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National paediatric immunization program of high risk groups: no effect on the incidence of invasive pneumococcal

P Rendi-Wagner1, M Paulke-Korinek, M Kundi

  • 1Department of Specific Prophylaxis and Tropical Medicine, Center for Physiology, Medical University of Vienna, A-1090 Vienna, Austria.

Vaccine
|April 28, 2009
PubMed

Insights

The Austrian risk group immunization program with Prevenar did not impact invasive pneumococcal disease (IPD) incidence in young children. While meningitis rates decreased, overall IPD rates and serotype distribution remained unchanged.

Area of Science:

  • Pediatric infectious diseases
  • Vaccinology
  • Epidemiology

Background:

  • Invasive pneumococcal diseases (IPD) pose a significant threat to young children.
  • Austria introduced a national risk group immunization program using the "Prevenar" vaccine in November 2004.
  • Monitoring IPD epidemiology before and after vaccination is crucial to assess program impact.

Purpose of the Study:

  • To evaluate the impact of the Austrian national risk group immunization program with "Prevenar" on IPD epidemiology in hospitalized children.
  • To analyze changes in IPD incidence rates, serotype distribution, and antimicrobial resistance patterns before and after program introduction.

Main Methods:

  • Prospective monitoring of IPD cases in hospitalized children aged up to 60 months.
  • Data collection occurred in two periods: pre-vaccination (February 2001-October 2004) and post-vaccination (November 2004-January 2007).
  • Incidence rates, serotype prevalence, and antimicrobial resistance were analyzed.

Main Results:

  • Overall IPD incidence rates per 100,000 children were 7.6 before and 6.4 after the program.
  • A significant reduction in meningitis incidence (p<0.05) was observed, decreasing from 3.1 to 1.6 per 100,000.
  • Common serotypes included 14, 6B, and 23F; 71.7% were vaccine types. No significant shift in serotype distribution or clinically relevant changes in IPD incidence were documented. Antimicrobial resistance was notable for erythromycin (32.5%) and clarithromycin (26.7%).

Conclusions:

  • The risk group vaccination program showed no discernible impact on the overall incidence of invasive pneumococcal diseases in young children in Austria.
  • A significant reduction in pneumococcal meningitis was observed, suggesting potential benefits for specific IPD manifestations.
  • Continued surveillance is necessary to monitor long-term trends and the emergence of antimicrobial resistance in pneumococcal strains.

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