Public Health Research Unit, Quebec University Hospital Research Centre, Quebec City, Canada.
Pediatr Infect Dis J. 2010 Jun;29(6):546-9. doi: 10.1097/INF.0b013e3181cffa2a.
In the province of Quebec, Canada, pneumococcal conjugate vaccine (PCV) is offered to all children aged less than 5 years, and a 2+1 schedule (2, 4, and 12 months) is recommended for low-risk infants, with other schedules including a lower number of doses for older children.
To estimate PCV effectiveness against invasive pneumococcal disease (IPD).
IPD cases in children aged 2-59 months and reported during the years 2005-2007 were eligible and uninfected controls were randomly identified in the provincial health insurance registry. Parents were interviewed by telephone and immunization records were reviewed. The PCV effectiveness was computed using unconditional logistic regression models adjusting for potential confounders.
180 IPD cases (60.4% of total reported) and 897 controls were included. Predictors of IPD risk were age, season, high-risk medical conditions, day-care attendance, and low family income. Overall PCV protection (> or =1 dose) against IPD caused by any serotype was 60% (95% CI: 38%-75%), and was 92% (83%-96%) against IPD caused by vaccine serotypes. Among low-risk children who received the recommended 2+1 schedule, 6 cases of vaccine failure occurred after the first dose, 1 case after the second dose, and no cases after the booster dose.
These results confirm the effectiveness of PCV after 2 and 3 doses.
在加拿大魁北克省，肺炎球菌结合疫苗（PCV）提供给所有 5 岁以下儿童，低危婴儿推荐采用 2+1 程序（2、4、12 月龄），对于年龄较大的儿童，其他方案则包括减少接种剂次。
评估 PCV 对侵袭性肺炎球菌病（IPD）的效果。
选择 2005-2007 年报告的 2-59 月龄儿童 IPD 病例，并在省级健康保险登记处随机选择未感染对照者。通过电话对父母进行访谈，并查阅免疫记录。采用非条件逻辑回归模型，根据潜在混杂因素进行调整，计算 PCV 效果。
纳入 180 例 IPD 病例（报告病例的 60.4%）和 897 例对照。IPD 发病风险的预测因素包括年龄、季节、高危医疗状况、日托中心入托情况和家庭收入低。所有血清型 IPD 的总体 PCV 保护率（≥1 剂）为 60%（95%CI：38%-75%），疫苗血清型引起的 IPD 保护率为 92%（83%-96%）。接受推荐的 2+1 程序的低危儿童中，在接种首剂后发生 6 例疫苗失败病例，在接种第 2 剂后发生 1 例，在加强剂次后无病例发生。
这些结果证实了 2 剂和 3 剂 PCV 的效果。
