Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic

Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Paul N Newton [verfasserIn] Ruth Lim [verfasserIn] Kim Mulholland [verfasserIn] Manivanh Vongsouvath [verfasserIn] Jocelyn Chan [verfasserIn] Cattram D Nguyen [verfasserIn] Jana Y R Lai [verfasserIn] Eileen M Dunne [verfasserIn] Siddhartha Datta [verfasserIn] Jason Hinds [verfasserIn] Anonh Xeuatvongsa [verfasserIn] David A B Dance [verfasserIn] Catherine Satzke [verfasserIn] Fiona M Russell [verfasserIn] Audrey Dubot-Pérès [verfasserIn] Melinda Morpeth [verfasserIn] Keoudomphone Vilivong [verfasserIn] Kimberley Fox [verfasserIn] Kerryn A Moore [verfasserIn] Monica L Nation [verfasserIn] Casey L Pell [verfasserIn] Toukta Bhounkhoun [verfasserIn] Laddaphone Bounvilay [verfasserIn] Anisone Chanthongthip [verfasserIn] Valin Chanthaluanglath [verfasserIn] Chanthachone Khamsy [verfasserIn] Shereen Labib [verfasserIn] Souphatsone Phommachanh [verfasserIn] Alicia Quach [verfasserIn] Soubanh Saysana [verfasserIn] Chanthaphone Syladeth [verfasserIn] Malisa Vongsakid [verfasserIn] Parnthong Xaithilath [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Übergeordnetes Werk:	In: BMJ Global Health - BMJ Publishing Group, 2018, 6(2021), 6
Übergeordnetes Werk:	volume:6 ; year:2021 ; number:6

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1136/bmjgh-2021-005187

Katalog-ID:	DOAJ05824946X

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100	0		\|a Paul N Newton \|e verfasserin \|4 aut
245	1	0	\|a Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic
264		1	\|c 2021
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520			\|a Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage.
653		0	\|a Medicine (General)
653		0	\|a Infectious and parasitic diseases
700	0		\|a Ruth Lim \|e verfasserin \|4 aut
700	0		\|a Kim Mulholland \|e verfasserin \|4 aut
700	0		\|a Manivanh Vongsouvath \|e verfasserin \|4 aut
700	0		\|a Jocelyn Chan \|e verfasserin \|4 aut
700	0		\|a Cattram D Nguyen \|e verfasserin \|4 aut
700	0		\|a Jana Y R Lai \|e verfasserin \|4 aut
700	0		\|a Eileen M Dunne \|e verfasserin \|4 aut
700	0		\|a Siddhartha Datta \|e verfasserin \|4 aut
700	0		\|a Jason Hinds \|e verfasserin \|4 aut
700	0		\|a Anonh Xeuatvongsa \|e verfasserin \|4 aut
700	0		\|a David A B Dance \|e verfasserin \|4 aut
700	0		\|a Catherine Satzke \|e verfasserin \|4 aut
700	0		\|a Fiona M Russell \|e verfasserin \|4 aut
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700	0		\|a Souphatsone Phommachanh \|e verfasserin \|4 aut
700	0		\|a Alicia Quach \|e verfasserin \|4 aut
700	0		\|a Soubanh Saysana \|e verfasserin \|4 aut
700	0		\|a Chanthaphone Syladeth \|e verfasserin \|4 aut
700	0		\|a Malisa Vongsakid \|e verfasserin \|4 aut
700	0		\|a Parnthong Xaithilath \|e verfasserin \|4 aut
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allfields	10.1136/bmjgh-2021-005187 doi (DE-627)DOAJ05824946X (DE-599)DOAJ813469955ec24de393fe4b383df62b17 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Paul N Newton verfasserin aut Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage. Medicine (General) Infectious and parasitic diseases Ruth Lim verfasserin aut Kim Mulholland verfasserin aut Manivanh Vongsouvath verfasserin aut Jocelyn Chan verfasserin aut Cattram D Nguyen verfasserin aut Jana Y R Lai verfasserin aut Eileen M Dunne verfasserin aut Siddhartha Datta verfasserin aut Jason Hinds verfasserin aut Anonh Xeuatvongsa verfasserin aut David A B Dance verfasserin aut Catherine Satzke verfasserin aut Fiona M Russell verfasserin aut Audrey Dubot-Pérès verfasserin aut Melinda Morpeth verfasserin aut Keoudomphone Vilivong verfasserin aut Kimberley Fox verfasserin aut Kerryn A Moore verfasserin aut Monica L Nation verfasserin aut Casey L Pell verfasserin aut Toukta Bhounkhoun verfasserin aut Laddaphone Bounvilay verfasserin aut Anisone Chanthongthip verfasserin aut Valin Chanthaluanglath verfasserin aut Chanthachone Khamsy verfasserin aut Shereen Labib verfasserin aut Souphatsone Phommachanh verfasserin aut Alicia Quach verfasserin aut Soubanh Saysana verfasserin aut Chanthaphone Syladeth verfasserin aut Malisa Vongsakid verfasserin aut Parnthong Xaithilath verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 6 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:6 https://doi.org/10.1136/bmjgh-2021-005187 kostenfrei https://doaj.org/article/813469955ec24de393fe4b383df62b17 kostenfrei https://gh.bmj.com/content/6/6/e005187.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 6
spelling	10.1136/bmjgh-2021-005187 doi (DE-627)DOAJ05824946X (DE-599)DOAJ813469955ec24de393fe4b383df62b17 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Paul N Newton verfasserin aut Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage. Medicine (General) Infectious and parasitic diseases Ruth Lim verfasserin aut Kim Mulholland verfasserin aut Manivanh Vongsouvath verfasserin aut Jocelyn Chan verfasserin aut Cattram D Nguyen verfasserin aut Jana Y R Lai verfasserin aut Eileen M Dunne verfasserin aut Siddhartha Datta verfasserin aut Jason Hinds verfasserin aut Anonh Xeuatvongsa verfasserin aut David A B Dance verfasserin aut Catherine Satzke verfasserin aut Fiona M Russell verfasserin aut Audrey Dubot-Pérès verfasserin aut Melinda Morpeth verfasserin aut Keoudomphone Vilivong verfasserin aut Kimberley Fox verfasserin aut Kerryn A Moore verfasserin aut Monica L Nation verfasserin aut Casey L Pell verfasserin aut Toukta Bhounkhoun verfasserin aut Laddaphone Bounvilay verfasserin aut Anisone Chanthongthip verfasserin aut Valin Chanthaluanglath verfasserin aut Chanthachone Khamsy verfasserin aut Shereen Labib verfasserin aut Souphatsone Phommachanh verfasserin aut Alicia Quach verfasserin aut Soubanh Saysana verfasserin aut Chanthaphone Syladeth verfasserin aut Malisa Vongsakid verfasserin aut Parnthong Xaithilath verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 6 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:6 https://doi.org/10.1136/bmjgh-2021-005187 kostenfrei https://doaj.org/article/813469955ec24de393fe4b383df62b17 kostenfrei https://gh.bmj.com/content/6/6/e005187.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 6
allfields_unstemmed	10.1136/bmjgh-2021-005187 doi (DE-627)DOAJ05824946X (DE-599)DOAJ813469955ec24de393fe4b383df62b17 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Paul N Newton verfasserin aut Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage. Medicine (General) Infectious and parasitic diseases Ruth Lim verfasserin aut Kim Mulholland verfasserin aut Manivanh Vongsouvath verfasserin aut Jocelyn Chan verfasserin aut Cattram D Nguyen verfasserin aut Jana Y R Lai verfasserin aut Eileen M Dunne verfasserin aut Siddhartha Datta verfasserin aut Jason Hinds verfasserin aut Anonh Xeuatvongsa verfasserin aut David A B Dance verfasserin aut Catherine Satzke verfasserin aut Fiona M Russell verfasserin aut Audrey Dubot-Pérès verfasserin aut Melinda Morpeth verfasserin aut Keoudomphone Vilivong verfasserin aut Kimberley Fox verfasserin aut Kerryn A Moore verfasserin aut Monica L Nation verfasserin aut Casey L Pell verfasserin aut Toukta Bhounkhoun verfasserin aut Laddaphone Bounvilay verfasserin aut Anisone Chanthongthip verfasserin aut Valin Chanthaluanglath verfasserin aut Chanthachone Khamsy verfasserin aut Shereen Labib verfasserin aut Souphatsone Phommachanh verfasserin aut Alicia Quach verfasserin aut Soubanh Saysana verfasserin aut Chanthaphone Syladeth verfasserin aut Malisa Vongsakid verfasserin aut Parnthong Xaithilath verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 6 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:6 https://doi.org/10.1136/bmjgh-2021-005187 kostenfrei https://doaj.org/article/813469955ec24de393fe4b383df62b17 kostenfrei https://gh.bmj.com/content/6/6/e005187.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 6
allfieldsGer	10.1136/bmjgh-2021-005187 doi (DE-627)DOAJ05824946X (DE-599)DOAJ813469955ec24de393fe4b383df62b17 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Paul N Newton verfasserin aut Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage. Medicine (General) Infectious and parasitic diseases Ruth Lim verfasserin aut Kim Mulholland verfasserin aut Manivanh Vongsouvath verfasserin aut Jocelyn Chan verfasserin aut Cattram D Nguyen verfasserin aut Jana Y R Lai verfasserin aut Eileen M Dunne verfasserin aut Siddhartha Datta verfasserin aut Jason Hinds verfasserin aut Anonh Xeuatvongsa verfasserin aut David A B Dance verfasserin aut Catherine Satzke verfasserin aut Fiona M Russell verfasserin aut Audrey Dubot-Pérès verfasserin aut Melinda Morpeth verfasserin aut Keoudomphone Vilivong verfasserin aut Kimberley Fox verfasserin aut Kerryn A Moore verfasserin aut Monica L Nation verfasserin aut Casey L Pell verfasserin aut Toukta Bhounkhoun verfasserin aut Laddaphone Bounvilay verfasserin aut Anisone Chanthongthip verfasserin aut Valin Chanthaluanglath verfasserin aut Chanthachone Khamsy verfasserin aut Shereen Labib verfasserin aut Souphatsone Phommachanh verfasserin aut Alicia Quach verfasserin aut Soubanh Saysana verfasserin aut Chanthaphone Syladeth verfasserin aut Malisa Vongsakid verfasserin aut Parnthong Xaithilath verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 6 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:6 https://doi.org/10.1136/bmjgh-2021-005187 kostenfrei https://doaj.org/article/813469955ec24de393fe4b383df62b17 kostenfrei https://gh.bmj.com/content/6/6/e005187.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 6
allfieldsSound	10.1136/bmjgh-2021-005187 doi (DE-627)DOAJ05824946X (DE-599)DOAJ813469955ec24de393fe4b383df62b17 DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Paul N Newton verfasserin aut Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage. Medicine (General) Infectious and parasitic diseases Ruth Lim verfasserin aut Kim Mulholland verfasserin aut Manivanh Vongsouvath verfasserin aut Jocelyn Chan verfasserin aut Cattram D Nguyen verfasserin aut Jana Y R Lai verfasserin aut Eileen M Dunne verfasserin aut Siddhartha Datta verfasserin aut Jason Hinds verfasserin aut Anonh Xeuatvongsa verfasserin aut David A B Dance verfasserin aut Catherine Satzke verfasserin aut Fiona M Russell verfasserin aut Audrey Dubot-Pérès verfasserin aut Melinda Morpeth verfasserin aut Keoudomphone Vilivong verfasserin aut Kimberley Fox verfasserin aut Kerryn A Moore verfasserin aut Monica L Nation verfasserin aut Casey L Pell verfasserin aut Toukta Bhounkhoun verfasserin aut Laddaphone Bounvilay verfasserin aut Anisone Chanthongthip verfasserin aut Valin Chanthaluanglath verfasserin aut Chanthachone Khamsy verfasserin aut Shereen Labib verfasserin aut Souphatsone Phommachanh verfasserin aut Alicia Quach verfasserin aut Soubanh Saysana verfasserin aut Chanthaphone Syladeth verfasserin aut Malisa Vongsakid verfasserin aut Parnthong Xaithilath verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 6 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:6 https://doi.org/10.1136/bmjgh-2021-005187 kostenfrei https://doaj.org/article/813469955ec24de393fe4b383df62b17 kostenfrei https://gh.bmj.com/content/6/6/e005187.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 6
language	English
source	In BMJ Global Health 6(2021), 6 volume:6 year:2021 number:6
sourceStr	In BMJ Global Health 6(2021), 6 volume:6 year:2021 number:6
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authorswithroles_txt_mv	Paul N Newton @@aut@@ Ruth Lim @@aut@@ Kim Mulholland @@aut@@ Manivanh Vongsouvath @@aut@@ Jocelyn Chan @@aut@@ Cattram D Nguyen @@aut@@ Jana Y R Lai @@aut@@ Eileen M Dunne @@aut@@ Siddhartha Datta @@aut@@ Jason Hinds @@aut@@ Anonh Xeuatvongsa @@aut@@ David A B Dance @@aut@@ Catherine Satzke @@aut@@ Fiona M Russell @@aut@@ Audrey Dubot-Pérès @@aut@@ Melinda Morpeth @@aut@@ Keoudomphone Vilivong @@aut@@ Kimberley Fox @@aut@@ Kerryn A Moore @@aut@@ Monica L Nation @@aut@@ Casey L Pell @@aut@@ Toukta Bhounkhoun @@aut@@ Laddaphone Bounvilay @@aut@@ Anisone Chanthongthip @@aut@@ Valin Chanthaluanglath @@aut@@ Chanthachone Khamsy @@aut@@ Shereen Labib @@aut@@ Souphatsone Phommachanh @@aut@@ Alicia Quach @@aut@@ Soubanh Saysana @@aut@@ Chanthaphone Syladeth @@aut@@ Malisa Vongsakid @@aut@@ Parnthong Xaithilath @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
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The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. 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callnumber-first	R - Medicine
author	Paul N Newton
spellingShingle	Paul N Newton misc R5-920 misc RC109-216 misc Medicine (General) misc Infectious and parasitic diseases Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic
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topic_title	R5-920 RC109-216 Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic
topic	misc R5-920 misc RC109-216 misc Medicine (General) misc Infectious and parasitic diseases
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title	Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic
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title_full	Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic
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author_browse	Paul N Newton Ruth Lim Kim Mulholland Manivanh Vongsouvath Jocelyn Chan Cattram D Nguyen Jana Y R Lai Eileen M Dunne Siddhartha Datta Jason Hinds Anonh Xeuatvongsa David A B Dance Catherine Satzke Fiona M Russell Audrey Dubot-Pérès Melinda Morpeth Keoudomphone Vilivong Kimberley Fox Kerryn A Moore Monica L Nation Casey L Pell Toukta Bhounkhoun Laddaphone Bounvilay Anisone Chanthongthip Valin Chanthaluanglath Chanthachone Khamsy Shereen Labib Souphatsone Phommachanh Alicia Quach Soubanh Saysana Chanthaphone Syladeth Malisa Vongsakid Parnthong Xaithilath
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title_sort	indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in lao people’s democratic republic
callnumber	R5-920
title_auth	Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic
abstract	Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage.
abstractGer	Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage.
abstract_unstemmed	Introduction Empiric data on indirect (herd) effects of pneumococcal conjugate vaccines (PCVs) in settings with low or heterogeneous PCV coverage are limited. The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. Individual vaccination with PCV13 was effective against VT carriage.
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title_short	Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic
url	https://doi.org/10.1136/bmjgh-2021-005187 https://doaj.org/article/813469955ec24de393fe4b383df62b17 https://gh.bmj.com/content/6/6/e005187.full https://doaj.org/toc/2059-7908
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author2	Ruth Lim Kim Mulholland Manivanh Vongsouvath Jocelyn Chan Cattram D Nguyen Jana Y R Lai Eileen M Dunne Siddhartha Datta Jason Hinds Anonh Xeuatvongsa David A B Dance Catherine Satzke Fiona M Russell Audrey Dubot-Pérès Melinda Morpeth Keoudomphone Vilivong Kimberley Fox Kerryn A Moore Monica L Nation Casey L Pell Toukta Bhounkhoun Laddaphone Bounvilay Anisone Chanthongthip Valin Chanthaluanglath Chanthachone Khamsy Shereen Labib Souphatsone Phommachanh Alicia Quach Soubanh Saysana Chanthaphone Syladeth Malisa Vongsakid Parnthong Xaithilath
author2Str	Ruth Lim Kim Mulholland Manivanh Vongsouvath Jocelyn Chan Cattram D Nguyen Jana Y R Lai Eileen M Dunne Siddhartha Datta Jason Hinds Anonh Xeuatvongsa David A B Dance Catherine Satzke Fiona M Russell Audrey Dubot-Pérès Melinda Morpeth Keoudomphone Vilivong Kimberley Fox Kerryn A Moore Monica L Nation Casey L Pell Toukta Bhounkhoun Laddaphone Bounvilay Anisone Chanthongthip Valin Chanthaluanglath Chanthachone Khamsy Shereen Labib Souphatsone Phommachanh Alicia Quach Soubanh Saysana Chanthaphone Syladeth Malisa Vongsakid Parnthong Xaithilath
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doi_str	10.1136/bmjgh-2021-005187
callnumber-a	R5-920
up_date	2024-07-03T16:52:49.863Z
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The indirect effects of PCV, which benefits both vaccinated and non-vaccinated individuals, are mediated by reductions in vaccine-type (VT) carriage (a prerequisite for disease). The aim of this study among hospitalised children in Lao People’s Democratic Republic (Lao PDR) is to determine the effectiveness of a 13-valent PCV (PCV13) against VT pneumococcal nasopharyngeal carriage (direct effects) and the association between village-level PCV13 coverage and VT carriage (indirect effects).Methods Pneumococcal nasopharyngeal carriage surveillance commenced in December 2013, shortly after PCV13 introduction (October 2013). We recruited and swabbed children aged 2–59 months admitted to hospital with acute respiratory infection. Pneumococci were detected using lytA quantitative real-time PCR and serotyped using microarray. PCV13 status and village-level PCV13 coverage were determined using written immunisation records. Associations between both PCV13 status and village-level PCV13 coverage and VT carriage were calculated using generalised estimating equations, controlling for potential confounders.Results We enrolled 1423 participants and determined PCV13 coverage for 368 villages (269 863 children aged under 5 years). By 2017, median village-level vaccine coverage reached 37.5%, however, the IQR indicated wide variation among villages (24.1–56.4). Both receipt of PCV13 and the level of PCV13 coverage were independently associated with a reduced odds of VT carriage: adjusted PCV13 effectiveness was 38.1% (95% CI 4.1% to 60.0%; p=0.032); and for each per cent increase in PCV13 coverage, the estimated odds of VT carriage decreased by 1.1% (95% CI 0.0% to 2.2%; p=0.056). After adjustment, VT carriage decreased from 20.0% to 12.8% as PCV13 coverage increased from zero to 60% among under 5.Conclusions Despite marked heterogeneity in PCV13 coverage, we found evidence of indirect effects in Lao PDR. 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Indirect effects of 13-valent pneumococcal conjugate vaccine on pneumococcal carriage in children hospitalised with acute respiratory infection despite heterogeneous vaccine coverage: an observational study in Lao People’s Democratic Republic

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