Research in context
Evidence before this study
We searched PubMed using the search terms “13-valent pneumococcal conjugate vaccine”, “Prevnar 13”, and “pneumococcal vaccine effectiveness”, with no language restrictions for articles published between Jan 1, 2012 (2 years after PCV13 was licensed), and July 9, 2015. 237 papers were identified, most of which related to the safety, immunogenicity, or cost-effectiveness of PCV13. Only one paper, by Andrews and colleagues, described a postlicensure effectiveness study of PCV13 in children. They described an assessment of the effectiveness and immunogenicity of PCV13 in England, Wales, and Northern Ireland using the indirect cohort method and found the vaccine effectiveness against the six serotypes unique to PCV13 was 73% (95% CI 55–84) for two doses given before 12 months of age or one dose given after 12 months of age.
Added value of this study
This study provides the first postlicensure estimates of vaccine effectiveness from a case-control study in an active population-based surveillance system. PCV13 had strong effectiveness against serotypes 7F and 19A and provided evidence of some effectiveness against serotype 3, an area of concern during prelicensure assessments.
Implications of all available evidence
Taken together with existing evidence from the USA and other vaccine programmes, the effectiveness of PCV13 was confirmed in a real-world setting (as opposed to a prelicensure trial), which should encourage countries not yet using conjugate vaccines to introduce them into their routine immunisation schedule.