Pneumonia hospitalisations in Scotland following the introduction of pneumococcal conjugate vaccination in young children
نویسندگان
چکیده
BACKGROUND Scotland introduced PCV7 and PCV13 immunisation in young children in 2006 and 2010 respectively. One recent study from the United States reported a decrease in hospitalisation rates for all-cause pneumonia most notably in adults older than 75 years of age following PCV7 introduction in the US child population. We aimed to examine the effect of PCV7 and PCV13 on hospitalisation rates for all-cause pneumonia across all age groups in Scotland. METHODS We linked hospital records and death certification datasets for the entire Scottish population for the period 2000 to 2012. We included all cases where the primary / secondary diagnosis was pneumonia. Differences in hospital admission rates for pneumonia by age group were calculated using the difference in average annual rates for each period. RESULTS We estimated that all-cause pneumonia hospitalisation rates in children <2 years decreased by about 30 % in the post-PCV-13 period compared with the pre-PCV period. However, in adults aged 75-84 years and ≥85 years, all-cause pneumonia hospitalisation rates increased by 63 and 46 % respectively in the post-PCV 13 period compared to the pre-PCV period. This resulted in an additional 7000 hospitalisations across all age groups in Scotland in 2012 about half of which were in adults >75 years. At the same time, the median length of hospital stay decreased by a third in children <2 years and by about 20 % in adults >75 years in the post-PCV13 period compared to the pre-PCV period. Additionally, there was an 11 % reduction in deaths due to all-cause pneumonia, and 30 % reduction in pneumococcal hospitalisations across all age groups in the post-PCV13 period compared with pre-PCV period. DISCUSSION The modest and sustained decline in the rates of hospitalisation for all-cause pneumonia in children and the reduction in proportion of pneumonia hospitalisations in children coded as pneumococcal disease in the post-PCV period should alleviate concerns that pneumococcal serotype replacement may have resulted in an increased pneumonia burden in this age group. The indirect impact of child PCV immunisation in those not vaccinated (in terms of reduction in all-cause pneumonia hospitalisations in the elderly) has not been seen in Scotland. Our results are likely to be confounded by changes in clinical coding and healthcare practices over the same period. CONCLUSIONS Our results illustrate that health care planners cannot, with confidence, predict indirect PCV vaccine impacts on hospitalisations. IPD surveillance across all age groups is needed to assess the indirect effects of PCV in the community.
منابع مشابه
Global Coverage of Pneumococcal Conjugate Vaccine (PCV) and Serotype Distribution after Receiving Vaccine among Targeted PCV Vaccine Countries: A Systematic Review
Background and Objectives: After the introduction of the pneumococcal vaccine, an increase has been observed in the disease due to nonspecific stereotypes of the vaccine. This study was conducted to determine the spatial distribution of pneumococcal vaccine coverage and common stereotypes of streptococcus pneumonia after vaccine introduction in the vaccine recipient countries. Methods: The ...
متن کاملNasopharyngeal Pneumococcal Colonization among Children after Pneumococcal Conjugate Vaccine Introduction
World Health Organization has recommended all countries to introduction of Pneumococcal Conjugate Vaccine (PCV) in routine immunization schedule, especially those countries with higher rate of mortality in children. However, Islamic Republic of Iran and more than 50 other countries including Algeria, Antigua and Barbuda, Belarus, Belize, Bhutan, Bosnia and Herzegovina, Brunei Darussalam, Cabo V...
متن کاملHow many episodes of hospital care might be prevented by widespread uptake of pneumococcal conjugate vaccine?
BACKGROUND It is likely that disease specific infectious morbidity is under-reported. Microbiologically identifiable diseases may be "hidden" in ICD-10 code as "unspecified" disease. AIMS To estimate the proportion of "unspecified" morbidity of infectious cause in infants and young children reported by Hospital Episode Statistics (HES) in England in 1999 that could reasonably be attributed to...
متن کاملPrevention of pneumococcal diseases in the post-seven valent vaccine era: A European perspective
BACKGROUND The burden of invasive pneumococcal disease in young children decreased dramatically following introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). The epidemiology of S. pneumoniae now reflects infections caused by serotypes not included in PCV7. Recently introduced higher valency pneumococcal vaccines target the residual burden of invasive and non-invasive infections...
متن کاملAetiology of paediatric pneumonia after the introduction of pneumococcal conjugate vaccine
We describe the aetiology of community-acquired pneumonia in children before and after the introduction of the pneumococcal conjugate vaccination (PCV) programme in 2006. Prospective studies were conducted in 2001-2002 (pre-vaccine) and 2009-2011 (post-vaccine) of children aged 0-16 years with radiologically confirmed pneumonia seen in hospital. Investigations included culture, serology, immuno...
متن کامل