Invasive pneumococcal disease among infants before and after introduction of pneumococcal conjugate vaccine - PubMed (original) (raw)
. 2006 Apr 12;295(14):1668-74.
doi: 10.1001/jama.295.14.1668.
Thomas R Talbot, Marie R Griffin, Allen S Craig, Cynthia G Whitney, Elizabeth Zell, Catherine A Lexau, Ann R Thomas, Lee H Harrison, Arthur L Reingold, James L Hadler, Monica M Farley, Bridget J Anderson, William Schaffner
Affiliations
- PMID: 16609088
- DOI: 10.1001/jama.295.14.1668
Invasive pneumococcal disease among infants before and after introduction of pneumococcal conjugate vaccine
Katherine A Poehling et al. JAMA. 2006.
Abstract
Context: Streptococcus pneumoniae is a serious infection in young infants. A heptavalent pneumococcal conjugate vaccine (PCV7) was licensed in 2000 and recommended for all children aged 2 to 23 months.
Objective: To determine the rates of invasive pneumococcal disease (IPD) in young infants before and after PCV7 was incorporated into the childhood immunization schedule in June 2000.
Design, setting, and participants: A prospective, population-based study of infants aged 0 to 90 days who resided in areas in 8 US states with active laboratory surveillance for invasive S pneumoniae infections from July 1, 1997, to June 30, 2004.
Main outcome measures: Rates of laboratory-confirmed IPD before (July 1, 1997-June 30, 2000) and after (July 1, 2001-June 30, 2004) PCV7 introduction, excluding a transition year (July 1, 2000-June 30, 2001).
Results: There were 146 cases of IPD, 89 before and 57 after PCV7 introduction. Isolated bacteremia occurred in 94 cases (64%), pneumonia in 27 (18%), meningitis in 22 (15%), and septic arthritis and/or osteomyelitis in 3 (2%). Mean rates of IPD for infants aged 0 to 90 days decreased 40% from 11.8 (95% confidence interval [CI], 9.6-14.5) to 7.2 (95% CI, 5.6-9.4; P = .004) per 100 000 live births following PCV7 introduction. Among black infants, mean rates of IPD decreased significantly from 17.1 (95% CI, 11.9-24.6) to 5.3 (95% CI, 2.8-10.1; P = .001) per 100,000 live births, with a nonsignificant decrease from 9.6 (95% CI, 7.3-12.7) to 6.8 (95% CI, 4.9-9.4) per 100,000 live births for white infants. Rates of PCV7-serotype isolates decreased significantly from 7.3 (95% CI, 5.3-10.1) to 2.4 (95% CI, 1.6-3.8; P<.001) per 100,000 live births, while rates of non-PCV7 serotypes remained stable (P = .55).
Conclusions: Since PCV7 introduction, rates of IPD in young infants have decreased significantly, providing evidence that vaccinating children aged 2 to 23 months has led to changes in pneumococcal carriage in infants too young to receive PCV7. With a significant decrease in rates of IPD among black infants, the previous racial difference has been eliminated.
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