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1990 2000 2010 2015 202099 06 13
Men C
3+0
Men C
2+1
Men C
1+1
+ adol
Men C
0+1
Men ACWY
adol
Men B
2+1
Hib
3+0
Hib
3+1
Hib
Booster
campaign
Licensed
3+1
PCV7
2+1
PCV13
2+1
Licensed
3+1
HPV
3 dose
HPV
2 dose
08 14
UK Vaccine
Introduction
and Schedule
Changes
YEAR 2000 2006/7 2010/11 2013/14
UK (2+1)
USA (3+1)
PCV7 IPD < 2y 99% reduction1
PCV7 Carriage
Near Elimination2
PCV7 IPD all ages
86% reduced1
13-7
69%2
PCV13-7 IPD <2
89% Reduction1
PCV7 IPD < 5y
97%3
PCV7 Carriage Mass.
Children near elimination4
PCV13-7 IPD < 5
93%5
1 Waight et al 2015, 2 van Hoek et al 2014, 3 Feikin et al 2013, 4 Wroe et al 2012, 5 Moore et al 2015, 6 Yildrim et al 2017
PCV13-7 Carr
Mass. Children
Very Low6
Impact of
PCV
Introduction
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3
Invasive pneumococcal disease
incidence rate per 100,000
popn by age grouping, E&W
1996-2005
0
10
20
30
40
50
60
70
80
<2m 2-5m 6-11 m 1 year 2-4 years 5-9 years 10-14
years
15-44
years
45-64
years
65-74
years
75-79
years
80+ years
Age range
Rateper100,000
population
1996/97 1997/98
1998/99 1999/00
2000/01 2001/02
2002/03 2003/04
2004/05
Data courtesy of the Health Protection Agency
Optimising the use of
Pneumococcal Conjugate Vaccines
PCV7 Type IPD
0.32/100,00035.78/100,000
17.73/100,000
0.55/100,000
• Australian paper
2017
3+0 2+1
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4
Invasive pneumococcal disease
incidence rate per 100,000
popn by age grouping, E&W
1996-2005
0
10
20
30
40
50
60
70
80
<2m 2-5m 6-11 m 1 year 2-4 years 5-9 years 10-14
years
15-44
years
45-64
years
65-74
years
75-79
years
80+ years
Age range
Rateper100,000
population
1996/97 1997/98
1998/99 1999/00
2000/01 2001/02
2002/03 2003/04
2004/05
Data courtesy of the Health Protection Agency
Optimising the use of
Pneumococcal Conjugate Vaccines
PCV7 Type IPD
0.32/100,000
35.78/100,000
17.73/100,000
0.55/100,000
Risks of removing this dose?
Whitney et al. Lancet 2006;368:1495-502
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5
Andrews NJ et al. Lancet Infect Dis 2014;14:839-46
1dose 2.5<13m VE 38% (95% CI -218 – 89)
Miller et al Vaccine 2011
Potential benefits of reducing the PCV
schedule to 1+1
• Simplified and more acceptable infant
schedule
• Possible reduced frequency of adverse
events
• Creates space in the schedule for new
vaccines in the future
• Cost Savings, resources saved can be
used on other vaccine related
interventions (eg improve coverage)
9. 11/23/17
9
Lancet Infectious Disease
Online 22rd November 2017
Presentation title - edit in Header and Footer
Minutes of the
4th October 2017
Meeting published
Today
Minutes of the 4th October 2017:
Decision to move to a 1+1 PCV schedule (3 m and 12m) based on date
from PHE on current England and Wales IPD Epidemiology, Vaccine Type
carriage prevalence and modelling as well as the recent 1+1 trial
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11
PCV IS LARGEST SINGLE “SPEND” FOR GAVI
2000-2020
20% of $20.8 billion
UK: $2.462 billion
Bhutan
Honduras
Mongolia
Sri Lanka
Ukraine
Angola Armenia Azerbaijan Bolivia
Congo Rep. Cuba Georgia Guyana
Indonesia. Kiribati. Moldova Nicaragua
PNG. Timor Leste Uzbekistan Vietnam
Ghana Nigeria Solomon Islands
$1045 $1580
Mean GNI Per capita over previous 3 years
Contribution
$0.20/dose
Contribution
15% pa increase
Inc to 100%
Over 5 yrs
$3.05/dose