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Effectiveness of pneumococcal conjugate vaccine in infants by maternal influenza vaccination status
Katharina L van Santen1, Robert A Bednarczyk, Dzifa Adjaye-Gbewonyo
1From the *Center for Health Research-Southeast, Kaiser Permanente; †Rollins School of Public Health; and ‡Emory Vaccine Center, Emory University, Atlanta GA.
Insights
Maternal influenza vaccination combined with infant pneumococcal conjugate vaccine (PCV) offers superior protection against acute otitis media and respiratory infections in infants compared to PCV alone.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Influenza virus infection increases susceptibility to secondary pneumococcal infections, particularly in infants.
- Infants under six months are most vulnerable and cannot receive influenza vaccines directly.
- Maternal influenza vaccination can provide passive immunity to young infants.
Purpose of the Study:
- To evaluate the effectiveness of combined maternal influenza vaccination and infant pneumococcal conjugate vaccine (PCV) against common infant infections.
- To compare the protective benefits of this combined strategy versus PCV alone.
Main Methods:
- Retrospective cohort study of 9807 mother-infant pairs.
- Assessed outcomes including acute otitis media and medically attended acute respiratory infection in the first year of life.
- Calculated vaccine effectiveness using incidence rate ratios during periods of influenza circulation.
Main Results:
- Combined maternal influenza vaccine and PCV showed 39.6% effectiveness against acute respiratory infections and 47.9% against acute otitis media.
- PCV alone demonstrated lower effectiveness: 29.8% for respiratory infections and 37.6% for otitis media.
Conclusions:
- The combination of maternal influenza vaccination and infant PCV provides enhanced protection against otitis media and acute respiratory infections.
- This dual vaccination strategy is more effective than PCV alone in protecting infants during their first year of life.
Background:
Influenza virus infection can predispose patients to secondary pneumococcal infections. Children are at greatest risk for pneumococcal infection in the first year of life and are not considered fully protected by pneumococcal conjugate vaccine (PCV) until their third dose at 6 months of age. Infants less than 6 months cannot receive influenza vaccination, though maternal influenza vaccination can protect infants.
Methods:
We conducted a retrospective cohort study of 9807 mother-infant pairs enrolled in a managed care organization for infants born June 1, 2002, to December 31, 2009. Exposure was assessed for receipt of infant PCV only and the combination of PCV and maternal influenza vaccine (trivalent inactivated vaccine). Outcomes of interest were acute otitis media and medically attended acute respiratory infection in the first year of life. We estimated the adjusted incidence of illness, incidence rate ratios and vaccine effectiveness using the ratio of incidence rate ratios between the periods of noncirculating influenza and that of at least local influenza circulation.
Results:
For medically attended acute respiratory infection, vaccine effectiveness for the combination of trivalent inactivated vaccine and PCV was 39.6% (95% confidence interval [CI]: 31.6%-46.7%) and for PCV only was 29.8% (95% CI: 11.4%-44.3%). For acute otitis media, vaccine effectiveness for the combination of trivalent inactivated vaccine and PCV was 47.9% (95% CI: 42%-53.3%) and for PCV only was 37.6% (95% CI: 23.1%-49.4%).
Conclusion:
In infants, the combination of maternal influenza vaccine and infant pneumococcal conjugate vaccination confers greater protection from acute otitis media infections and medically attended acute respiratory infections than does PCV alone.
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