{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:50:32Z","timestamp":1782175832774,"version":"3.54.5"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"The National Centre for Immunization Research and Surveillance"},{"DOI":"10.13039\/501100003921","name":"Australian Government Department of Health and Aged Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council of Australia Investigator Grant","doi-asserted-by":"publisher","award":["2010091"],"award-info":[{"award-number":["2010091"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council of Australia Investigator Grant","doi-asserted-by":"publisher","award":["1173163"],"award-info":[{"award-number":["1173163"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council of Australia Investigator Grant","doi-asserted-by":"publisher","award":["1197335"],"award-info":[{"award-number":["1197335"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In mid-2018, the Australian childhood 13-valent pneumococcal conjugate vaccine schedule changed from 3+0 to 2+1, moving the third dose to 12 months of age, to address increasing breakthrough cases of invasive pneumococcal disease (IPD), predominantly in children aged &amp;gt;12 months. This study assessed the impact of this change using national IPD surveillance data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Pre- and postschedule change 3-dose 13-valent pneumococcal conjugate vaccine breakthrough cases were compared by age group, serotype, and clinical syndrome. Annual rates of breakthrough cases were calculated (per 100 000) using respective birth cohort sizes and 3-dose vaccine coverage. Using time-series modelling, observed IPD rates in children aged &amp;lt;12 years were compared to that expected if the 3+0 schedule were continued.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Over 2012\u20132022, rate of 3-dose breakthrough cases in children aged &amp;gt;12 months was 2.8 per 100 000 (n = 557; 11 birth cohorts). Serotype 3 replaced 19A as predominant breakthrough serotype (respectively, 24% and 65% in 2013 to 60% and 20% in 2022) followed by 19F. In breakthrough cases, the most frequent clinical phenotype was bacteremic pneumonia (69%), with meningitis accounting for 3%\u20134%. In cohorts eligible for 2+1 versus 3+0 schedules, rate of breakthrough cases was lower for all vaccine serotypes, except type 3 (incidence rate ratio, 0.50 [95% confidence interval, .28\u2013.84] and 1.12 [0.71\u20131.76], respectively). Observed compared to expected IPD was 51.7% lower (95% confidence interval, \u221260.9 to \u221240.7%) for vaccine serotypes, but the change for nonvaccine types was not significant 12% (\u22129.6 to 39.7).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interpretations<\/jats:title>\n                  <jats:p>The 2+1 schedule is likely superior to 3+0 for overall IPD control, a finding that may be worth consideration for other countries considering or using 3+0 PCV schedules.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae377","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T13:01:04Z","timestamp":1723640464000},"page":"207-214","source":"Crossref","is-referenced-by-count":12,"title":["Assessing the Impact of Pneumococcal Conjugate Vaccine Immunization Schedule Change From 3+0 to 2+1 in Australian Children: A Retrospective Observational Study"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6161-6306","authenticated-orcid":false,"given":"Sanjay","family":"Jayasinghe","sequence":"first","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance , Kids Research, Sydney Childrens Hospital Network, Westmead, New South Wales ,","place":["Australia"]},{"name":"Children's Hospital at Westmead Clinical School, Faculty of Medicine, The University of Sydney , Westmead, New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoebe C M","family":"Williams","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance , Kids Research, Sydney Childrens Hospital Network, Westmead, New South Wales ,","place":["Australia"]},{"name":"School of Public Health, Faculty of Medicine, The University of Sydney , Camperdown, New South Wales ,","place":["Australia"]},{"name":"Department of Infectious Diseases, Sydney Children's Hospital Network , Randwick, New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine K","family":"Macartney","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance , Kids Research, Sydney Childrens Hospital Network, Westmead, New South Wales ,","place":["Australia"]},{"name":"Children's Hospital at Westmead Clinical School, Faculty of Medicine, The University of Sydney , Westmead, New South Wales ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel W","family":"Crawford","sequence":"additional","affiliation":[{"name":"Immunisation Services, Royal Children's Hospital , Melbourne, Victoria ,","place":["Australia"]},{"name":"Infection and Immunity, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne , Parkville, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C","family":"Blyth","sequence":"additional","affiliation":[{"name":"Wesfarmers Centre of Vaccines and Infectious Disease, Telethon Kids Institute and School of Medicine, University of Western Australia , Nedlands, Western Australia ,","place":["Australia"]},{"name":"Department of Infectious Diseases, Perth Children's Hospital , Perth, Western Australia ,","place":["Australia"]},{"name":"Department of Microbiology, PathWest Laboratory, QEII Medical Centre , Nedlands, Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"2025020710474627100_ciae377-B1","author":"National Centre for Immunisation Research and Surveillance"},{"key":"2025020710474627100_ciae377-B2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00006454-200003000-00003","article-title":"Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group","volume":"19","author":"Black","year":"2000","journal-title":"Pediatr Infect Dis J"},{"key":"2025020710474627100_ciae377-B3","doi-asserted-by":"crossref","first-page":"S172","DOI":"10.1097\/INF.0000000000000076","article-title":"Dosing schedules for pneumococcal conjugate vaccine: considerations for policy makers","volume":"33 Suppl 2","author":"Whitney","year":"2014","journal-title":"Pediatr Infect Dis J"},{"key":"2025020710474627100_ciae377-B4","first-page":"18","article-title":"Invasive pneumococcal disease in Australia, 2006","volume":"32","author":"Roche","year":"2008","journal-title":"Commun Dis Intell Q Rep"},{"key":"2025020710474627100_ciae377-B5","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1093\/cid\/ciy129","article-title":"Effectiveness of 7- and 13-valent pneumococcal conjugate vaccines in a schedule without a booster dose: a 10-year observational study","volume":"67","author":"Jayasinghe","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2025020710474627100_ciae377-B6","first-page":"E291","article-title":"Immunisation coverage annual report, 2011","volume":"37","author":"Hull","year":"2013","journal-title":"Commun Dis Intell Q Rep"},{"key":"2025020710474627100_ciae377-B7","first-page":"E151","article-title":"Invasive pneumococcal disease in Australia 2007 and 2008","volume":"36","author":"Barry","year":"2012","journal-title":"Commun Dis Intell"},{"key":"2025020710474627100_ciae377-B8","doi-asserted-by":"crossref","first-page":"6666","DOI":"10.1016\/j.vaccine.2015.10.089","article-title":"Evaluation of impact of 23 valent pneumococcal polysaccharide vaccine following 7 valent pneumococcal conjugate vaccine in Australian Indigenous children","volume":"33","author":"Jayasinghe","year":"2015","journal-title":"Vaccine"},{"key":"2025020710474627100_ciae377-B9","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/cid\/ciw720","article-title":"Long-term impact of a \u201c3 + 0\u201d schedule for 7- and 13-valent pneumococcal conjugate vaccines on invasive pneumococcal disease in Australia, 2002\u20132014","volume":"64","author":"Jayasinghe","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2025020710474627100_ciae377-B10","first-page":"1","article-title":"Annual immunisation coverage report 2021","volume":"47","author":"Hull","year":"2023","journal-title":"Commun Dis Intell (2023)"},{"key":"2025020710474627100_ciae377-B11","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1093\/cid\/ciz493","article-title":"A rationale for change: an increase in invasive pneumococcal disease in fully vaccinated children","volume":"70","author":"Blyth","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2025020710474627100_ciae377-B12","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1093\/cid\/ciz500","article-title":"Smart scheduling: optimizing national immunization programs to achieve maximum impact","volume":"70","author":"Ladhani","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2025020710474627100_ciae377-B13","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1093\/cid\/cix418","article-title":"Characteristics and serotype distribution of childhood cases of invasive pneumococcal disease following pneumococcal conjugate vaccination in England and Wales, 2006\u20132014","volume":"65","author":"Oligbu","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2025020710474627100_ciae377-B14","author":"Australian Government Department of Health"},{"key":"2025020710474627100_ciae377-B15","volume-title":"Considerations for pneumococcal conjugate vaccine (PCV) product choice","author":"World Health Organisation","year":"2021"},{"issue":"12 Suppl 2","key":"2025020710474627100_ciae377-B16","doi-asserted-by":"crossref","first-page":"S258","DOI":"10.1093\/infdis\/jiab037","article-title":"Pneumococcal carriage in Burkina Faso after 13-valent pneumococcal conjugate vaccine introduction: results from 2 cross-sectional population-based surveys","volume":"224","author":"Kabor\u00e9","year":"2021","journal-title":"J Infect Dis"},{"key":"2025020710474627100_ciae377-B17","doi-asserted-by":"crossref","first-page":"e050312","DOI":"10.1136\/bmjopen-2021-050312","article-title":"A pragmatic health centre-based evaluation comparing the effectiveness of a PCV13 schedule change from 3+0 to 2+1 in a high pneumococcal carriage and disease burden setting in Malawi: a study protocol","volume":"11","author":"Swarthout","year":"2021","journal-title":"BMJ Open"},{"key":"2025020710474627100_ciae377-B18","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1093\/jpids\/piaa132","article-title":"Effect of 10-valent pneumococcal conjugate vaccine on Streptococcus pneumoniae nasopharyngeal carriage among children less than 5 years old: 3 years post-10-valent pneumococcal conjugate vaccine introduction in Mozambique","volume":"10","author":"Valenciano","year":"2021","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2025020710474627100_ciae377-B19","doi-asserted-by":"crossref","first-page":"e360","DOI":"10.1016\/S2589-7500(21)00077-7","article-title":"Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: a prospective analysis of surveillance data","volume":"3","author":"Brueggemann","year":"2021","journal-title":"Lancet Digit Health"},{"key":"2025020710474627100_ciae377-B20","doi-asserted-by":"crossref","first-page":"e055575","DOI":"10.1136\/bmjopen-2021-055575","article-title":"Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study","volume":"11","author":"Chan","year":"2021","journal-title":"BMJ Open"},{"key":"2025020710474627100_ciae377-B21","doi-asserted-by":"crossref","first-page":"e341","DOI":"10.1097\/INF.0000000000003972","article-title":"Clinical and epidemiologic profile of invasive pneumococcal disease in Australian children following the relaxation of nonpharmaceutical interventions against SARS-COV-2","volume":"42","author":"Williams","year":"2023","journal-title":"Pediatr Infect Dis J"},{"key":"2025020710474627100_ciae377-B22","first-page":"505","article-title":"Invasive pneumococcal disease in Australia, 2001","volume":"26","author":"Roche","year":"2002","journal-title":"Commun Dis Intell"},{"key":"2025020710474627100_ciae377-B23","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/1753-6405.12891","article-title":"Children overdue for immunisation: a question of coverage or reporting? An audit of the Australian Immunisation Register","volume":"43","author":"Law","year":"2019","journal-title":"Aust N Z J Public Health"},{"key":"2025020710474627100_ciae377-B24","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.3201\/eid2606.190951","article-title":"Failures of 13-valent conjugated pneumococcal vaccine in age-appropriately vaccinated children 2\u201359 months of age, Spain","volume":"26","author":"Hern\u00e1ndez","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"2025020710474627100_ciae377-B25","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1080\/14760584.2022.2012455","article-title":"A systematic review of invasive pneumococcal disease vaccine failures and breakthrough with higher-valency pneumococcal conjugate vaccines in children","volume":"21","author":"Mungall","year":"2022","journal-title":"Expert Rev Vaccines"},{"key":"2025020710474627100_ciae377-B26","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/S1473-3099(23)00706-5","article-title":"Invasive pneumococcal disease 3 years after introduction of a reduced 1 + 1 infant 13-valent pneumococcal conjugate vaccine immunisation schedule in England: a prospective national observational surveillance study","volume":"24","author":"Bertran","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2025020710474627100_ciae377-B27","doi-asserted-by":"crossref","first-page":"613287","DOI":"10.3389\/fcimb.2020.613287","article-title":"Sugar-coated killer: serotype 3 pneumococcal disease","volume":"10","author":"Luck","year":"2020","journal-title":"Front Cell Infect Microbiol"},{"key":"2025020710474627100_ciae377-B28","doi-asserted-by":"crossref","first-page":"e0107722","DOI":"10.1128\/spectrum.01077-22","article-title":"Continued vaccine breakthrough cases of serotype 3 complicated pneumonia in vaccinated children, Portugal (2016\u20132019)","volume":"10","author":"Silva-Costa","year":"2022","journal-title":"Microbiol Spectr"},{"key":"2025020710474627100_ciae377-B29","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1136\/thoraxjnl-2020-216032","article-title":"Assessing the impact of the 13 valent pneumococcal vaccine on childhood empyema in Australia","volume":"76","author":"Strachan","year":"2021","journal-title":"Thorax"},{"key":"2025020710474627100_ciae377-B30","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/S1473-3099(14)70822-9","article-title":"Serotype-specific effectiveness and correlates of protection for the 13-valent pneumococcal conjugate vaccine: a postlicensure indirect cohort study","volume":"14","author":"Andrews","year":"2014","journal-title":"Lancet Infect Dis"},{"key":"2025020710474627100_ciae377-B31","doi-asserted-by":"crossref","first-page":"e0183191","DOI":"10.1371\/journal.pone.0183191","article-title":"Effectiveness of the 13-valent pneumococcal conjugate vaccine in preventing invasive pneumococcal disease in children aged 7\u201359 months. A matched case-control study","volume":"12","author":"Dom\u00ednguez","year":"2017","journal-title":"PLoS One"},{"key":"2025020710474627100_ciae377-B32","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12879-019-4754-0","article-title":"Changes in pneumococcal carriage prevalence and factors associated with carriage in Norwegian children, four years after introduction of PCV13","volume":"20","author":"L\u00f8vlie","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2025020710474627100_ciae377-B33","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1097\/INF.0000000000000267","article-title":"Trends in asymptomatic nasopharyngeal colonization with streptococcus pneumoniae after introduction of the 13-valent pneumococcal conjugate vaccine in Calgary, Canada","volume":"33","author":"Ricketson","year":"2014","journal-title":"Pediatr Infect Dis J"},{"key":"2025020710474627100_ciae377-B34","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.1080\/22221751.2021.2000892","article-title":"Re-emergence of invasive pneumococcal disease (IPD) and increase of serotype 23B after easing of COVID-19 measures, Switzerland, 2021","volume":"10","author":"Casanova","year":"2021","journal-title":"Emerg Microbes Infect"},{"key":"2025020710474627100_ciae377-B35","doi-asserted-by":"crossref","first-page":"e2218959","DOI":"10.1001\/jamanetworkopen.2022.18959","article-title":"Association of nonpharmaceutical interventions during the COVID-19 pandemic with invasive pneumococcal disease, pneumococcal carriage, and respiratory viral infections among children in France","volume":"5","author":"Rybak","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2025020710474627100_ciae377-B36","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1001\/jama.2013.228052","article-title":"Immunogenicity of 13-valent pneumococcal conjugate vaccine administered according to 4 different primary immunization schedules in infants: a randomized clinical trial","volume":"310","author":"Spijkerman","year":"2013","journal-title":"JAMA"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciae377\/58793056\/ciae377.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/1\/207\/58793056\/ciae377.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/1\/207\/58793056\/ciae377.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T10:48:18Z","timestamp":1738925298000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/80\/1\/207\/7731313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,14]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,8,14]]},"published-print":{"date-parts":[[2025,2,5]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciae377","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,1,15]]},"published":{"date-parts":[[2024,8,14]]}}}