On 31st March 2023 the Prevenar Study closed after nearly 17 years of running in the UK, and it was an emotional day for myself and my colleagues who have been part of it for so many years.
The Prevenar Study or ‘paediatric post-pneumococcal conjugate vaccine carriage study’, was run by the University of Southampton’s Infectious Disease Epidemiology group lead by Professor Stuart Clarke alongside co-principal investigator and director of the NIHR Southampton Clinical Research Facility, Professor Saul Faust. It aimed to look at how effective the PCV (or Prevenar Vaccine) was in protecting babies and children under the age of 5 against Streptococcus pneumoniae, a leading infectious cause of mortality worldwide. Streptococcus pneumoniae or S. pneumoniae can cause illnesses such as meningitis, septicaemia and pneumonia, as well as less serious problems such as otitis media (an infection of the middle ear).
Originally introduced in 2006, the vaccine covered seven of the most invasive types of S. pneumoniae and was given to children at 8 weeks, 16 weeks and 1 year. Since then, the vaccine has been updated a few times over the years; in 2010 six additional types of bacteria were included, and in 2020 the immunisation schedule in the UK was updated so that children received the vaccine at 12 weeks and 1 year.
When I first began working in research, I worked at the University of Southampton with the Prevenar study team, and I would join the research nurses in recruiting participants at the hospital. Despite it being a serious environment with families having to spend a long time in the department, many people were still interested and willing to taking part. At the end of the day, I would take the collected samples back to the laboratory and process them; it was fascinating to see what grew and could be found in our community. I also wrote and published a couple of journal articles about this bacterium, and it was really interesting to gain that in depth understanding.
I joined the Solent team in April 2020, and because of the pandemic, the way we ran the Prevenar study at that time is different to how it had ever been done before. Despite this, the way people banded together as a community during that time saw a huge number of people willing to take part in research – ‘anything to help’ was a mentality I saw a lot at the time. Personally, it’s the greatest number of approached people saying yes to research that I had seen, and it was really heart-warming at such a concerning time.
Initially, the team hypothesised that the asymptomatic carriage rate of approximately 30% would decrease with the introduction of a pneumococcal vaccine. What they actually found was that the carriage rate stayed the same throughout the years and it was the type of bacteria that changed. Both times a vaccine was introduced, an immediate reduction in carriage of vaccine types was seen in our community, and an increase in non-vaccine types made up the difference in the carriage rate. Although this seems like the vaccine was ineffective, the non-vaccine types that replaced them were much less harmful and typically did not have the potential to cause disease, whereas the vaccine types had the genetic makeup to be much more harmful. The most recent publication of their results can be found on the National Library of Medicine website.
Over the years the Solent Prevenar team have worked across Hampshire and the Isle of Wight; using our existing connections within the community and making new ones. We were supported by the Solent Health Visitor team where we attended their clinics and ‘Stay and Play’ sessions, we’ve been to SureStart centre sessions and worked with the council to attend children’s activities at libraries. We’ve also reached out to local schools, attended parent’s evenings and so much more.
On one of my favourite workdays we visited children on the Isle of Wight (IoW) to set up the study with our IoW research nurse, Julie. To take part in the study, parents would complete a consent form and a short questionnaire, then one of the research team would take two swabs from the child’s nose and one from their mouth. Our recruitment efforts resulted in a huge 2,090 participants at Solent, and we are so grateful to all of the families who volunteered to take part with us.
We asked the families who took part to share their feedback and experience of the Prevenar study, and 92% said that they were ‘very satisfied’, with the other 8% being ‘satisfied’. My personal experience with the children has been that even the most hesitant child was up for swapping their bogies for sparkly stickers, or to see if the magic nose stick would make them sneeze!
The study has been a clear example of the heart and soul of community-based research. It’s something that the whole research team have been involved with in one way or another over the years. It’s been a huge part of what we do and across the team we have expressed how emotional it is to see the end of such an important study.
A huge thank you is needed for the Solent Health Visitor teams, who’s support has made this study a success, not only by allowing us to attend their clinics, particularly during COVID, but also because the families trust the team and their support of the study has given many parents the confidence to take part.