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The effect of routine vaccination on invasive pneumococcal infections in Canadian children, Immunization Monitoring

Julie A Bettinger1, David W Scheifele, James D Kellner

  • 1Vaccine Evaluation Center, BC Children's Hospital and the University of British Columbia, Vancouver, BC, Canada. jbettinger@cw.bc.ca

Vaccine
|January 2, 2010
PubMed

Insights

Universal infant immunization programs using pneumococcal conjugate vaccines significantly reduced invasive pneumococcal disease (IPD) cases by 48% in children. Vaccine-targeted serotypes causing IPD decreased by over 87%, demonstrating vaccine effectiveness.

Area of Science:

  • Pediatric Infectious Diseases
  • Vaccinology
  • Microbiology

Background:

  • Invasive pneumococcal disease (IPD) remains a significant public health concern globally.
  • Streptococcus pneumoniae serotypes targeted by conjugate vaccines have historically caused a substantial burden of IPD.

Purpose of the Study:

  • To evaluate the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) program on IPD incidence, serotype distribution, and antibiotic resistance in Canadian children.
  • To assess changes in IPD caused by vaccine-type and non-vaccine-type Streptococcus pneumoniae strains.

Main Methods:

  • Active surveillance data from 12 Canadian Immunization Monitoring Program, Active centers (2000-2007).
  • Analysis of IPD cases in children aged 16 years and younger.
  • Evaluation of serotype prevalence and antibiotic resistance patterns.

Main Results:

  • Overall IPD cases decreased by 48% (p<0.01) and by 56% (p<0.01) in children aged 0-4 years.
  • IPD cases caused by vaccine serotypes dropped by 87.5% overall and 92% in children aged 0-4 years (p<0.01).
  • Penicillin resistance remained stable at 17%, and cefotaxime/ceftriaxone resistance at 2% annually. Serotype 19A showed a significant increase (p<0.01).

Conclusions:

  • Universal infant immunization with PCV7 has dramatically reduced the incidence of IPD in children.
  • While vaccine-type strains decreased, emergence of non-vaccine serotypes like 19A warrants continued monitoring.
  • Antibiotic resistance patterns for key agents remained largely unchanged during the study period.

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