by Mary Slack, FRCPATH; Andrew Vyse, PhD; Harish Madhava, MD; Ralf-Rene Reinert, MD; Gillian Ellsbury, MD; Carole Czudek, PhD; Bradford Gessner, MDPublished in The Pediatric Infectious Disease Journal, April 2019. doi: 10.1097/INF.0000000000002184 "To the editors:
We read with interest the article by Makwana et al. The authors note that most childhood invasive pneumococcal disease (IPD) cases are now due to non-13 valent pneumococcal conjugate vaccine (PCV13) serotypes though PCV13 serotypes remain in circulation with serotypes 3 and 19A listed among the top 10 that caused IPD in children in 2015/16. Of the 25 cases with PCV13-type IPD in 2015/16, 11 (44%) were due to serotype 19A.
Key insight is given into the IPD burden in infants 3–11 months of age, which over the 6-year study period accounted for a substantial proportion (508/1255, 40%) of the total in children <5 years of age. Additionally, meningitis was most prevalent in infants (209/456 cases, 45.8%) and was associated with the highest case fatality (9.6%). The most recent data from 2015/16 showed 103/271 (38%) of IPD cases occurred in infants 3–11 months of age, with 5 (4.8%) attributed to PCV13 serotypes. This reflects an increase in infant IPD compared with 2014/15 and slightly exceeds the number of cases in this age group in 2010/11 when PCV13 was first introduced illustrating a continuing and substantial burden of infant IPD. ..."