1101The Gap Widens: Invasive Pneumococcal Serotype Distribution among Adults
Bibliographic record
Abstract
Background. Indirect effects of routine pediatric use of pneumococcal conjugate vaccines (PCVs) influence which serotypes cause adult invasive pneumococcal disease (IPD). We sought to describe how those changes correspond to the proportion of IPD cases targeted by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) or PCV13, using the most recent data available. Methods. We reviewed PubMed and national websites for reports from 2003 to 2014 describing the proportions and incidence of adult IPD matching PPSV23 or PCV13. Eligible studies came from settings with widespread uptake of PCV10 or PCV13 among children, involved >= 150 adult isolates, typed for >= 20 serotypes, and excluded cases <2 years of age. Results. Eligible studies described Australia, Austria, Canada, Denmark, England, France, Germany, Ireland, New Zealand, Norway, Portugal, and the USA. The European CDC reported a composite measure for 23 countries. For adult IPD serotype distribution before pediatric PCV7 use, the proportion of IPD isolates matching the 23-serotype bundle was 88.4% and 74.8% for the 13-serotype bundle, with a median differential between the two bundles of 16.3%. In the most recent analyses, after widespread pediatric PCV uptake, IPD proportions were 77.1% for the 23-serotype bundle and 49.2% for the 13-serotype bundle, with a median differential of 28.8%. Germane articles describing serotype-specific adult IPD incidence rates from settings with widespread pediatric adoption of PCV10 or PCV13 were not yet available on May 1, 2014. Conclusion. The differences between the proportions of IPD cases due to serotypes included in PPSV23 vs PCV13 have widened further, consistently across multiple countries, following extensive pediatric use of PCV10 or PCV13. Clinicians and policy-makers should consider the increasing proportion of adult IPD cases caused by serotypes targeted by PPSV23 when making vaccine decisions. Disclosures. J. D. Grabenstein, Merck and Co., Inc.: Employee and Shareholder, Salary M. A. Kohn, Merck and Co., Inc.: Employee and Shareholder, Salary D. J. Weber, Merck and Co., Inc.: Scientific Advisor and Speaker's Bureau, Consulting fee and Speaker honorarium
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.032 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.009 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".