Effectiveness of the 7-valent pneumococcal conjugate vaccine in children with sickle cell disease in the first decade of life
Effectiveness of the 7-valent pneumococcal conjugate vaccine in children with sickle cell disease in the first decade of life
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DOI：
10.1542/peds.2007-0018
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发表时间：
2008-03-01
期刊：
影响因子：
8
通讯作者：
Farley, Monica M.
中科院分区：
文献类型：
--
作者：
Adamkiewicz, Thomas V.;Silk, Benjamin J.;Farley, Monica M.
背景。镰状细胞病儿童侵袭性肺炎球菌疾病的发病率和死亡率明显高于普通儿科人群。这项以人群为基础的研究的目的是评估肺炎球菌结合疫苗对镰状细胞病儿童侵袭性肺炎球菌疾病发生率的影响。患者和方法。在1995年1月1日至2003年1月1日期间，将1247名1983年以后出生、居住在佐治亚州亚特兰大市的确诊血红蛋白病儿童的记录，包括肺炎球菌结合疫苗接种史，与侵袭性肺炎球菌疾病的主动监测数据库相关联。在获得肺炎球菌结合疫苗许可前后，估计了侵袭性肺炎球菌疾病的发病率和发病率降低的百分比。生存分析用于估计肺炎球菌结合疫苗在考虑群体免疫的情况下对侵袭性肺炎球菌疾病发病率的影响。在肺炎球菌结合疫苗获得许可后的2年内，在控制群体免疫的情况下，1剂肺炎球菌结合疫苗对镰状细胞病患儿侵袭性肺炎球菌疾病的显著降低估计为84.5%，分层生存分析估计为81.4%。6A血清型侵袭性肺炎球菌病在肺炎球菌结合疫苗许可前占侵袭性肺炎球菌病的36%，在肺炎球菌结合疫苗许可后占0%，提示对这种肺炎球菌结合疫苗相关血清型具有保护作用。侵袭性肺炎球菌病在镰状细胞病儿童中显著减少
BACKGROUND. The incidence of and mortality from invasive pneumococcal disease are significantly higher in children with sickle cell disease than in the general pediatric population. The objective of this population-based study was to assess the effect of pneumococcal conjugate vaccine on rates of invasive pneumococcal disease among children with sickle cell disease.PATIENTS AND METHODS. Records, including the history of pneumococcal conjugate vaccine administration, of 1247 children born after 1983 residing in metropolitan Atlanta, Georgia, with confirmed hemoglobinopathies were linked to an active surveillance database for invasive pneumococcal disease for the period of January 1, 1995, through January 1, 2003. The incidence of invasive pneumococcal disease and the percentage of rate reduction were estimated before and after pneumococcal conjugate vaccine licensure. Survival analysis was used to estimate the effect of pneumococcal conjugate vaccine on invasive pneumococcal disease rates while accounting for herd immunity.RESULTS. A significant decline in invasive pneumococcal disease in children with sickle cell disease = 1 dose of pneumococcal conjugate vaccine was estimated by crude analysis to be 84.5% and by stratified survival analysis to be 81.4% when controlling for the presence of herd immunity in the 2 years after pneumococcal conjugate vaccine licensure. Serotype 6A invasive pneumococcal disease represented 36% of invasive pneumococcal disease before pneumococcal conjugate vaccine licensure and 0% after pneumococcal conjugate vaccine licensure, suggesting a protective effect against this pneumococcal conjugate vaccine-related serotype.CONCLUSIONS. Invasive pneumococcal disease significantly decreased in children with sickle cell disease