Impact of Universal Pneumococcal Vaccination on Hospitalizations for Pneumonia and Meningitis in Children in Montevideo, Uruguay
Impact of Universal Pneumococcal Vaccination on Hospitalizations for Pneumonia and Meningitis in Children in Montevideo, Uruguay
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DOI：
10.1097/inf.0b013e3182152bf1
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发表时间：
2011-08-11
影响因子：
3.6
通讯作者：
Montano, Alicia
中科院分区：
文献类型：
--
作者：
Catalina Pirez, Maria;Algorta, Gabriela;Montano, Alicia
背景：2008年3月，乌拉圭将PCV7纳入常规疫苗接种计划，对2岁及2岁的儿童实行2+1计划。向2007年出生的儿童提供补种免疫。超过95%的儿童接种了第一剂和第二剂疫苗。这项研究的目的是评估这一策略的效果。方法：描述了14岁儿童社区获得性肺炎(CAP)和肺炎球菌脑膜炎的年住院率(每万人出院)，分别在接种PCV7疫苗前(2005-2007年)、实施年份(2008年)和疫苗接种后(2009年)进行了描述。结果：与接种前一年(2005-2007)和接种后一年(2009)相比，所有儿童的CAP住院率和肺炎球菌CAP住院率分别下降了56%和48.2%。在2岁以下的儿童中，观察到疫苗血清型P-CAP显著减少(血清14型P-CAP从每10,000个出院26.6个下降到2.5个)。这一年龄组肺炎球菌性脑膜炎的发病率显著下降了59%；接种疫苗后，预防接种的中位数从17(12.2-24.9)降至7(3-11.8)。在完全免疫的儿童中没有发现P-CAP或肺炎球菌脑膜炎的疫苗失败。结论：在将PCV7引入乌拉圭常规疫苗接种计划一年后，CAP、P-CAP和肺炎球菌脑膜炎在2岁儿童中的发病率迅速而显著地下降。
Background: In March 2008, Uruguay included PCV7 into the routine vaccination program, in a 2 + 1 schedule for children < 2 years of age. Catch-up immunization was offered to children born in 2007. Greater than 95% of children received their first and second doses. The aim of this study was to assess the effect of this strategy.Methods: Annual hospitalization rates (per 10,000 discharges) for community-acquired pneumonia (CAP) in children < 14 years of age and pneumococcal meningitis are described prior to PCV7 vaccination (2005-2007), during the year of implementation (2008) and following vaccine introduction (2009). Data regarding age, diagnosis, vaccination status, and pneumococcal serotype were obtained from Hospital Pereira Rossell databases and vaccination records.Results: Comparison of hospitalization rates for CAP and pneumococcal-CAP (P-CAP) between prevaccine years (2005-2007) and the year after vaccination (2009) decreased significantly in all children by 56% and 48.2%, respectively. Significant reduction was observed for vaccine serotype P-CAP (serotype 14 P-CAP decreased from 26.6 to 2.5 per 10,000 discharges) in children < 2 years of age. A significant reduction in pneumococcal meningitis of 59% was seen in this age group; median rates prevaccination decreased from 17 (12.2-24.9) to 7 (3-11.8) after the administration of vaccine. No vaccine failures for P-CAP or pneumococcal meningitis were seen in fully immunized children.Conclusions: One year after PCV7 introduction into the routine vaccination schedule of Uruguay, there was a rapid and significant reduction in rates of CAP, P-CAP, and pneumococcal meningitis in children < 2 years of age.