Document Detail

Invasive pneumococcal disease among infants before and after introduction of pneumococcal conjugate vaccine.
MedLine Citation:
PMID:  16609088     Owner:  NLM     Status:  MEDLINE    
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.
Katherine A Poehling; 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
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA     Volume:  295     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-12     Completed Date:  2006-04-14     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1668-74     Citation Subset:  AIM; IM    
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MeSH Terms
Drug Resistance, Bacterial
Immunity, Herd
Infant, Newborn
Meningococcal Vaccines*
Pneumococcal Infections / epidemiology*,  immunology,  microbiology,  prevention & control*
Pneumococcal Vaccines*
Population Surveillance
Prospective Studies
Streptococcus pneumoniae / classification,  drug effects
United States / epidemiology
Vaccines, Conjugate
Grant Support
U50/CCU416123//PHS HHS
Reg. No./Substance:
0/Meningococcal Vaccines; 0/Pneumococcal Vaccines; 0/Vaccines, Conjugate; 0/heptavalent pneumococcal conjugate vaccine

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