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In comparing the pre- and post-PCV7 periods, we found a slight but non-significant decrease in carriage rates of pneumococcus (AOR = 0.85 [0.69;1.05]), H. influenzae (AOR = 0.89 [0.73;1.09]) and S. aureus (AOR = 0.92 [0.92;1.19]).
Although the decrease in carriage in the year 2002 could reflect spontaneous changes in epidemiologic features of the outbreak, a number of public health interventions may have played a role.
Primary analysis at one month after the vaccination series did not reveal significant impact of the 4CMenB vaccine, but at later time points 4CMenB was associated with a decrease in carriage of MenBCWY strains (24.2%).
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In addition, a significant decrease in nasopharyngeal carriage has been reported, with no increase in the carriage of other serogroups.
Huang [ 12] reported a decrease in the carriage of VT from 36%to3%3% seven years after mass introduction of PCV7, whereas NVT carriage increased from 15%to29%9%.
As a result, a significant decrease in MenA carriage was documented among vaccinated and unvaccinated individuals [ 5], and the burden of meningitis from MenA dramatically decreased [ 6, 7].
Median CD4+ cell count increased over time in patients started on ART, but no decrease in pneumococcal carriage was observed (Fig. 1).
In a recent study, Dagan et al. did not show any decrease in nasopharyngeal carriage of serotype 3 after vaccination with PCV13 [ 25].
A decrease in the carriage through vaccination with a conjugate vaccine could help reduce outbreaks of epidemics of meningitis in the meningitis belt.
Vaccination rates of >80% would be expected to induce herd protection via decrease in nasopharyngeal carriage of vaccination serotypes [ 30, 31].
The 47% decrease in MRSA carriage rate (from 11.3 to 6.1%) within a short time period is consistent with the effect of the active screening and decolonization program in period 2 on blocking nosocomial MRSA transmission [ 22].
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