ArticleBMC medicine2019
Determinants of high residual post-PCV13 pneumococcal vaccine-type carriage in Blantyre, Malawi: a modelling study.
Article in BMC medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed.
- Serotype-specific Immunity and Association With Pneumococcal Carriage Following 3+1, 3+0, and 2+1 Schedules of 10-valent Pneumococcal Conjugate Vaccine.The Journal of infectious diseases · 2026Trial
- Natural Carriage of Streptococcus pneumoniae Is Associated With Increased Experimental Pneumococcal Carriage but Reduced Conjugate Vaccine Efficacy in a Human Challenge Model.The Journal of infectious diseases · 2025Trial
- Memory B cell responses induced by pneumococcal conjugate vaccine schedules with fewer doses: analysis of a randomised-controlled trial in Viet Nam.Nature communications · 2024Trial
- Genomic and statistical models to characterizeMicrobial genomics · 2026Article
- What is driving the resurgence and persistence of vaccine-targeted pneumococcal serotypes?-Serotype 19F as the paradigm.PLoS pathogens · 2026Review
- Identification of age-group reservoirs for persistent vaccine-type pneumococcal carriage in rural Gambia.Pneumonia (Nathan Qld.) · 2025Article
- Article
- Estimating pneumococcal carriage dynamics in adults living with HIV in a mature infant pneumococcal conjugate vaccine programme in Malawi, a modelling study.BMC medicine · 2024Article
- Expansion of pneumococcal serotype 23F and 14 lineages with genotypic changes in capsule polysaccharide locus and virulence gene profiles post introduction of pneumococcal conjugate vaccine in Blantyre, Malawi.Microbial genomics · 2024Article
- Article
- Considerations in planning a controlled human infection model in at-risk groups in sub-Saharan Africa: the case for pneumococcal challenge in people living with HIV in Malawi and a report of stakeholder consultation.Wellcome open research · 2024Article
- Experimental pneumococcal carriage in people living with HIV in Malawi: the first controlled human infection model in a key at-risk population.Wellcome open research · 2024Article
- The metabolic, virulence and antimicrobial resistance profiles of colonising Streptococcus pneumoniae shift after PCV13 introduction in urban Malawi.Nature communications · 2023Article
- Population immunity to pneumococcal serotypes in Kilifi, Kenya, before and 6 years after the introduction of PCV10 with a catch-up campaign: an observational study of cross-sectional serosurveys.The Lancet. Infectious diseases · 2023Observational
- Streptococcus pneumoniae and other bacterial nasopharyngeal colonization seven years post-introduction of 13-valent pneumococcal conjugate vaccine in South African children.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- Article
- The impact of introduction of the 10-valent pneumococcal conjugate vaccine on pneumococcal carriage in Nigeria.Nature communications · 2023Article
- Invasiveness potential of pneumococcal serotypes in children after introduction of PCV13 in Blantyre, Malawi.BMC infectious diseases · 2023Article
- Waning of antibody levels induced by a 13-valent pneumococcal conjugate vaccine, using a 3 + 0 schedule, within the first year of life among children younger than 5 years in Blantyre, Malawi: an observational, population-level, serosurveillance study.The Lancet. Infectious diseases · 2022Observational
- Article
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Authors and funding
14 authors.
Funding
Abstract
backgroundIn November 2011, Malawi introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into the routine infant schedule. Four to 7 years after introduction (2015-2018), rolling prospective nasopharyngeal carriage surveys were performed in the city of Blantyre. Carriage of Streptococcus pneumoniae vaccine serotypes (VT) remained higher than reported in high-income countries, and impact was asymmetric across age groups.
methodsA dynamic transmission model was fit to survey data using a Bayesian Markov-chain Monte Carlo approach, to obtain insights into the determinants of post-PCV13 age-specific VT carriage.
resultsAccumulation of naturally acquired immunity with age and age-specific transmission potential were both key to reproducing the observed data. VT carriage reduction peaked sequentially over time, earlier in younger and later in older age groups. Estimated vaccine efficacy (protection against carriage) was 66.87% (95% CI 50.49-82.26%), similar to previous estimates. Ten-year projected vaccine impact (VT carriage reduction) among 0-9 years old was lower than observed in other settings, at 76.23% (CI 95% 68.02-81.96%), with sensitivity analyses demonstrating this to be mainly driven by a high local force of infection.
conclusionsThere are both vaccine-related and host-related determinants of post-PCV13 pneumococcal VT transmission in Blantyre with vaccine impact determined by an age-specific, local force of infection. These findings are likely to be generalisable to other Sub-Saharan African countries in which PCV impact on carriage (and therefore herd protection) has been lower than desired, and have implications for the interpretation of post-PCV carriage studies and future vaccination programs.
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