PCV13 pneumococcal vaccine reduces risk of acute chest syndrome in kids with sickle cell anemia: JAMA
France: Implementing a 13-valent pneumococcal conjugate vaccine (PCV13) in the general pediatric population may reduce the incidence of acute chest syndrome (ACS) in children with sickle-cell disease (SCD), a recent study has revealed. The findings of the study, published in JAMA Network Open, provide new evidence of the important role of Streptococcus pneumoniae in ACS.
Acute chest syndrome is one of the most significant acute severe complications of sickle-cell disease. Streptococcus pneumoniae (S pneumonia) is highly prevalent in SCD children, there is no clarity on its precise role in ACS. Also, the efficacy of PCV13 implementation on ACS is still not known.
Considering the above, Zein Assad, Université Caen-Normandie, Caen, France, and colleagues aimed to assess the association of PCV13 implementation in the general pediatric population with the incidence of ACS in children with SCD in a cohort study.
For this purpose, the researchers used an interrupted time-series analysis of patient records from a national hospital-based French surveillance system. It included all children younger than 18 years with SCD hospitalized in France between January 2007 and December 2019.
The main outcomes of the study were the monthly incidence of ACS per 1000 children with SCD over time as analyzed by segmented linear regression with autoregressive error; asthma crisis, monthly incidence of hospitalization for a vaso-occlusive crisis, and acute pyelonephritis per 1000 children with SCD over the same period as the control outcomes.
Based on the study, the researchers reported the following findings:
- Among the 107 694 hospitalizations of children with SCD, 4007 episodes of ACS were included (median age, 8 years; 55.6% were boys).
- PCV13 implementation in 2010 was followed by a significant decrease in the incidence of ACS (−0.9% per month), with an estimated cumulative change of −41.8% by 2019.
- Sensitivity analyses yielded the same results, including the incidence of ACS adjusted for that of vaso-occlusive crisis over time.
- The results were similar among different age groups. By contrast, no change was found for the 3 control outcomes over the study period.
"Implementation of PCV13 in France is associated with a significant decrease in ACS incidence among children with SCD," the researchers wrote. "These results provide new evidence for the underestimated involvement of S pneumoniae in childhood ACS."
"Evaluation of the potential public health benefit of next-generation PCVs should include their potential to decrease ACS incidence among children with SCD," they concluded.
Reference:
Assad Z, Michel M, Valtuille Z, et al. Incidence of Acute Chest Syndrome in Children With Sickle Cell Disease Following Implementation of the 13-Valent Pneumococcal Conjugate Vaccine in France. JAMA Netw Open. 2022;5(8):e2225141. doi:10.1001/jamanetworkopen.2022.25141
