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Racial and Regional Differences in Rates of Invasive Pneumococcal Disease

Annabelle de St Maurice1, Carlos G Grijalva2, Christopher Fonnesbeck3

  • 1Departments of Pediatrics.

Pediatrics
|October 14, 2015
PubMed

Insights

The 13-valent pneumococcal conjugate vaccine (PCV13) significantly reduced invasive pneumococcal disease (IPD) rates in Tennessee children. PCV13 also decreased disparities in IPD rates among different races and regions.

Area of Science:

  • Pediatric infectious diseases
  • Vaccinology
  • Public health surveillance

Background:

  • Invasive pneumococcal disease (IPD) remains a significant public health concern for children in the United States.
  • Pneumococcal conjugate vaccines (PCVs) have been instrumental in reducing the burden of IPD.
  • The introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) aimed to broaden protection against additional pneumococcal serotypes.

Purpose of the Study:

  • To evaluate the impact of PCV13 introduction on pediatric IPD incidence in Tennessee.
  • To assess changes in racial and regional disparities in IPD rates following PCV13 implementation.
  • To compare IPD trends across different eras defined by PCV7 and PCV13 vaccination schedules.

Main Methods:

  • Utilized active laboratory and population-based surveillance data for IPD in Tennessee.
  • Compared IPD rates across three distinct periods: early PCV7 (2001-2004), late PCV7 (2005-2009), and post-PCV13 (2011-2012).
  • Stratified IPD rates by age, race, and geographic region within Tennessee (east and middle-west).

Main Results:

  • A 70% decline in IPD rates was observed among children younger than 2 years, from 67 to 19 per 100,000 person-years, between the early PCV7 and post-PCV13 eras.
  • Similar decreasing trends in IPD rates were noted in older pediatric age groups (2-4 and 5-17 years).
  • Racial disparities in IPD rates among children under 2 were significant in the late PCV7 era (black vs. white: 70 vs. 43 per 100,000) but diminished post-PCV13.
  • Regional differences in IPD rates in East Tennessee versus Middle-West Tennessee among children under 2 also became non-significant after PCV13 introduction (91 vs. 45 per 100,000).

Conclusions:

  • The introduction of PCV13 resulted in substantial reductions in childhood IPD rates in Tennessee.
  • PCV13 vaccination was associated with a significant decrease in both racial and regional disparities in pediatric IPD.
  • These findings underscore the effectiveness of PCV13 in controlling IPD and promoting health equity in the pediatric population.
Abstract

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