Safety of a 13-Valent Pneumococcal Conjugate Vaccine in Elderly Adults Previously Immunized with a 23-Valent Pneumococcal Polysaccharide Vaccine: An Open-Label Trial

An open-label, multicenter study was conducted to describe the safety of the 13-valent pneumococcal conjugate vaccine (PCV13) in 1049 individuals aged ≥68 years, who had previously been immunized with the unconjugated 23-valent pneumococcal polysaccharide vaccine (PPSV23). In addition, the safety profile of PCV13 in this study was compared, in a post-hoc descriptive analysis, to that observed in other elderly populations, who had received PCV13 or PPSV23 as part of other completed studies. Local (56.6%) and systemic reactions (58.4%) were very common, but were mainly mild, and of short duration (mean: 1.3 - 4.6 days). There were no related serious adverse events (AEs) within 1 month after PCV13. 123 days after PCV13 and 94 days after a nonstudy influenza vaccine, a case of transient Guillain-Barré syndrome occurred, which the investigator assessed as possibly related to the vaccination. Reactogenicity observed in this study population was generally similar to that of other elderly study populations with PPSV23-preimmunized adults, and with PPSV23-naive adults. Reactogenicity was less common in this study than that observed in PPSV23-preimmunized adults who were revaccinated with PPSV23 rather than a subsequent dose of PCV13. There were no related serious AEs reported after PCV13 and PPSV23 in these comparator studies. Conclusion: PCV13 may be administered safely to older adults previously immunized with PPSV23. (ClinicalTrials. gov Identifier: NCT00500266)

Effect of 7 and 13-Valent Pneumococcal Conjugate Vaccines Different Number of Doses for Pneumonia Control in 2008 and 2010 Birth Cohort Children

The 7-valent pneumococcal conjugate vaccine (PCV) was introduced in Uruguay in March 2008. In April 2010, it was replaced by PCV13. Surveillance of both vaccines was performed on hospitalized children with consolidated pneumonia. The effect of different number of vaccine doses was evaluated in 2008 and 2010 birth cohorts vaccinated with PCV7 and PCV13 respectively. The study aims to estimate the effects of PCV7 and PCV13 different number of doses on consolidated pneumonia, through the study of hospitalized children from 2008 and 2010 birth cohorts. Vaccination records of every child were available providing precise vaccination data;therefore a new approach was used to estimate PCVs effect. Incidence rate was calculated for each year of the study and for the different number of vaccine doses used each year. Exposure was calculated as person per year and rate ratio values determined the decrease of consolidated pneumonias. This decrease in percentage was estimated as the difference between the incidence with no vaccine and the incidence of every one of the doses. Incidence rate ratio revealed significant values for the three vaccine doses of PCVs for both cohorts. Upon comparing incidences, significant reduction percentages of consolidated pneumonia admissions were found. The reduction percentage of consolidated pneumonia for fully vaccinated (3 doses) patients was 69.3% and 84.6 % for PCV7 and PCV13, respectively. These results confirm that PCV7 and PCV13 are highly effective for reducing pediatric hospitalizations due to consolidated pneumonia, as reported by other national publications and demonstrated by international researchers.

Potential carrier priming effect in Australian infants after 7-valent pneumococcal conjugate vaccine introduction

AIM:To investigate evidence of clinical protection in infants after one dose of 7-valent pneumococcal conjugate vaccine(7vPCV) owing to carrier priming.METHODS:Using Australian National Notifiable Diseases Surveillance System data,we conducted a descriptive analysis of cases of vaccine type invasive pneumococcal disease(VT-IPD) during "catch-up" years,when 7vPCV was carrier primed by prior administration of DTPa vaccine.We compared the number of VT-IPD cases occurring 2-9 wk after a single dose of 7vPCV(carrier primed),with those < 2 wk post vaccination,when no protection from 7vPCV was expected yet.Further comparison was conducted to compare the occurrence of VT-IPD cases vs non-VT-IPD cases after a single carrier-primed dose of 7vPCV.RESULTS:We found four VT-IPD cases occurring <2 wk after one carrier primed dose of 7vPCV while only one case occurred 2-9 wk later.Upon further comparison with the non-VT-IPD cases that occurred after one carrier primed dose of 7vPCV,two cases were detected within 2 wk,whereas seven occurred within2-9 wk later;suggesting a substantial level of protection from VT-IPD occurring from 2 wk after carrier-primed dose of 7vPCV.CONCLUSION:This data suggest that infants may benefit from just one dose of 7vPCV,likely through enhanced immunity from carrier priming effect.If this is proven,an adjusted 2-dose schedule(where the first dose of PCV is not given until after DTPa) may be sufficient and more cost-effective.

Impact of Seven Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Carriage in Young Children in Okinawa, Japan

In Japan, the heptavalent pneumococcal conjugate vaccine (PCV7) became available in February 2010 and was subsidized by the national funding system from May 2011 in Okinawa, after which it was incorporated into the national immunization practice (NIP) in April 2013 using a 3 + 1 schedule for all infants. We conducted an annual survey in 2012 to determine the effect of PCV7 on nasopharyngeal colonization by pneumococcal serotypes and to analyze the risk factors for colonization in infants. Nasopharyngeal swabs for pneumococcal isolation and serotyping were obtained from infant 2 to 22 months of age before and after PCV7 immunization among 4 clinics in Okinawa, Japan. Between January 2012 and December 2012, nasopharyngeal swabs for bacterial cultures were obtained among 782 infants aged 2 to 22 months old and demographic data was obtained among 725 participant infants. Among the 725 evaluable infants, 193 pneumococcal strains were detected in 180 infants for an overall nasopharyngeal carriage of 24.8%. The main capsular serotypes isolated were 6C (16.1%), 19A (12.4%) and 15B (9.8%). Carriage of PCV7 serotypes accounted for 21.8% (42/193). The result of multivariate data analysis showed the pneumococcal carriage rate of non-PCV7 serotypes was significantly (P < 0.001) high in infant with siblings and daycare attendance. On the other hand, the result of multivariate data analysis showed that carriage rate of PCV7 serotype had only significantly high risk in infant with siblings and did not have a significant risk dependent on age and daycare attendance. Carriage PCV7 serotypes increased in the presence of other siblings, while PCV7 vaccination was shown to eliminate daycare attendance as a risk. The results of this study demonstrates that PCV7 vaccination decrease the overall nasopharyngeal carriage of PCV7 serotypes in vaccinated children including children at risk such as children attending day-care centers.

Persistence of Pleural Effusions and Empyemas after Pneumococcal Conjugate Vaccine Implementation in Uruguay

In Uruguay a post pneumococcal conjugate vaccine implementation surveillance of hospitalized children with pneumonia showed an increase of complicated pneumonias, while uncomplicated pneumonias decreased. Out of 151 pleural effusions, 62 were empyemas requiring drainage, the rest of cases were treated with antibiotics with a favorable outcome. Patient’s vaccinated status varied. Pneumococcal etiology was poorly documented. The few identified sero-types were 1 and 3, a fact that urges PCV13 use for their control.

Optimization of the Process for Preparing Bivalent Polysaccharide Conjugates to Develop Multivalent Conjugate Vaccines against Streptococcus pneumoniae or Neisseria meningitidis and Comparison with the Corresponding Licensed Vaccines in Animal Models

Objective:This study aimed to describe,optimize and evaluate a method for preparing multivalent conjugate vaccines by simultaneous conjugation of two different bacterial capsular polysaccharides(CPs)with tetanus toxoid(TT)as bivalent conjugates.Methods:Different molecular weights(MWs)of polysaccharides,activating agents and capsular polysaccharide/protein(CP/Pro)ratio that may influence conjugation and immunogenicity were investigated and optimized to prepare the bivalent conjugate bulk.Using the described method and optimized parameters,a 20-valent pneumococcal conjugate vaccine and a bivalent meningococcal vaccine were developed and their effectiveness was compared to that of corresponding licensed vaccines in rabbit or mouse models.Results:The immunogenicity test revealed that polysaccharides with lower MWs were better for Pn1-TT-Pn3 and MenA-TT-MenC,while higher MWs were superior for Pn4-TT-Pn14,Pn6A-TT-Pn6B,Pn7F-TT-Pn23F and Pn8-TT-Pn11A.For activating polysaccharides,1-cyano-4-dimethylaminopyridinium tetrafluoroborate(CDAP)was superior to cyanogen bromide(CNBr),but for Pn1,Pn3 and MenC,N-(3-dimethylaminopropyl)-N’-ethylcarbodiimide hydrochloride(EDAC)was the most suitable option.For Pn6A-TT-Pn6B and Pn8-TT-Pn11A,rabbits immunized with bivalent conjugates with lower CP/Pro ratios showed significantly stronger CP-specific antibody responses,while for Pn4-TT-Pn14,higher CP/Pro ratio was better.Instead of interfering with the respective immunological activity,our bivalent conjugates usually induced higher IgG titers than their monovalent counterparts.Conclusion:The result indicated that the described conjugation technique was feasible and efficacious to prepare glycoconjugate vaccines,laying a solid foundation for developing extended-valent multivalent or combined conjugate vaccines without potentially decreased immune function.

<i>Streptococcus pneumoniae</i>Upper Respiratory Carriage in Costa Rican Children with Otitis Media before the Introduction of the Heptavalent Conjugated Vaccine in the National Immunization Program

Objective: The aim of this study was to analyze the NP/OP S. pneumoniae serotype distribution and potential vaccine coverage in Costa Rican children with Otitis Media (OM) before the introduction of PCV-7 in the National Immunization Program (NIP). Methods: Between 2002 and 2006, NP and OP samples were obtained from 641 children from 6 to 79 months of age, at the time of OM diagnosis. S. pneumoniae serotyping and antimicrobial susceptibility were performed. Results: 386 S. pneumoniae isolates were recovered. The most common S. pneumoniae serotypes (ST) were: ST 6B, ST 14, ST 19F. Penicillin non-susceptibility was observed among 57% of the isolates obtained from children < 24 months of age. 15% strains were multidrug resistant. Potential vaccine coverage was: PCV-7: 60%;PCV-10: 62%;and PCV-13: 76% and against penicillin non-susceptible and multidrug resistant isolates was: PCV-7;59% and 83%, respectively;PCV-10: 60% and 85%, respectively and PCV-13: 74% and 96%, respectively. Conclusions: S. pneumoniae was isolated from the NP and/or OP in the majority (59%) of studied children with OM. At a statistical significant level, only serotype 3 was more frequently isolated among children >24 months of age. Antibiotic non-susceptibility and MDR were significantly higher in children <24 months of age. This study demonstrates that PCV-13 offers the highest potential vaccine coverage and serves to assess the impact of introduction of one of the conjugated vaccines in the NIP in Costa Rica.

13-Valent pneumococcal conjugate vaccines vaccination innovative strategy in Weifang City,China:a case study

The World Health Organization(WHO)prioritizes pneumococcal disease as a vaccine-preventable disease and recommends the inclusion of pneumococcal conjugate vaccines(PCV)in national immunization programs worldwide.However,PCV is not included in the National Immunization Program in China and has low vaccination coverage due to its high cost.To address this,Weifang City implemented an innovative strategy for a 13-valent PCV(PCV13)on June 1,2021.This strategy aimed to provide one dose of PCV13 free of charge for children aged 6 months to 2 years in registered households and to adopt a commercial insurance model with one dose of PCV13 free of charge in 2023 for children over 2 years old.The Health Commission of Weifang and other departments conducted a comprehensive investigation and considered various factors,such as vaccine efectiveness,safety,accessibility,vaccine price,and immunization schedules,for eligible children(under 5 years old).Stakeholder opinions were also solicited before implementing the policy.The Commission negotiated with various vaccine manufacturers to maximize its negotiating power and reduce vaccine prices.The implementation plan was introduced under the Healthy Weifang Strategy.Following the implementation of this strategy,the full course of vaccination coverage increased signifcantly from 0.67 to 6.59%.However,vaccination coverage is still lower than that in developed countries.Weifang’s PCV13 vaccination innovative strategy is the frst of its kind in Chinese mainland and is an active pilot of non-immunization program vaccination strategies.To further promote PCV13 vaccination,Weifang City should continue to implement this strategy and explore appropriate fnancing channels.Regions with higher levels of economic development can innovate the implementation of vaccine programs,broaden fnancing channels,improve accessibility to vaccination services,and advocate for more localities to incorporate PCV13 into locally expanded immunization programs or people-benefting projects.A monitoring and evaluation system should also be established to evaluate implementation efects.

Accelerating Pneumococcal Conjugate Vaccine introductions in Indonesia:key learnings from 2017 to 2022

Despite high pneumococcal disease and economic burden in Indonesia and interest to introduce pneumococcal conjugate vaccine (PCV), there were challenges in establishing a comprehensive strategy to accelerate and enable the introduction in country in the early 2010s. Starting in 2017, Clinton Health Access Initiative and partners supported the government of Indonesia with evidence-based decision-making and implementation support for introducing PCV into the routine immunization program. Indonesia has since accelerated PCV roll out, with nationwide reach achieved in 2022. On the path to PCV introduction, several challenges were observed that impacted decision making on whether and on how to optimally roll out PCV, resulting in significant introduction delays;including (1) a complex country context with a devolved government structure, fragmented domestic funding streams, and an imminent transition out of major immunization donor (Gavi) support;(2) strong preference to use domestically sourced products, with limited experience accessing global pooled procurement mechanism including for vaccines;and (3) concerns around programmatic feasibility and sustainability. This case study documents key insights into the challenges experienced and how those were systematically addressed to accelerate new vaccine introduction in Indonesia, with support from local and global stakeholders over time. The learnings would be beneficial for other countries yet to introduce critical new vaccines, in particular those with similar archetype as Indonesia e.g., middle-income countries with domestic manufacturing capacity and/or countries recently transitioning out of Gavi support.

Novel polysaccharide-protein conjugates provide an immunogenic 13-valent pneumococcal conjugate vaccine for S.pneumoniae

Pneumonia remains the single leading cause of childhood death worldwide.Despite the commercial availability of multiple pneumococcal conjugate vaccines(PCVs),high dosage cost and supply shortages prevent PCV delivery to much of the developing world.The current work presents high-yield pneumococcal conjugates that are immunogenic in animals and suitable for use in human vaccine development.The 13-valent pneumococcal conjugate vaccine(PCV-13)investigated in this research incorporated serotypes 1,3,4,5,6A,6B,7F,9V,14,18C,19A,19F,and 23F.Pneumococcal polysaccharides(PnPSs)and CRM197 carrier protein were produced and purified in-house,and used to prepare PnPS-CRM conjugates using unique,cyanide-free,in vacuo glycation conjugation methods.In vitro characterization confirmed the generation of higher molecular weight PnPS-CRM conjugates low in free protein.In vivo animal studies were performed to compare PnuVax's PCV-13 to the commercially available PCV-13,Prevnar®13(Pfizer,USA).A boost dose was provided to all groups post-dose 1 at t?14 days.Post-dose 2 results at t?28 days showed that all 13 serotypes in PnuVax's PCV-13 were boostable.Per serotype IgG GMCs demonstrated that PnuVax's PCV-13 is immunogenic for all 13 serotypes,with 10 of the 13 serotypes statistically the same or higher than Prevnar®13 post-dose 2.As a result,the novel polysaccharideprotein conjugates developed in this work are highly promising for use in human PCV development.The in vacuo conjugation technique applied in this work could also be readily adapted to develop many other conjugate vaccines.

Immunogenicity and protective immunity against otitis media caused by pneumococcus in mice of Hib conjugate vaccine with PsaA protein carrier

This study evaluated the immunogenicity and protective immunity of a Hemophilus influenzae b （Hib） polysaccharide conjugate vaccine with the pneumococcal surface adhesin A （PsaA） protein carrier in young mice. The Hib polysaccharide was conjugated with the rPsaA protein carrier, which was produced using recombinant DNA technology. A total of 15 young mice aged 3 weeks to 5 weeks were immunized with the conjugate vaccine, and another 15 young mice of the same age were immunized with the licensed Hib-tetanus toxoid （TT） vaccine. Furthermore, the third group of 15 young mice was inoculated with phosphate buffer saline as control. The immunized mice were inoculated with pneumococcus in the middle ear. Results showed that IgG antibody responses against both the PsaA protein and Hib polysaccharide were observed in the Hib-PsaA group. However, no statistical difference was observed in the titer of ｜gG against the Hib polysaccharide between Hib-PsaA and Hib-TT groups. The elimination rate of pneumococcus and the inflammation of the middle ear showed the effectiveness of protective immunity against otitis media caused by pneumococcus. Our results suggest that the Hib polysaccharide can be successfully conjugated with rPsaA via amide condensation. This new Hib-PsaA conjugate vaccine can induce both anti-PsaA and anti-Hib immune responses in young mice and elicit effective protection against acute otitis media caused by pneumococcus.

2岁以下儿童肺炎球菌疫苗接种情况及应用效果分析

目的分析2岁以下儿童肺炎球菌疫苗接种率及其应用效果。方法采用多阶段随机抽样法,调查2岁以下儿童13价肺炎球菌疫苗(PCV13)接种率,了解呼吸道疾病的发生率和住院率,分析疫苗应用效果。结果PCV13全程接种率为56.26%。非全程接种组有43.45%存在因病就医,高于完成PCV13全程免疫的儿童(28.18%),其住院率(13.69%)高于完成PCV13全程免疫的儿童(3.64%),差异有统计学意义(P<0.05)。结论儿童PCV13全程接种率偏低,需采取针对性措施提高儿童PCV13接种率。

肺炎链球菌血清型监测结果与疫苗覆盖情况

目的研究2014至2018年中河北省肺炎链球菌血清型分布与动态变迁,分析疫苗覆盖率。方法应用多重聚合酶链式反应对菌株进行血清分型;计算PCV7、PCV10、PCV13、PPV23疫苗的覆盖率,使用卡方检验和Bonferroni检验,进行差异比较。结果可分型菌株中较多的血清型包括:19F(176株33.40%)、6(87株16.51%)、19A(57株10.82%)、14(30株5.69%)、23F(20株3.80%)。19F型和19A型在非侵袭性菌株中占比高于侵袭性(P<0.05);14型在侵袭性菌株中比例明显高于非侵袭性菌株(P<0.05)。19F 2015年达到高点后开始下降;2017至2018年出现了19A比例回升、6群下降和14型明显上升。PCV7、PCV10、PCV13、PPV23的总体覆盖率依次为60.34%、64.33%、78.37%、83.30%,PCV13和PCV23显著高于PCV7和PCV10(P<0.05)。结论本地2014至2018年间优势血清型依次为:19F、6、19A、14、23F型。对于本地区肺炎链球菌引发的感染,19F型和19A型菌株起到的作用可能会下降,引起的症状可能会减轻。相反,6群和14型起的作用会上升,引起的症状也可能会加重。推荐使用PCV13替代PCV7和PCV10,对于>2岁儿童也推荐使用PPV23。

肺炎链球菌18C型糖蛋白结合物的制备及其免疫原性

制备肺炎链球菌 18C型荚膜多糖 破伤风类毒素结合物 (CPS TT) ,测定结合物的理化性质、抗原特异性及其在动物中的免疫原性。结果显示 ,结合物能与相应的多糖和破伤风抗血清形成明显的沉淀线 ,蛋白 /多糖比率为 1.86 ,结合物分子大小 (Kd值 )为 0 .0 5 8。注射小鼠后可诱导明显的抗体应答 ,而且随着注射针次的增加 ,抗体反应水平明显增高 ,显示加强效应。结果表明 ,制备的肺炎链球菌糖蛋白结合物抗原性良好 ,具有胸腺依赖性抗原的特性 。

肺炎球菌结合疫苗诱导的抗荚膜多糖抗体活性研究

目的 研究肺炎球菌荚膜多糖-蛋白结合物在小鼠体内诱导产生的功能性抗体活性。方法 用荚膜多糖及其结合物免疫BALB/c小鼠,用ELISA法测定小鼠血清IgG抗体,用KSCN解离法测定IgG抗体的亲和力,用体外调理吞噬实验测定血清的调理吞噬滴度。结果 18C-TT、19F-TT免疫小鼠后,抗体滴度显著升高,有免疫记忆反应,18C-TT第1针和第3针免后的抗体亲和指数(AI)分别为22.3％±4.8％和49.7％±1.8％,调理吞噬滴度分别达到16和32;19F-TT免后AI分别为52.6％±3.0％和61.6％±3.4％,调理吞噬滴度则分别为32和64。结论18C-TT和19F-TT免疫小鼠后,能有效地产生再次免疫应答,其IgG有良好的亲和力和补体依赖的调理吞噬功能,能有效地清除肺炎链球菌的感染。

患儿非侵入性肺炎链球菌血清型及抗生素耐药性研究

目的研究患儿非侵入性肺炎链球菌血清型和抗生素耐药性。方法回顾性分析863例患儿的非侵入性肺炎链球菌分离株血清学分型和抗生素敏感性试验结果。另选取860例健康儿童作为对照组,对2组患儿相关生化指标进行对比分析。结果共得到45个不同的血清型。其中6个主要血清型(流行率大于5.0%)为19F(21.7%),6B(12.8%),23F(10.1%),14(9.0%),6A(8.4%)和3(7.5%)。大多数多重耐药菌分离株的血清型为6B,14,19A,19F。28%的分离株为青霉素不敏感型。红霉素的耐药率为26%。克林霉素的耐药率为32%(6/19)。肺炎患儿hs-CRP、PCT、WBC、PLT、ESR、ALT和CK-MB水平高于健康对照组,差异有统计学意义(P<0.05)。结论耐药肺炎链球菌血清型分布增多。双重大环内酯耐药肺炎球菌菌株的出现需要高度监控。

6B型肺炎球菌荚膜多糖-破伤风类毒素结合疫苗的制备及其免疫原性

目的 制备6B型肺炎球菌荚膜多糖(6B-PNCPS)-破伤风类毒素蛋白(TT)结合疫苗,并研究其免疫原性。方法6B-PNCPS用溴化氰活化后与己二酰肼形成多糖-酰肼基衍生物,然后在蛋白活化剂碳二亚胺作用下将6B-PNCPS与TT进行共价结合。分别将其结合物及多糖免疫NIH小鼠,用ELISA检测小鼠血清中抗6B-PNCPS抗体。结果6B-PNCPS-TT结合物经凝胶色谱分析显示具有较6B-PNCPS更大的相对分子质量,多糖/蛋白比为1.42-1.66。结合物具有6B-PNCPS的血清学特异性,所诱生的抗6B-PNCPS特异性IgG抗体滴度与6B-PNCPS差异有显著意义。结论 用该法制备6B-PNCPS-TT结合疫苗,具有良好的免疫原性。

幼儿园儿童年龄与肺炎链球菌疫苗覆盖率间的剂量-反应关系

目的了解幼儿园儿童年龄与肺炎链球菌疫苗覆盖率间的潜在关系,为指导疫苗接种和开发新型蛋白疫苗提供依据。方法采用分层整群随机抽样方法,抽取佛山市顺德区6所幼儿园中1830名健康儿童,进行鼻咽拭子采样并分离鉴定肺炎链球菌。采用基于限制性立方样条的logistic回归模型分析儿童年龄与肺炎链球菌相关疫苗覆盖率间的剂量-反应关系。结果幼儿园儿童鼻咽部肺炎链球菌携带率为22.46%(411/1830),常见血清型为6B、19F、15A、23A、34与23F。对于肺炎链球菌结合疫苗(pneumococcal conjugate vaccine,PCV),PCV10与PCV13血清型覆盖率分别为53.0%、57.9%,且儿童年龄与PCV10和PCV13血清型覆盖率间存在明显的非线性剂量-反应关系(均P<0.05),2岁组儿童的PCV10(88.0%)和PCV13(91.1%)血清型覆盖率均较高。儿童年龄与菌毛基因岛(pilus islet,PI)相关基因PI-1、PI-2覆盖率间存在非线性剂量-反应关系(均P<0.05),PI-1(37.7%)和PI-2(16.1%)覆盖率较低,且各年龄组儿童的PI-1(13.0%~58.5%)和PI-2(6.0%~29.4%)覆盖率均较低。候选蛋白疫苗相关的毒力基因lytA(99.5%)、ply(99.0%)覆盖率高。结论幼儿园儿童年龄与PCV10、PCV13血清型覆盖率存在明显的非线性剂量-反应关系,且2岁组幼儿园儿童具有较高的PCV血清型覆盖率;毒力基因lytA与ply的各年龄段高流行使其有望作为候选毒力因子开发新一代重组蛋白疫苗。

13价肺炎球菌结合疫苗在老年人群中的免疫原性研究

老年人群对肺炎球菌疫苗的免疫应答不同于婴幼儿,在对老年人群肺炎球菌疫苗免疫原性的研究中,临床试验设计和判定标准均有所不同。现将美国13价肺炎球菌结合疫苗(13-valent conjugated vaccine,PCV13)在老年人群免疫原性研究的临床资料进行归纳和分析,为国内肺炎球菌疫苗在老年人群中的临床研究提供参考。

贵州省基于离散选择实验的13价肺炎球菌结合疫苗的选择偏好研究

目的了解儿童家长对13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine,PCV13)的选择偏好,分析不同人群的偏好异质性,为疫苗的合理推广和使用提供建议。方法基于离散选择实验,在多阶段随机整群抽样的基础上,纳入2月龄至10周岁儿童的家长,使用电子问卷对儿童家长进行面对面调查,利用混合logit模型来评估受访者对PCV13的选择偏好。结果此次调查共收到有效问卷1476份,通过一致性检验的问卷1175份。所有疫苗属性对选择偏好均有统计学意义,有效性和保护时长是儿童家长更注重的疫苗属性。包含交互效应的混合logit模型显示,大专及以上学历的家长更偏好90%有效性以及低不良事件发生率的疫苗,家庭人均月收入大于3000元的家庭更偏好进口疫苗。在为儿童选择PCV13方面,儿童家长更愿意为疫苗高有效性和10年的保护时长支付更多的费用,普遍更偏好国产疫苗和全程接种费用低的疫苗。结论研究结果将为后续相关部门对于PCV13的管理决策提供数据支撑,并且为疫苗生产方提供参考,有助于合理推广PCV13并提高其接受度。