Early impact of 10-valent pneumococcal conjugate vaccine in childhood pneumonia hospitalizations using primary data from an active population-based surveillance

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• 作者：Sabrina Sgambatti^a ; ^b ; ^{sasgambatti@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ruth Minamisava^c ; Ana Luiza Bierrenbach^d ; Cristiana Maria Toscano^d ; Maria Aparecida Vieira^e ; Gabriela Policena^d ; Ana Lucia Andrade^d
• 关键词：CAP ; community-acquired pneumonia ; PCV ; pneumococcal conjugate vaccines ; PCV7 ; 7-valent pneumococcal conjugate vaccine ; PCV10 ; 10-valent pneumococcal conjugate vaccine ; PCV13 ; 13-valent pneumococcal conjugate vaccine ; NIP ; National Immunization Programs ; SIH ; National Hospitalization Information System ; SUS ; Unified Health System ; LEAP-BRA ; Latin American Epidemiologic Assessment of Pneumococcus ; CXR ; chest radiography ; WHO ; World Health Organization ; CI ; confidence intervals
• 刊名：Vaccine
• 出版年：2016
• 出版时间：27 January 2016
• 年：2016
• 卷：34
• 期：5
• 页码：663-670
• 全文大小：792 K

文摘

In Brazil, 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in 2010 in the childhood routine immunization program. We used primary data to evaluate the effect of PCV10 on the reduction of hospital admissions due to community-acquired pneumonia (CAP).

Methods

Active population-based surveillance studies on pneumonia hospitalizations in children aged <36 months were conducted before and after PCV10 introduction in Central Brazil. The surveillances comprised all 17 pediatric hospitals of the study area, which provide assistance for public and private health insurances. Linear regression was performed to detect any trend in pneumonia monthly rates previously to vaccine introduction. PCV10 post-vaccination impact (Nov/2011 to Oct/2013) on clinical and X-Ray confirmed pneumonia was estimated as the relative and the absolute reduction (prevented burden) in pneumonia admission rates, taking as baseline the pre-vaccination period (May/2007 to Apr/2009).

Results

Overall, males presented higher rates of pneumonia hospitalization, compared to females. The relative rate reduction for clinical and X-Ray confirmed pneumonia was 13.1%, and 25.4%, respectively for children aged 2–23 months. The highest prevented burden was observed in age-groups 2–11 months, respectively 853/100,000 (from 6788/100,000 to 5935/100,000), and 729/100,000 (from 2871/100,000 to 2142/100,000), for clinical and X-Ray confirmed pneumonia.

Conclusions

This study provides evidence for the impact of PCV10 in clinical and X-Ray confirmed pneumonia in routine vaccination program in Brazil, after 3 years of vaccine introduction. Extended follow-up studies should confirm the benefit of vaccination through herd effect given the high burden of pneumonia in our setting.