke Steens ; J Anthony Scott ORCID logo ; Larisa Savrasova ; Juan Carlos Sanz ; Aalisha Sahu Khan ; Kazunori Oishi ; Néhémie Nzoyikorera ; J Pekka Nuorti ; Jolita Mereckiene ; Kimberley McMahon ; Allison McGeer ; Grant A Mackenzie ORCID logo ; Laura MacDonald ; Shamez N Ladhani ; Karl G Kristinsson ; Jackie Kleynhans ; James D Kellner ; Sanjay Jayasinghe ; Pak-Leung Ho ; Markus Hilty ; Laura L Hammitt ; Marcela Guevara ; Charlotte Gilkison ; Ryan Gierke ; Stefanie Desmet ; Philippe De Wals ; Ron Dagan ; Edoardo Colzani ; Pilar Ciruela ; Urtnasan Chuluunbat ; Guanhao Chan ; Romina Camilli ; Michael G Bruce ; Maria-Cristina C Brandileone ; Krow Ampofo ; Katherine L O'Brien ; Kyla Hayford ; PSERENADE Team ; (2025) Global impact of 10- and 13-valent pneumococcal conjugate vaccines on pneumococcal meningitis in all ages: The PSERENADE project. The Journal of infection, 90 (3). 106426-. ISSN 0163-4453 DOI: 10.1016/j.jinf.2025.106426
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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 <5 y from PCV13 sites and 2849 from PCV10 sites, 3711 and 1549 for 5-17 y and 29,187 and 5653 for ≥18 y 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 48-74% across products and PCV7 impact strata for children <5 y, 35-62% for 5-17 y and 0-36% for ≥18 y. Impact against PCV10-types at PCV10 sites, and PCV13-types at PCV13 sites was high for all age groups (<5 y: 96-100%; 5-17 y: 77-85%; ≥18 y: 73-85%). 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.

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