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Published VersionCC BY-NC-ND V4.0, Open Access
Journal article
Nasopharyngeal carriage of otitis media pathogens in infants receiving 10-valent non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10), 13-valent pneumococcal conjugate vaccine (PCV13) or a mixed primary schedule of both vaccines: A randomised controlled trial
Vaccine, Vol.39(16), pp.2271-2280
2021
PMID: 33766422
Abstract
Background: Aboriginal children in Northern Australia have a high burden of otitis media, driven by early and persistent nasopharyngeal carriage of otopathogens, including non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae (Spn). In this context, does a combined mixed primary series of Synflorix and Prevenar13 provide better protection against nasopharyngeal carriage of NTHi and Spn serotypes 3, 6A and 19A than either vaccine alone?
Methods: Aboriginal infants (n = 425) were randomised to receive Synflorix(TM) (S, PHiD-CV10) or Prevenar13(TM) (P, PCV13) at 2, 4 and 6 months (_SSS or _PPP, respectively), or a 4-dose early mixed primary series of PHiDCV10 at 1, 2 and 4months and PCV13 at 6 months of age (SSSP). Nasopharyngeal swabs were collected at 1, 2, 4, 6 and 7 months of age. Swabs of ear discharge were collected from tympanic membrane perforations.
Findings: At the primary endpoint at 7 months of age, the proportion of nasopharyngeal (Np) swabs positive for PCV13-only serotypes 3, 6A, or 19A was 0%, 0.8%, and 1.5% in the _PPP, _SSS, and SSSP groups respectively, and NTHi 55%, 52%, and 52% respectively, and no statistically significant vaccine group differences in other otopathogens at any age. The most common serotypes (in order) were 16F, 11A, 10A, 7B, 15A, 6C, 35B, 23B, 13, and 15B, accounting for 65% of carriage. Ear discharge swabs (n = 108) were culture positive for NTHi (52%), S. aureus (32%), and pneumococcus (20%).
Conclusions: Aboriginal infants experience nasopharyngeal colonisation and tympanicmembrane perforations associated with NTHi, non-PCV13 pneumococcal serotypes and S. aureus in the first months of life. Nasopharyngeal carriage of pneumococcus or NTHi was not significantly reduced in the early 4-dose combined SSSP group compared to standard _PPP or _SSS schedules at any time point. Current pneumococcal conjugate vaccine formulations do not offer protection from early onset NTHi and pneumococcal colonisation in this high-risk population.
Details
- Title
- Nasopharyngeal carriage of otitis media pathogens in infants receiving 10-valent non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10), 13-valent pneumococcal conjugate vaccine (PCV13) or a mixed primary schedule of both vaccines: A randomised controlled trial
- Authors
- Jemima Beissbarth (Corresponding Author) - Charles Darwin UniversityNicole Wilson - Charles Darwin UniversityBeth Arrowsmith - Charles Darwin UniversityMichael J. Binks - Charles Darwin UniversityVictor Oguoma - University of CanberraKatrina A. Lawrence - Charles Darwin UniversityA Llewellyn - Charles Darwin UniversityEdward Kim Mulholland - The University of MelbourneMathuram Santosham - Johns Hopkins UniversityPeter Stanley Morris - Charles Darwin UniversityHeidi C Smith-Vaughan - Charles Darwin UniversityAllen C. Cheng - Monash UniversityAmanda Jane Leach - Charles Darwin University
- Publication details
- Vaccine, Vol.39(16), pp.2271-2280
- Publisher
- Elsevier Ltd
- Date published
- 2021
- DOI
- 10.1016/j.vaccine.2021.03.032
- ISSN
- 1873-2518; 0264-410X
- PMID
- 33766422
- Copyright note
- (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
- Grants
- Organisation Unit
- Thompson Institute
- Language
- English
- Record Identifier
- 991121852302621
- Output Type
- Journal article
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