The impact of the pneumococcal conjugate vaccines on the incidence of community-acquired alveolar pneumonia in premature compared with in term-born infants.

Abstract

BACKGROUND:

Preterm-born children are prone to respiratory infections and complications during infancy and early childhood. In Israel, pneumococcal conjugated vaccines (PCVs) were introduced in 2009-2010, with high vaccination coverage. We assessed the impact of PCV implementation on community-acquired alveolar pneumonia (CAAP) in children < 2 years old born prematurely, in comparison with term born infants.

METHODS:

We conducted a prospective, active, population-based surveillance of children < 2 years old with radiologically-proven CAAP, visiting the only regional medical center. CAAP incidence in the pre-PCV and post-PCV eras were compared in early premature (29-32 weeks gestational age [WGA]), late premature (33-36 WGA) and term-born infants (>36 WGA).

RESULTS:

Of 214,947 births during the study period, 6'791 CAAP episodes were diagnosed; 211, 653 and 5,806 were in early premature, late premature and term infants, respectively. After PCV implementation, overall CAAP visits were reduced by 44% (95% CI 36-51): 60%, 21% and 45% among those born early preterm, late preterm and at term, respectively (statistically significant for children born early preterm and at term). For outpatients, the respective rate reductions were 79%, 40% and 65% (statistically significant for the children born at term). Importantly, the mean annual rates in the post-PCV period became similar in all 3 groups. The rate reductions among the hospitalized children were lower those that among the non-hospitalized children, with reductions of 56%, 16% and 33% for the three groups, respectively (statistically significant for early preterm and at term children).

CONCLUSIONS:

CAAP reduction trends after PCV implementation for preterm-born infants were similar to those for term-born infants. Whether this was because of similar direct PCV- protection, because of indirect (herd) protection or both, is unclear. Post-PCV implementation, the gaps in CAAP rates between infants born prematurely and at term were reduced.

• Authors: Yaniv Faingelernt, Ron Dagan, Noga Givon-Lavi, Bart Adriaan van der Beek, Shalom Ben-Shimol, Eilon Shany, David Greenberg
• Journal: Vaccine (Vaccine) Vol. 40 Issue 4 Pg. 568-573 (01 28 2022) ISSN: 1873-2518 [Electronic] Netherlands
• PMID: 34973848 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Ltd. All rights reserved.

Chemical References

• Pneumococcal Vaccines
• Vaccines, Conjugate

Topics

• Child
• Child, Preschool
• Humans
• Incidence
• Infant
• Infant, Newborn
• Pneumococcal Infections
• Pneumococcal Vaccines
• Pneumonia
• Pneumonia, Pneumococcal
• Prospective Studies
• Vaccines, Conjugate