Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel.
Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel.
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DOI：
10.3201/eid1907.121625
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发表时间：
2013-07
影响因子：
11.8
通讯作者：
Dagan R
中科院分区：
文献类型：
--
作者：
Weinberger DM;Givon-Lavi N;Shemer-Avni Y;Bar-Ziv J;Alonso WJ;Greenberg D;Dagan R
肺炎发病率的许可后监测可用于估计肺炎球菌结合疫苗（PCV）是否影响发病率。我们使用Poisson回归模型控制基线季节性，以确定PCV的影响和以色列病毒活性变化对这些监测估计的可能影响。PCV与年龄<6个月、6-17个月和18-35个月的患者中放射学证实的肺泡性肺炎（RCAP）显著下降相关（分别为-31% [95% CI -51%至-15%]、-41% [95% CI -52至-32%]和-34% [95% CI -42%至-25%]）。呼吸道合胞病毒（RSV）活动与RCAP发病率的显著增加相关，在6个月以下的婴儿中，高达44%的病例可归因于RSV，在年龄较大的儿童中，RSV的影响较低，但意义重大。季节性变化，特别是RSV活性，掩盖了7价PCV的影响，特别是在疫苗引入后的前2年对幼儿的影响。
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.