1474 - Impact of 13-valent Pneumococcal Conjugate Vaccine (PCV13) on Non-bacteremic Pneumococcal Pneumonia (NBPP) among Adults in the United States, 2013-2017

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Presenting Author(s)

RG

Ryan Gierke

Epidemiologist
Centers of Disease Control and Prevention
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

AM

Almea Matanock

Dr
CDC
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NS

Nong Shang

Mathematical Statistician
Centers for Disease Control and Prevention, Atlanta, GA, USA
Atlanta, GA
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MF

Monica M. Farley

Division Director/Professor of Medicine
Emory University School of Medicine, Division of Infectious Diseases
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
WS

William Schaffner

Professor
Vanderbilt University Medical Center
Nashville, Tennessee
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AT

Ann Thomas

Public Health Physician
Oregon Health Authority
Portland, Oregon
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AR

Art Reingold

Professor and Division Head, Epidemiology
University of California, Berkeley
Berkeley, CA
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LH

Lee Harrison

Professor of Medicine and Epidemiology
University of Pittsburgh
Pittsburgh, Pennsylvania
Disclosure: GSK (Consultant)Merck (Consultant)Pfizer (Consultant)Sanofi Pasteur (Consultant)
KS

Katherine Schleiss

Epidemiologist Intermediate
Minnesota Department of Health
Saint Paul, Minnesota
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KB

Kari Burzlaff

Emerging Infections Program Surveillance Officer
New York State Department of Health
Buffalo, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SP

Susan Petit

Epidemiologist
Connecticut Department of Public Health
Hartford, Connecticut
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NA

Nisha B. Alden

Respiratory and Invasive Bacterial Disease Program Manager
Colorado Department of Public Health and Environment
Denver, Colorado
Disclosure: CDC (Grant/Research Support)
TP

Tamara Pilishvili

Epidemiologist
Centers for Disease Control and Prevention, Atlanta, GA, USA
Atlanta, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: PCV13 was recommended for U.S. children in 2010 and for adults ≥ 65 years in 2014. Vaccine coverage among adults ≥ 65 years was 43% in 2017. We evaluated PCV13 impact on NBPP among adults.

Methods: NBPP cases (clinically or radiographically confirmed pneumonia and a positive pneumococcal urine antigen test (PUAT) in a hospitalized adult aged ≥ 18 years) were identified at select hospitals in 10 sites within CDC’s Active Bacterial Core surveillance during 2013-2017. NBPP rates (per 100,000) were estimated using U.S. Census Bureau population denominators and adjusted for the proportion of pneumonia patients tested by PUAT and the number of pneumonia admissions in the catchment area.

Results: Between 2013 and 2017, 4,430 NBPP cases were identified. Adults aged ≥ 65 years accounted for 49% of cases. Case fatality rate was 6%. From 2013 to 2014, rates of NBPP declined from 153 to 90 (41% reduction, 95%CI 28%, 51%) in ≥ 65 year-olds; 60 to 40 (34% reduction, 95%CI 22%, 45%) in 50-64 year-olds; and 15 to 10 (36% reduction, 95%CI 25%, 47%) in 18-49 year-olds. From 2014 to 2017, rates of NBPP increased in all ages, but remained below 2013 rates (Figure).Figure. Estimated Annual Non-Bacteremic Pneumococcal Pneumonia Incidence by Age Group, 2013–2017

Conclusion: Reductions in NBPP among adults were primarily due to indirect effects of PCV13 use in children, with no additional declines following PCV13 introduction for adults aged ≥ 65 years.