Trends in Pneumococcal and Bacterial Meningitis in Brazil from 2007 to 2019

The pneumococcal conjugate vaccination (PCV) was introduced into the Brazilian Child-hood National Immunization Program in 2010; however, universal pneumococcal vaccination for older adults has not been implemented yet. Our aim is to evaluate the trends in pneumococcal meningitis incidence and case fatality rate (CFR) across all age groups from 2007 to 2019 using data from the National Surveillance System. The pre-PCV (2007-2009) and post-PCV (2011-2019) periods were compared; changes in incidence and CFR were assessed by joinpoint regression. Additional analyses of bacterial meningitis were performed to compare the patterns and trends. Over the 13-year period, 81,203 and 13,837 cases were classified as bacterial and pneumococcal meningitis, respectively. S. pneumoniae was the main etiological agent of bacterial meningitis in adults aged =50 years and the most lethal in all age groups. In the post-PCV period, a 56.5% reduction in the average incidence was seen in pneumococcal meningitis in the pediatric population. In contrast, there was an increasing trend among adults. The CFR for pneumococcal and bacterial meningitis remained stable in most age groups during the study period. These findings highlight the value of expanding pneumococcal vaccination policies, including vaccines that provide better indirect protection from children to adults and broadening vaccination to older adults.

Automated summary

The study evaluates the trends in pneumococcal meningitis incidence and case fatality rate across different age groups in Brazil from 2007 to 2019, comparing the pre-PCV and post-PCV periods. It is found that pneumococcal meningitis incidence decreased significantly in children after the introduction of PCV, but increased among adults. The study emphasizes the importance of expanding pneumococcal vaccination policies to include older adults and vaccines with better indirect protection from children to adults.