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.
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.
Authors: Krow Ampofo; Andrew T Pavia; Chris R Stockmann; Anne J Blaschke; Hsin Yi Cindy Weng; Kent E Korgenski; Judy Daly; Carrie L Byington Journal: Pediatr Infect Dis J Date: 2011-12 Impact factor: 2.129
Authors: Shabir A Madhi; Alane Izu; Avye Violari; Mark F Cotton; Ravindre Panchia; Els Dobbels; Poonam Sewraj; Nadia van Niekerk; Patrick Jean-Philippe; Peter V Adrian Journal: Vaccine Date: 2012-12-08 Impact factor: 3.641
Authors: Heather E Hsu; Kathleen A Shutt; Matthew R Moore; Bernard W Beall; Nancy M Bennett; Allen S Craig; Monica M Farley; James H Jorgensen; Catherine A Lexau; Susan Petit; Arthur Reingold; William Schaffner; Ann Thomas; Cynthia G Whitney; Lee H Harrison Journal: N Engl J Med Date: 2009-01-15 Impact factor: 91.245
Authors: Stephen I Pelton; Melinda M Pettigrew; Stephen J Barenkamp; Fabrice Godfroid; Carlos G Grijalva; Amanda Leach; Janak Patel; Timothy F Murphy; Sanja Selak; Lauren O Bakaletz Journal: Otolaryngol Head Neck Surg Date: 2013-04 Impact factor: 3.497