U.S. Hospitalizations for Pneumonia after a Decade of Pneumococcal Vaccination

Griffin, Marie R.; Zhu, Yuwei; Moore, Matthew R.; Whitney, Cynthia G.; Grijalva, Carlos G.

doi:10.1056/nejmoa1209165

Cited by 458 publications

(344 citation statements)

References 32 publications

(43 reference statements)

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“…Although one trend study from the United States reported no decline in confirmed or presumptive hospitalized pneumonia cases in this age group (28), others that used large administrative databases found significant PCV-related reductions in pneumonia hospitalization in seniors (7,8,19,20). Our secondary analyses, in which we use a simple linear trend to make the adjustment, might explain this difference.…”

mentioning

confidence: 78%

Estimating the population-level impact of vaccines using synthetic controls

Bruhn

Hetterich²,

Schuck‐Paim³

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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When a new vaccine is introduced, it is critical to monitor trends in disease rates to ensure that the vaccine is effective and to quantify its impact. However, estimates from observational studies can be confounded by unrelated changes in healthcare utilization, changes in the underlying health of the population, or changes in reporting. Other diseases are often used to detect and adjust for these changes, but choosing an appropriate control disease a priori is a major challenge. The “synthetic controls” (causal impact) method, which was originally developed for website analytics and social sciences, provides an appealing solution. With this approach, potential comparison time series are combined into a composite and are used to generate a counterfactual estimate, which can be compared with the time series of interest after the intervention. We sought to estimate changes in hospitalizations for all-cause pneumonia associated with the introduction of pneumococcal conjugate vaccines (PCVs) in five countries in the Americas. Using synthetic controls, we found a substantial decline in hospitalizations for all-cause pneumonia in infants in all five countries (average of 20%), whereas estimates for young and middle-aged adults varied by country and were potentially influenced by the 2009 influenza pandemic. In contrast to previous reports, we did not detect a decline in all-cause pneumonia in older adults in any country. Synthetic controls promise to increase the accuracy of studies of vaccine impact and to increase comparability of results between populations compared with alternative approaches.

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mentioning

confidence: 78%

Estimating the population-level impact of vaccines using synthetic controls

Bruhn

Hetterich²,

Schuck‐Paim³

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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“…(12) Results of a study carried out in the United States showed a substantial improvement in vaccination coverage against pneumonia, started in 2000, led to a decrease in hospital admission for pneumonia in children through 2004; this decrease was sustained until 2009. (13) This result can be attributed to improved access to health service, adoption of prevention measures (mainly the incorporation of pneumococcal vaccine), and the provision of adequate and opportune treatment.…”

Section: Discussionmentioning

confidence: 99%

Análise da tendência das taxas de internações por pneumonia bacteriana em crianças e adolescentes

et al. 2015

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Objective: To analyze distribution and tendency of hospital admissions rates for bacterial pneumonia in children and adolescents. Methods: This ecological, time series study included secondary data obtained from the Hospital Information System of the SUS. We calculated hospital admission coefficients for 10,000 inhabitants triennially. For the analysis of tendency, a model of polynomial regression was used. Results: Most hospital admissions occurred in the East health macro-region between the second and fourth triennial periods. Rates were higher for children age one to four years and in male patients throughout the study period. We observed an increased tendency toward hospital admission in children younger than one year. Conclusion: Hospital admission rates for pneumonia differ by health macro-region, age and sex. The region with the highest incidence was the East region, and boys aged one to four years were more affected. A growing tendency was seen in children younger than one year. ResumoObjetivo: Analisar a distribuição e a tendência das taxas de internações por pneumonia bacteriana em crianças e adolescentes. Métodos: Estudo ecológico de séries temporais com dados secundários obtidos no Sistema de Informações Hospitalares do Sistema Único de Saúde. Foram calculados coeficientes de internação para 10.000 habitantes, por triênio. Para análise de tendência utilizaram-se modelos de regressão polinomial. Resultados: As maiores taxas de internação ocorreram na Macrorregião de Saúde Oeste, entre o segundo e o quarto triênio. As taxas foram maiores na faixa etária de um a quatro anos e no sexo masculino, durante todo o período. Observou-se tendência crescente das internações em crianças menores de um ano. Conclusão: As taxas de internação por pneumonia diferem por macrorregional de saúde, idade e sexo, sendo maior na região oeste, em crianças do sexo masculino e com idade entre um e quatro anos, com tendência crescente entre os menores de um ano.

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“…In contrast, a recent study from the United States showed a sustained decrease in hospitalizations for pneumonia in children and a decrease in people .65 years old, possibly a herd effect. 26 Our use of a discharge diagnosis of pneumonia coded as bacterial pneumonia as an endpoint was motivated by the difficulty of establishing an etiological diagnosis of pneumonia, especially in small children.…”

Section: Discussionmentioning

confidence: 99%

Sinusitis and Pneumonia Hospitalization After Introduction of Pneumococcal Conjugate Vaccine

Lindstrand

Bennet²,

Galanis

et al. 2014

Pediatrics

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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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U.S. Hospitalizations for Pneumonia after a Decade of Pneumococcal Vaccination

Cited by 458 publications

References 32 publications

Estimating the population-level impact of vaccines using synthetic controls

Estimating the population-level impact of vaccines using synthetic controls

Análise da tendência das taxas de internações por pneumonia bacteriana em crianças e adolescentes

Sinusitis and Pneumonia Hospitalization After Introduction of Pneumococcal Conjugate Vaccine

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