P-645. Post-pandemic changes in the epidemiology of invasive pneumococcal disease in adults in Toronto, Canada
Bibliographic record
Abstract
Abstract Background Substantial reductions in invasive pneumococcal disease (IPD) occurred during the COVID-19 pandemic. Disease incidence then increased in 2022. We assessed whether the epidemiology of IPD had changed in 2022/3 when compared to that prior to the pandemic.Figure 1:Incidence of IPD in adults by age group, Toronto and Peel region, Canada, 2015-2023 Methods TIBDN performs population-based surveillance for IPD in Toronto/Peel region (pop 4.5M). Microbiology laboratories serving area residents report sterile site isolates of S. pneumoniae; annual audits ensure completeness. Isolates are serotyped at Canada's National Microbiology Laboratory. Population data estimates are from Statistics Canada. We compared IPD in adults occurring in 2017-2019 to that in 2022-23.Figure 2:Proportion of infecting strains of serotypes included in PCV20 or PCV21/V116, by age group, 2016-2023, TIBDNEach panel shows, for a different age group, the change over time of the proportion of IPD caused by isolates of serotypes included in PCV20 (orange dashed line), and PCV21(V116) (the solid blue line). Results Overall, 1047 IPD cases occurred in 2017-19 and 613 in 2022-23. Serotype is available for 970 (93%) and 562 (92%) of cases, and clinical information for 993 (95%) and 537 (88%) cases, respectively. Annual IPD incidence in all age groups declined during the pandemic, but has returned to 2019 rates (Figure 1). In 2022-23 compared to 2017-19, the median age of IPD patients did not differ [64y (IQR 51-75) vs 65y (52-76), P=.39] but males were more commonly affected (62% v 56%, P=.03) as were patients with cardiac (22% v 17%, P=.01) and renal (12% v 7.3% P=.007) disease (Table). Long term care (LTC) residents were less likely to have IPD in 2022-23 (1.3% v 4.5%, P< .0001). Outcomes (hospital admission, ICU admission, 30 day mortality) did not differ (Table). Between 2017-2019 and 2022-23, the proportion of IPD isolates of serotypes (STs) in PCV7 increased from 10.8% (163/970) to 18% (103/562), P< .001, while proportion of STs in PCV13 declined from 21% (207) to 16% (90), P=.01, resulting in no change in the proportion of STs in PCV20 (67% to 69%, P=.31), but a decline in the proportion in PCV21(V116) (79% to 71%, P< .001). The decline in PCV21(V116) ST proportions was more prominent in younger adults (Figure 2).Table.Characteristics of adults with IPD pre- (2017-2019) and post- (2022-2023) pandemic, Toronto and Peel Region, Canada Conclusion The incidence of IPD in adults has returned to pre-pandemic levels, but differences in epidemiology persist: some (reduced disease in women and LTC residents) may be due to residual changes associated with the pandemic. Currently, PCV20 and PCV21(V116) have similar coverage in adults < 75 yrs of age in our population. Whether these changes will persist is uncertain. Disclosures Allison McGeer, MD, AstraZeneca: Honoraria|GSK: Honoraria|Merck: Honoraria|Moderna: Honoraria|Novavax: Honoraria|Pfizer: Grant/Research Support|Pfizer: Honoraria|Roche: Honoraria|Seqirus: Grant/Research Support|Seqirus: Honoraria
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 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".