A new approach to define the optimal immunization strategy against pneumococcal disease: the example of Canada
Bibliographic record
Abstract
New-generation pneumococcal conjugate vaccines (PCVs) are available to replace PCV-13 for childhood and adult immunization. Besides cost-effectiveness evaluations which have highly variable results, the comparative immunogenicity of these new vaccines (PCV15, PCV20, PCV21) and their coverage of invasive pneumococcal disease (IPD) and carriage strains in different age-groups should be regarded as well as the antibody susceptibility, antibiotic resistance, invasiveness and virulence of serotypes included in each vaccine. Based on the Canadian experience, these topics are discussed. The optimal strategy would be a 2+1 PCV20 schedule for children, PCV21 for elderly adults and a dual PCV20+PCV21 schedule for adults at very high IPD risk. Shifting from PCV-13 to PCV-15 for children entails a risk of increased IPD incidence in adults because additional serotypes are of low virulence and could be replaced by more invasive and virulent serotypes. This risk can be reasonably excluded if PCV-20 replaces PCV-13 as the former covers additional serotypes being highly invasive and virulent. It is recognized that off-label use of PCV-20 according to a 2+1 schedule could be problematic for some jurisdictions as this is not authorized in all countries. In Canada, however, the 2+1 PCV20 schedule was authorized based on the same dataset submitted elsewhere.
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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 | 0.006 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.007 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.008 | 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".