Incidence of Invasive Pneumococcal Disease (IPD) Post Pneumococcal Conjugate Vaccines in Toronto/Peel, Canada, 2001–2015
Bibliographic record
Abstract
Background. In 2001, the 1st pneumococcal conjugate vaccine (PCV) was authorized in Ontario, Canada. Publicly funded PCV7 was introduced in 1/2005 (3 + 1 schedule), PCV10 in October 2009 and PCV13 in November 2010 (2 + 1 schedule with catchup to 35m). TIBDN performs population-based surveillance for invasive pneumococcal disease (IPD) in Toronto/Peel to evaluate program impact. Methods. IPD cases are reported to a central office and one isolate/case is serotyped. Demographic/clinical data are collected by chart review and patient/physician interview. Results. From January 2001 to April 2015, 6076 IPD cases were identified. 17% of cases were aged <15y, 44% were aged 15–64y and 40% were aged ≥65y. The IPD rate in adults decreased from 8/100000/y in 2005–2010 to 6/100000/y in 2013/14. In children, the IPD rate decreased from local peak of 11/100000/y in 2009 to 5/100000/y in 2013/14. Since 2009, IPD due to PCV13 STs has decreased in both children and adults (figure). Since the introduction of PCVs, nonPCV ST IPD increased from 2.6 to 3.8/100000/y among adults and from 1.4 to 2.8/100000/y among children (2001–2004 versus 2010–2014). From January 2014 to April 2015, ST was available for 472 (87%) IPD cases. NonPCV STs represented 64% of adult and 60% of pediatric cases. PCV13 STs 19A and 3 remained the most common ST among adults (11% and 10%) and children (30% and 10%). Most common nonPCV STs were 22F (10%), 23A (7%) and 9N (5%) among adults and 15C (10%), 22F (8%) and 23B (6%) among children. From January 2013 to April 2015, 37 pediatric cases were due to PCV13/non7 STs. Of these, 3 were PCV13 ineligible (aged >35 mos when catch up program implemented). Of the 34 vaccine-eligible children (10 in 2013, 18 in 2014, and 6 January-April 2015), vaccine history is available for 30. One case immigrated to Ontario at age 4 (history of PCV7); 14 cases occurred in children who missed ≥1 scheduled doses (12 ST19A, 2 ST3); 6 cases occurred in children eligible for a single dose of PCV13 only (4 ST3, 2 ST19A); 1 case (ST3) occurred in an 11 month old child who had received doses at 2 and 4 mos; and 8 vaccine failures were identified (5 ST19A, 2 ST3, 1 ST5). Conclusion. Since PCV13-program implementation, the IPD rate due to PCV13/not7 STs has decreased in children and adults. NonPCV ST IPD has increased somewhat and now represents 60% of pediatric and 64% of adult cases. Disclosures. A. Mcgeer, Pfizer: Investigator, Research grant GSK: Investigator, Research support
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".