Invasive pneumococcal disease and serotype emergence in the Auckland region during the vaccine era 2009–16
Nick Eichler 1 , Edwin Reynolds 1 2 , Catherine Jackson 1 , Simon Thornley 1 , Julia Peters 11 Auckland Regional Public Health Service, Cornwall Complex Private Bag 92-605, Symonds Street, Auckland 1150, New Zealand
2 Corresponding author. Email: edwinr@adhb.govt.nz
Journal of Primary Health Care 11(1) 24-31 https://doi.org/10.1071/HC17080
Published: 3 April 2019
Journal Compilation © Royal New Zealand College of General Practitioners 2019.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: There is a deficit of knowledge in New Zealand as the epidemiology of invasive pneumococcal disease varies significantly between countries.
AIM: Time trends and sociodemographic characteristics of cases of invasive pneumococcal disease (IPD) in the Auckland region are reviewed after the introduction of a conjugate vaccination, to provide evidence for future vaccine policy and to ensure Auckland region analysis is representative of national trends for subsequent IPD analysis.
METHODS: Data on all cases of IPD occurring in Waitemata, Auckland and Counties Manukau District Health Boards between 2009 and 2016 were extracted from EpiSurv. Denominator data were drawn from mid-year estimates supplied by Statistics New Zealand. Descriptive epidemiology and time-series regression was performed to analyse trends.
RESULTS: Rates of IPD have fallen in the Auckland region over the past 8 years by 32%. While absolute rates in the elderly have reduced by 12%, they have the highest disease burden at 32/100,000. The ethnic disparity continues with Pacific people (33/100,000) and Māori (14/100,000) over represented compared to European (10/100,000). In the elderly, the 19A serotype has increased from an incidence of 0 in 2008 to 8.2/100,000.
DISCUSSION: Large ethnic and age-related disparities are observed in the Auckland region, consistent with the rest of the country, since the start of the pneumococcal vaccination era. Extending immunisation to the elderly may help close these gaps. As with other countries, there is 19A serotype replacement occurring following conjugate vaccine introduction.
KEYWORDS: Invasive pneumococcal disease; descriptive epidemiology; ethnic disparity; vaccine policy
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