Related Experiment Video

Updated: Jul 17, 2025

Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria

Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria

Published on: February 23, 2014

Pediatric outpatient visits and antibiotic use attributable to higher valency pneumococcal conjugate vaccine

Laura M King¹, Kristin L Andrejko², Sarah Kabbani³

¹School of Public Health, University of California, Berkeley, Berkeley, CA.

Medrxiv : the Preprint Server for Health Sciences

|September 4, 2023

Insights

New pneumococcal conjugate vaccines (PCV15, PCV20) target additional serotypes causing significant pediatric outpatient visits and antibiotic prescriptions. PCV20-additional serotypes represent a substantial burden, suggesting these vaccines may reduce acute respiratory infections and antibiotic use in children.

Area of Science:

Pediatric infectious diseases
Vaccinology
Public health

Background:

Streptococcus pneumoniae causes numerous childhood acute respiratory infections (ARIs), driving outpatient visits and antibiotic prescriptions.
Recent recommendations for 15- and 20-valent pneumococcal conjugate vaccines (PCV15, PCV20) necessitate understanding the impact of their additional serotypes.

Approach:

Utilized multi-component study design with descriptive analyses of cross-sectional and cohort data (2016-2019).
Included meta-analyses of pneumococcal serotype distribution in non-invasive respiratory infections.
Analyzed data from National Ambulatory Medical Care Survey, National Hospital Ambulatory Medicare Care Survey, and Merative MarketScan for U.S. children.

Key Points:

PCV15-additional serotypes were associated with 2.7 visits and 2.4 antibiotic prescriptions per 1,000 children annually.
PCV20-additional serotypes were linked to 15.0 visits and 13.2 antibiotic prescriptions per 1,000 children annually.
Nationally, PCV15/20-additional serotypes account for an estimated 173,000 and 968,000 antibiotic prescriptions, respectively, representing 0.4% and 2.1% of all pediatric outpatient antibiotic use.

Conclusions:

Additional serotypes in PCV15 and PCV20 contribute significantly to pediatric outpatient healthcare utilization.
PCV20-additional serotypes account for over five times the burden of visits and antibiotic prescriptions compared to PCV15-additional serotypes.
Widespread adoption of higher-valency pneumococcal conjugate vaccines, particularly PCV20, holds potential for substantial reductions in ARIs and associated antibiotic use among children.

Read full analysis

Abstract

Importance:

Streptococcus pneumoniae is a known etiology of acute respiratory infections (ARIs), which account for large proportions of outpatient visits and antibiotic use in children. In 2023, 15- and 20-valent pneumococcal conjugate vaccines (PCV15, PCV20) were recommended for routine use in infants. However, the burden of outpatient healthcare utilization among U.S. children attributable to the additional, non-PCV13 serotypes in PCV15/20 is unknown.

Objective:

To estimate the incidence of outpatient visits and antibiotic prescriptions in U.S. children for acute otitis media, pneumonia, and sinusitis associated with PCV15- and PCV20-additional serotypes (non-PCV13 serotypes) to quantify potential impacts of PCV15/20 on outpatient visits and antibiotic prescriptions for these conditions.

Design:

Multi-component study including descriptive analyses of cross-sectional and cohort data on outpatient visits and antibiotic prescriptions from 2016-2019 and meta-analyses of pneumococcal serotype distribution in non-invasive respiratory infections.

Setting:

Outpatient visits and antibiotic prescriptions among U.S. children.

Participants:

Pediatric visits and antibiotic prescriptions among children captured in the National Ambulatory Medical Care Survey (NAMCS), the National Hospital Ambulatory Medicare Care Survey (NHAMCS), and Merative MarketScan, collectively representing healthcare delivery across all outpatient settings. Incidence denominators estimated using census (NAMCS/NHAMCS) and enrollment (MarketScan) data.

Main Outcomes And Measures:

Pediatric outpatient visit and antibiotic prescription incidence for acute otitis media, pneumonia, and sinusitis associated with PCV15/20-additional serotypes.

Results:

We estimated that per 1000 children annually, PCV15-additional serotypes accounted for 2.7 (95% confidence interval 1.8-3.9) visits and 2.4 (1.6-3.4) antibiotic prescriptions. PCV20-additional serotypes resulted in 15.0 (11.2-20.4) visits and 13.2 (9.9-18.0) antibiotic prescriptions annually per 1,000 children. Projected to national counts, PCV15/20-additional serotypes account for 173,000 (118,000-252,000) and 968,000 (722,000-1,318,000) antibiotic prescriptions among U.S. children each year, translating to 0.4% (0.2-0.6%) and 2.1% (1.5-3.0%) of all outpatient antibiotic use among children.

Conclusions And Relevance:

PCV15/20-additional serotypes account for a large burden of pediatric outpatient healthcare utilization. Compared with PCV15-additional serotypes, PCV20-additional serotypes account for >5 times the burden of visits and antibiotic prescriptions. These higher-valency PCVs, especially PCV20, may contribute to preventing ARIs and antibiotic use in children.

More Related Videos

Opsono-Adherence Assay to Evaluate Functional Antibodies in Vaccine Development Against Bacillus anthracis and Other Encapsulated Pathogens

Opsono-Adherence Assay to Evaluate Functional Antibodies in Vaccine Development Against Bacillus anthracis and Other Encapsulated Pathogens

Published on: May 19, 2020

Constructing Mutants in Serotype 1 Streptococcus pneumoniae strain 519/43

Constructing Mutants in Serotype 1 Streptococcus pneumoniae strain 519/43

Published on: September 11, 2020

Related Concept Videos

Pneumonia III: Complications and Assessment

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:

Healthcare Associated Infections II: Preventive Measures

Healthcare Associated Infections II: Preventive Measures

Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...

Pneumonia I: Introduction

Pneumonia I: Introduction

Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...

Antimicrobial Effectiveness

Antimicrobial Effectiveness

The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...

Pneumonia V: Nursing management and Prevention

Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....

Acute Pharyngitis

Acute Pharyngitis

Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:

Articles linked to this work by shared authors, journal, and citation graph.

Bivalent RSVpreF Effectiveness Against Respiratory Syncytial Virus (RSV)-Related Respiratory Disease Hospitalization and Emergency Department Visits Across Three RSV Seasons.

Infectious diseases and therapy·2026

The Impact of Respiratory Syncytial Virus Undertesting on Estimates of Disease Burden and Vaccine Effectiveness in a Large Integrated Healthcare System.

Open forum infectious diseases·2026

High-grade astrocytoma with piloid features: a clinical and genomic analysis of prognostic factors using a large cohort.

Neuro-oncology·2026

Can We Compare Adverse Events' Attributable Risk Using a Self-Controlled Case Series Design for Vaccine Safety? A Guillain-Barré Syndrome Use Case.

Infectious diseases and therapy·2026

Estimating optimal levels of WHO Access, Watch, Reserve (AWaRe) antibiotic use in 186 countries, territories, and areas on the basis of clinical infection and resistance burden.

The Lancet. Public health·2026

Bivalent RSVpreF effectiveness against RSV-associated hospital or emergency department care over two seasons: a retrospective test-negative case control study.

Lancet regional health. Americas·2026

See all related articles