Delivering Pneumococcal Vaccine to a High Risk Population: The Navajo Experience

Benin, Andrea L.; Watt, James; O’Brien, Katherine L.; Reid, Raymond; Zell, Elizabeth R.; Katz, Scott; Donaldson, Connie; Schuchat, Anne; Santosham, Mathuram; Whitney, Cynthia G.

doi:10.4161/hv.1.2.1562

Cited by 4 publications

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“…Rates of VT IPD among adults have decreased by 150% (range by age strata, 42%-81%) with 14 cases in the routine-use era compared with 29 in the prevaccine era. There has been no reduction in the IPD rate from the 16 serotypes in PPV23 but not in PCV7, providing evidence that the reduction in PCV7 serotypes among adults is not attributable to improved PPV23 use [12].…”

Section: Discussionmentioning

confidence: 80%

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Invasive Pneumococcal Disease a Decade after Pneumococcal Conjugate Vaccine Use in an American Indian Population at High Risk for Disease

et al. 2010

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Background. Before 7-valent pneumococcal conjugate vaccine (PCV7) introduction, invasive pneumococcal disease (IPD) rates among Navajo were several-fold those of the general US population. Only 50% of IPD cases in children involved PCV7 serotypes.Methods. We conducted active, population-based surveillance for IPD for the period 1995-2006. We documented case characteristics and serotyped the isolates. Results. Over 12-year period, we identified 1508 IPD cases, 447 of which occurred in children aged !5 years. Rates of IPD due to vaccine serotypes among children aged !1 year, 1 to !2 years, and 2 to !5 years decreased from 210, 263, and 51 cases per 100,000 population, respectively in 1995-1997 to 0 cases in 2004-2006 (P ! .001). Among adults aged у65 years, rates of IPD due to vaccine serotypes decreased 81% (95% confidence interval, Ϫ98% to Ϫ9%; P p .02). Rates of nonvaccine serotype IPD were unchanged in all age strata except for persons aged 18 to !40 years, among whom the rate decreased by 35% from 27 to 18 cases per 100,000 population (95% confidence interval, Ϫ57% to Ϫ1%; P p .03).Conclusions. Vaccine-serotype IPD has virtually been eliminated in the PCV7 era among Navajo of all ages. Overall rates of nonvaccine-serotype IPD have not increased, although increases have occurred for some individual types. Rates of all-serotype IPD among Navajo children remain 3-5-fold greater than in the general US population.

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Section: Discussionmentioning

confidence: 80%

“…PCV7 was introduced into the infant immunization schedule after the trial, allowing the analysis of PCV7 impact during a decade of use. 14 (11)(12)(13)(14)(15)(16)(17)(18)(19) 19 (16- NOTE. Data are no.…”

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Invasive Pneumococcal Disease a Decade after Pneumococcal Conjugate Vaccine Use in an American Indian Population at High Risk for Disease

et al. 2010

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The epidemiologic evidence underlying recommendations for use of pneumococcal polysaccharide vaccine among American Indian and Alaska Native populations

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O’Brien

Nuorti

et al. 2011

Vaccine

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Neglected Infections of Poverty in the United States of America

2008

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In the United States, there is a largely hidden burden of diseases caused by a group of chronic and debilitating parasitic, bacterial, and congenital infections known as the neglected infections of poverty. Like their neglected tropical disease counterparts in developing countries, the neglected infections of poverty in the US disproportionately affect impoverished and under-represented minority populations. The major neglected infections include the helminth infections, toxocariasis, strongyloidiasis, ascariasis, and cysticercosis; the intestinal protozoan infection trichomoniasis; some zoonotic bacterial infections, including leptospirosis; the vector-borne infections Chagas disease, leishmaniasis, trench fever, and dengue fever; and the congenital infections cytomegalovirus (CMV), toxoplasmosis, and syphilis. These diseases occur predominantly in people of color living in the Mississippi Delta and elsewhere in the American South, in disadvantaged urban areas, and in the US–Mexico borderlands, as well as in certain immigrant populations and disadvantaged white populations living in Appalachia. Preliminary disease burden estimates of the neglected infections of poverty indicate that tens of thousands, or in some cases, hundreds of thousands of poor Americans harbor these chronic infections, which represent some of the greatest health disparities in the United States. Specific policy recommendations include active surveillance (including newborn screening) to ascertain accurate population-based estimates of disease burden; epidemiological studies to determine the extent of autochthonous transmission of Chagas disease and other infections; mass or targeted treatments; vector control; and research and development for new control tools including improved diagnostics and accelerated development of a vaccine to prevent congenital CMV infection and congenital toxoplasmosis.

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Delivering Pneumococcal Vaccine to a High Risk Population: The Navajo Experience

Cited by 4 publications

References 5 publications

Invasive Pneumococcal Disease a Decade after Pneumococcal Conjugate Vaccine Use in an American Indian Population at High Risk for Disease

Invasive Pneumococcal Disease a Decade after Pneumococcal Conjugate Vaccine Use in an American Indian Population at High Risk for Disease

The epidemiologic evidence underlying recommendations for use of pneumococcal polysaccharide vaccine among American Indian and Alaska Native populations

Neglected Infections of Poverty in the United States of America

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