Skip to main content
release_alert
Welcome to the new Scholars 3.0! Read about new features and let us know what you think.
cancel
Journal cover image

Effectiveness of the 10-valent pneumococcal conjugate vaccine against radiographic pneumonia among children in rural Bangladesh: A case-control study.

Publication ,  Journal Article
McCollum, ED; Ahmed, S; Roy, AD; Chowdhury, NH; Schuh, HB; Rizvi, SJR; Hanif, AAM; Khan, AM; Mahmud, A; Pervaiz, F; Harrison, M; Reller, ME ...
Published in: Vaccine
September 29, 2020

BACKGROUND: Pneumococcal conjugate vaccine (PCV) effectiveness against radiographic pneumonia in South Asia is unknown. Bangladesh introduced PCV10 in 2015 using a three dose primary series (3 + 0). We sought to measure PCV10 effectiveness for two or more vaccine doses on radiographic pneumonia among vaccine-eligible children in rural Bangladesh. METHODS: We conducted a matched case-control study over two years from 2015 to 2017 using clinic and community controls in three subdistricts of Sylhet, Bangladesh. Cases were vaccine eligible 3-35 month olds at Upazila Health Complex outpatient clinics with World Health Organization-defined radiographic primary endpoint pneumonia (radiographic pneumonia). Clinic controls were matched to cases within a one week time window by age, sex, and clinic and had an illness unlikely to be Streptococcus pneumoniae; community controls were healthy and similarly matched within a one week time window by age and sex, and distance from the clinic. We estimated adjusted vaccine effectiveness (aVE) using conditional logistic regression. RESULTS: We matched 1262 cases with 2707 clinic and 2461 community controls. Overall, aVE using clinic controls was 21.4% (95% confidence interval, -0.2%, 38.4%) for ≥2 PCV10 doses and among 3-11 month olds was 47.3% (10.5%, 69.0%) for three doses. aVE increased with higher numbers of doses in clinic control sets (p = 0.007). In contrast, aVE using community controls was 7.6% (95% confidence interval, -22.2%, 30.0%) for ≥2 doses. We found vaccine introduction in the study area faster and less variable than expected with 75% coverage on average, which reduced power. Information bias may also have affected community controls. CONCLUSIONS: Clinic control analyses show PCV10 prevented radiographic pneumonia in Bangladesh, especially among younger children receiving three doses. While both analyses were underpowered, community control enrollment - compared to clinic controls - was more difficult in a complex, pluralistic healthcare system. Future studies in comparable settings may consider alternative study designs.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Vaccine

DOI

EISSN

1873-2518

Publication Date

September 29, 2020

Volume

38

Issue

42

Start / End Page

6508 / 6516

Location

Netherlands

Related Subject Headings

  • Virology
  • Vaccines, Conjugate
  • Pneumonia, Pneumococcal
  • Pneumonia
  • Pneumococcal Vaccines
  • Pneumococcal Infections
  • Infant
  • Humans
  • Child
  • Case-Control Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
McCollum, E. D., Ahmed, S., Roy, A. D., Chowdhury, N. H., Schuh, H. B., Rizvi, S. J. R., … Projahnmo Study Group in Bangladesh, . (2020). Effectiveness of the 10-valent pneumococcal conjugate vaccine against radiographic pneumonia among children in rural Bangladesh: A case-control study. Vaccine, 38(42), 6508–6516. https://doi.org/10.1016/j.vaccine.2020.08.035
McCollum, Eric D., Salahuddin Ahmed, Arun D. Roy, Nabidul H. Chowdhury, Holly B. Schuh, Syed J. R. Rizvi, Abu A. M. Hanif, et al. “Effectiveness of the 10-valent pneumococcal conjugate vaccine against radiographic pneumonia among children in rural Bangladesh: A case-control study.Vaccine 38, no. 42 (September 29, 2020): 6508–16. https://doi.org/10.1016/j.vaccine.2020.08.035.
McCollum ED, Ahmed S, Roy AD, Chowdhury NH, Schuh HB, Rizvi SJR, et al. Effectiveness of the 10-valent pneumococcal conjugate vaccine against radiographic pneumonia among children in rural Bangladesh: A case-control study. Vaccine. 2020 Sep 29;38(42):6508–16.
McCollum, Eric D., et al. “Effectiveness of the 10-valent pneumococcal conjugate vaccine against radiographic pneumonia among children in rural Bangladesh: A case-control study.Vaccine, vol. 38, no. 42, Sept. 2020, pp. 6508–16. Pubmed, doi:10.1016/j.vaccine.2020.08.035.
McCollum ED, Ahmed S, Roy AD, Chowdhury NH, Schuh HB, Rizvi SJR, Hanif AAM, Khan AM, Mahmud A, Pervaiz F, Harrison M, Reller ME, Simmons N, Quaiyum A, Begum N, Santosham M, Checkley W, Moulton LH, Baqui AH, Projahnmo Study Group in Bangladesh. Effectiveness of the 10-valent pneumococcal conjugate vaccine against radiographic pneumonia among children in rural Bangladesh: A case-control study. Vaccine. 2020 Sep 29;38(42):6508–6516.
Journal cover image

Published In

Vaccine

DOI

EISSN

1873-2518

Publication Date

September 29, 2020

Volume

38

Issue

42

Start / End Page

6508 / 6516

Location

Netherlands

Related Subject Headings

  • Virology
  • Vaccines, Conjugate
  • Pneumonia, Pneumococcal
  • Pneumonia
  • Pneumococcal Vaccines
  • Pneumococcal Infections
  • Infant
  • Humans
  • Child
  • Case-Control Studies