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Invasive Pneumococcal Disease in High-risk Children: A 10-Year Retrospective Study.

Jacqui van Warmerdam1, Aaron Campigotto2,3, Ari Bitnun2,4

  • 1From the Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

The Pediatric Infectious Disease Journal
|November 30, 2022
PubMed
Summary

Invasive pneumococcal disease (IPD) remains a threat to high-risk children despite available vaccines. Improving vaccination rates with pneumococcal conjugate vaccine (PCV) and PPSV23 is crucial to prevent IPD caused by vaccine-preventable serotypes.

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Area of Science:

  • Pediatric Infectious Diseases
  • Vaccinology
  • Epidemiology

Background:

  • High-risk children remain susceptible to invasive pneumococcal disease (IPD) despite existing conjugate pneumococcal vaccines.
  • This study addresses the ongoing challenge of IPD in pediatric populations with underlying health conditions.

Purpose of the Study:

  • To determine the prevalence of IPD among high-risk children.
  • To analyze vaccination status and outcomes in this vulnerable group.

Main Methods:

  • Retrospective cohort study of IPD hospitalizations from 2009-2018 at a major pediatric hospital.
  • Utilized ICD-10 and microbiology codes to identify cases and define high-risk conditions (e.g., malignancy, transplant, immunodeficiency).

Main Results:

  • 94 high-risk children were hospitalized for IPD, with malignancy, transplant, and sickle cell disease being most common.
  • No deaths occurred; however, 23% of patients were unvaccinated, and many IPD cases involved vaccine-preventable serotypes in incompletely immunized children.
  • Serotype analysis showed significant coverage gaps for current vaccines like PCV13 and PPSV23.

Conclusions:

  • IPD continues to affect high-risk children, underscoring the need for enhanced vaccination strategies.
  • Increased uptake of pneumococcal conjugate vaccine (PCV) and PPSV23 could substantially decrease IPD incidence in this population.
  • Targeted immunization efforts are vital, especially for vaccine-preventable serotypes prevalent in incompletely vaccinated high-risk children.