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Decreasing invasive pneumococcal disease in the elderly: a state-level analysis.

A Marshall McBean1, Kyoungrae Jung, Paul L Hebert

  • 1Division of Health Services Research and Policy, University of Minnesota School of Public Health, MMC 97 A369 Mayo Memorial Building, 420 Delaware St., S.E., Minneapolis, MN 55455, USA. mcbea002@umn.edu

Vaccine
|May 27, 2006
PubMed
Summary

Childhood vaccination with 7-valent pneumococcal conjugate vaccine (PCV7) is linked to fewer invasive pneumococcal disease (IPD) cases in seniors. This study confirms a significant negative association between PCV7 use in children and IPD hospitalizations in the elderly.

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Area of Science:

  • Public Health
  • Epidemiology
  • Vaccinology

Background:

  • Invasive pneumococcal disease (IPD) poses a significant health burden, particularly in elderly populations.
  • Previous studies suggest a potential indirect protective effect of childhood pneumococcal conjugate vaccines on older adults.

Purpose of the Study:

  • To investigate the association between childhood 7-valent pneumococcal conjugate vaccine (PCV7) coverage and IPD hospitalization rates in elderly individuals.
  • To examine the relationship between 23-valent pneumococcal polysaccharide vaccine (PPV23) use and IPD hospitalizations in the elderly.

Main Methods:

  • State-level analysis correlating pediatric PCV7 vaccination coverage rates (children 19-35 months) with elderly IPD hospitalization rates.
  • Multivariate analysis using a state fixed-effect model to control for time-invariant state-level factors.

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  • Statistical significance was assessed using p-values.

    • Main Results:

    • A statistically significant negative relationship was observed between PCV7 vaccination coverage in children and IPD hospitalizations in the elderly (p = 0.035).
    • Simple correlation analyses also suggested a negative association.
    • No statistically significant relationship was found between PPV23 use and IPD hospitalizations in the elderly.

    Conclusions:

    • Childhood PCV7 vaccination programs appear to contribute to a reduction in IPD burden among the elderly population.
    • The findings support the public health strategy of widespread childhood pneumococcal conjugate vaccination for broader community protection.
    • PPV23 use in the elderly did not show a statistically significant association with reduced IPD hospitalizations in this analysis.