University of Iceland, Faculty of Medicine, Iceland.
University of Iceland, Faculty of Medicine, Iceland; Department of Clinical Microbiology, Landspítali University Hospital, Iceland.
Vaccine. 2020 Mar 10;38(12):2707-2714. doi: 10.1016/j.vaccine.2020.01.094. Epub 2020 Feb 13.
Pneumococcus is an important respiratory pathogen. The 10-valent pneumococcal vaccine (PHiD-CV) was introduced into the Icelandic vaccination programme in 2011. The aim was to estimate the impact of PHiD-CV on paediatric hospitalisations for respiratory tract infections and invasive disease.
The 2005-2015 birth-cohorts were followed until three years of age and hospitalisations were recorded for invasive pneumococcal disease (IPD), meningitis, sepsis, pneumonia and otitis media. Hospitalisations for upper- and lower respiratory tract infections (URTI, LRTI) were used as comparators. The 2005-2010 birth-cohorts were defined as vaccine non-eligible cohorts (VNEC) and 2011-2015 birth-cohorts as vaccine eligible cohorts (VEC). Incidence rates (IR) were estimated for diagnoses, birth-cohorts and age groups, and incidence rate ratios (IRR) between VNEC and VEC were calculated assuming Poisson variance. Cox regression was used to estimate the hazard ratio (HR) of hospitalisation between VNEC and VEC.
51,264 children were followed for 142,315 person-years, accumulating 1,703 hospitalisations for the respective study diagnoses. Hospitalisations for pneumonia decreased by 20% (HR 0.80, 95%CI:0.67-0.95) despite a 32% increase in admissions for LRTI (HR 1.32, 95%CI:1.14-1.53). Hospital admissions for culture-confirmed IPD decreased by 93% (HR 0.07, 95%CI:0.01-0.50) and no hospitalisations for IPD with vaccine-type pneumococci were observed in the VEC. Hospitalisations for meningitis and sepsis did not change. A decrease in hospital admissions for otitis media was observed, but did not coincide with PHiD-CV introduction.
Following the introduction of PHiD-CV in Iceland, hospitalisations for pneumonia and culture confirmed IPD decreased. Admissions for other LRTIs and URTIs increased during this period.
肺炎球菌是一种重要的呼吸道病原体。10 价肺炎球菌结合疫苗（PHiD-CV）于 2011 年被引入冰岛免疫接种计划。目的是评估 PHiD-CV 对儿科呼吸道感染和侵袭性疾病住院的影响。
对 2005-2015 年出生队列进行了随访，直至 3 岁，并记录了侵袭性肺炎球菌病（IPD）、脑膜炎、败血症、肺炎和中耳炎的住院情况。上呼吸道感染（URTI）和下呼吸道感染（LRTI）的住院情况作为对照。2005-2010 年出生队列被定义为疫苗非合格队列（VNEC），2011-2015 年出生队列为疫苗合格队列（VEC）。对诊断、出生队列和年龄组的发病率（IR）进行了估计，并假设泊松方差计算了 VNEC 和 VEC 之间的发病率比（IRR）。使用 Cox 回归估计 VNEC 和 VEC 之间的住院风险比（HR）。
51264 名儿童随访 142315 人年，累计发生 1703 例相应研究诊断的住院病例。尽管 LRTI 的住院人数增加了 32%（HR 1.32，95%CI：1.14-1.53），但肺炎的住院人数减少了 20%（HR 0.80，95%CI：0.67-0.95）。培养证实的 IPD 的住院人数减少了 93%（HR 0.07，95%CI：0.01-0.50），且 VEC 中未观察到疫苗型肺炎球菌引起的 IPD 住院病例。脑膜炎和败血症的住院人数没有变化。观察到中耳炎住院人数减少，但与 PHiD-CV 的引入并不相符。
冰岛引入 PHiD-CV 后，肺炎和培养证实的 IPD 的住院人数减少。在此期间，其他 LRTIs 和 URTIs 的住院人数增加。
