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Published on: February 23, 2014
Sinusitis and pneumonia hospitalization after introduction of pneumococcal conjugate vaccine
Ann Lindstrand1, Rutger Bennet2, Ilias Galanis3
1Public Health Agency of Sweden, Solna, Sweden; Departments of Public Health Sciences, Division of Global Health, ann.lindstrand@folkhalsomyndigheten.se.
Insights
Pneumococcal conjugate vaccines (PCV7 and PCV13) significantly reduced hospitalizations for sinusitis by 66% and pneumonia by 19% in young children. These findings highlight the vaccines' effectiveness in preventing serious pediatric respiratory infections.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Streptococcus pneumoniae causes significant pediatric pneumonia and sinusitis.
- Pneumococcal conjugate vaccines (PCV) are effective against invasive disease but less so against pneumonia, with unknown effects on sinusitis.
- This study evaluates PCV's impact on pediatric hospitalization rates for sinusitis, pneumonia, and empyema.
Purpose of the Study:
- To compare hospitalization rates for sinusitis, pneumonia, and empyema in children before and after the introduction of PCV7 and PCV13.
- To assess the effectiveness of sequential PCV introduction on pediatric respiratory illness burden.
Main Methods:
- Population-based study using hospital registry data from Stockholm County, Sweden (2003-2012).
- Included children aged 0 to <18 years hospitalized for sinusitis, pneumonia, or empyema.
- Trend analysis and incidence rate calculations compared periods before and after PCV introduction, excluding the initial introduction year.
Main Results:
- Sinusitis hospitalizations decreased by 66% (RR=0.34) in children aged 0 to <2 years.
- Pneumonia hospitalizations decreased by 19% (RR=0.81) in children aged 0 to <2 years and by 15% (RR=0.85) in those aged 2 to <5 years.
- Trend analysis confirmed decreased sinusitis and pneumonia hospitalizations post-intervention in children aged 0 to <5 years.
Conclusions:
- PCV7 and PCV13 vaccination significantly reduced hospitalization risk for sinusitis and pneumonia in young children.
- The vaccines demonstrated substantial effectiveness in preventing pediatric sinusitis and pneumonia, contributing to reduced healthcare burden.
Background And Objective:
Streptococcus pneumoniae is a major cause of pneumonia and sinusitis. Pneumonia kills >1 million children annually, and sinusitis is a potentially serious pediatric disease that increases the risk of orbital and intracranial complications. Although pneumococcal conjugate vaccine (PCV) is effective against invasive pneumococcal disease, its effectiveness against pneumonia is less consistent, and its effect on sinusitis is not known. We compared hospitalization rates due to sinusitis, pneumonia, and empyema before and after sequential introduction of PCV7 and PCV13.
Method:
All children 0 to <18 years old hospitalized for sinusitis, pneumonia, or empyema in Stockholm County, Sweden, from 2003 to 2012 were included in a population-based study of hospital registry data on hospitalizations due to sinusitis, pneumonia, or empyema. Trend analysis, incidence rates, and rate ratios (RRs) were calculated comparing July 2003 to June 2007 with July 2008 to June 2012, excluding the year of PCV7 introduction.
Results:
Hospitalizations for sinusitis decreased significantly in children aged 0 to <2 years, from 70 to 24 cases per 100 000 population (RR = 0.34, P < .001). Hospitalizations for pneumonia decreased significantly in children aged 0 to <2 years, from 450 to 366 per 100 000 population (RR = 0.81, P < .001) and in those aged 2 to <5 years from 250 to 212 per 100 000 population (RR = 0.85, P = .002). Hospitalization for empyema increased nonsignificantly. Trend analyses showed increasing hospitalization for pneumonia in children 0 to <2 years before intervention and confirmed a decrease in hospitalizations for sinusitis and pneumonia in children aged 0 to <5 years after intervention.
Conclusions:
PCV7 and PCV13 vaccination led to a 66% lower risk of hospitalization for sinusitis and 19% lower risk of hospitalization for pneumonia in children aged 0 to <2 years, in a comparison of 4 years before and 4 years after vaccine introduction.
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