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Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel.

ABSTRACT: Postlicensure surveillance of pneumonia incidence can be used to estimate whether pneumococcal conjugate vaccines (PCVs) affect incidence. We used Poisson regression models that control for baseline seasonality to determine the impact of PCVs and the possible effects of variations in virus activity in Israel on these surveillance estimates. PCV was associated with significant declines in radiologically confirmed alveolar pneumonia (RCAP) among patients <6 months, 6-17 months, and 18-35 months of age (-31% [95% CI -51% to -15%], -41% [95% CI -52 to -32%], and -34% [95% CI -42% to -25%], respectively). Respiratory syncytial virus (RSV) activity was associated with strong increases in RCAP incidence, with up to 44% of cases attributable to RSV among infants <6 months of age and lower but significant impacts in older children. Seasonal variations, particularly in RSV activity, masked the impact of 7-valent PCVs, especially for young children in the first 2 years after vaccine introduction.

SUBMITTER: Weinberger DM

PROVIDER: S-EPMC3713978 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel.

Weinberger Daniel M DM Givon-Lavi Noga N Shemer-Avni Yonat Y Bar-Ziv Jacob J Alonso Wladimir J WJ Greenberg David D Dagan Ron R

Emerging infectious diseases 20130701 7

Postlicensure surveillance of pneumonia incidence can be used to estimate whether pneumococcal conjugate vaccines (PCVs) affect incidence. We used Poisson regression models that control for baseline seasonality to determine the impact of PCVs and the possible effects of variations in virus activity in Israel on these surveillance estimates. PCV was associated with significant declines in radiologically confirmed alveolar pneumonia (RCAP) among patients <6 months, 6-17 months, and 18-35 months of ...[more]

PMID: 23763864

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Project description:Abstract Background Pneumococcal conjugate vaccines (PCV) reduced the risk of respiratory syncytial virus (RSV) in a randomized clinical trial. We aimed to assess the real-world effectiveness of PCV on RSV-hospitalizations among Western Australian infants. Methods We conducted a population-based cohort study of births during 2000–2012, using probabilistically linked individual-level immunization, hospitalization, respiratory microbiology testing, and perinatal data. We performed Cox proportional hazard models with time-varying exposure (receipt of infant PCV doses) against the first RSV-confirmed hospitalization 0–12 months adjusted for perinatal and sociodemographic factors. Results From 360 994 children, 3-dose PCV coverage in Aboriginal infants ranged from 29% to 51% in 2001–2004 when PCV was funded for Aboriginal children only. Following universal funding in 2005, coverage increased to 85% for Aboriginal and 73% for non-Aboriginal infants. RSV-hospitalization rates were highest in young infants aged 0–5 months (22.5/1000 child-years) and >2 times higher in Aboriginal infants than in non-Aboriginal infants. Receipt of ≥3 PCV doses in the universal funded period was associated with a 30% reduction in RSV-hospitalization in Aboriginal infants (adjusted hazard ratio, aHR 0.70 [95% confidence interval, CI 0.46–1.06]) and 21% reduction in non-Aboriginal infants (aHR 0.79 [95% CI 0.63–0.99]) compared with unvaccinated infants. Conclusions Prior to the introduction of RSV vaccines, our study suggests that universal childhood PCV vaccination may result in a reduction in severe RSV infections in children and may be important for countries that are yet to consider PCV programs. Through population-based linked data analysis, we show a real-world protective benefit of pneumococcal conjugate vaccines (PCV) on respiratory syncytial virus (RSV) hospitalizations in infants. These findings are relevant for settings with a high RSV burden but no current universal PCV program.

Dataset Information

Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel.

Publications

Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel.

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