Title :

Long-term association of 13-valent pneumococcal conjugate vaccine implementation with rates of community-acquired pneumonia in children

Author(s) :

Ouldali, Naim [Auteur]
Levy, Corinne [Auteur]
Minodier, Philippe [Auteur]
Morin, Laurence [Auteur]
Biscardi, Sandra [Auteur]
Aurel, Marie [Auteur]
Dubos, Francois [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Dommergues, Marie-Aliette [Auteur]
Mezgueldi, Ellia [Auteur]
Levieux, Karine [Auteur]
Madhi, Fouad [Auteur]
Hees, Laure [Auteur]
Craiu, Irina [Auteur]
Gras-Le Guen, Christele [Auteur]
Launay, Elise [Auteur]
Zenkhri, Ferielle [Auteur]
Lorrot, Mathie [Auteur]
Gillet, Yves [Auteur]
Bechet, Stéphane [Auteur]
Hau, Isabelle [Auteur]
Martinot, Alain [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Varon, Emmanuelle [Auteur]
Angoulvant, François [Auteur]
Cohen, Robert [Auteur]

Journal title :

JAMA pediatrics

Abbreviated title :

JAMA Pediatr

Publication date :

2019-02-04

ISSN :

2168-6211

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

In several countries, 5 years after 13-valent pneumococcal conjugate vaccine (PCV13) implementation, serotype replacement has been reported for invasive pneumococcal disease, which raises concerns about the long-term outcome ...
Show more >In several countries, 5 years after 13-valent pneumococcal conjugate vaccine (PCV13) implementation, serotype replacement has been reported for invasive pneumococcal disease, which raises concerns about the long-term outcome of PCV13 implementation. The long-term effect of vaccination on community-acquired pneumonia (CAP) remains unknown. To assess the long-term outcome of PCV13 implementation on CAP in children. This quasi-experimental, population-based, interrupted time-series analysis was based on a prospective multicenter study conducted from June 2009 to May 2017 in 8 French pediatric emergency departments. All patients 15 years and younger with chest radiography-confirmed CAP were included. Community-acquired pneumonia. The number of CAP cases per 1000 pediatric emergency department visits over time, analyzed using a segmented regression model, adjusted for influenza-like illness syndromes. We enrolled 12 587 children with CAP, including 673 cases of CAP with pleural effusion (5.3%), 4273 cases of CAP requiring hospitalization (33.9%), 2379 cases of CAP with high inflammatory biomarkers (18.9%), and 221 cases of proven pneumococcal CAP (1.8%). The implementation of PCV13 in 2010 was followed by a sharp decrease in the frequency of CAP (-0.8% per month [95% CI, -1.0% to -0.5% per month]), from 6.3 to 3.5 cases of CAP per 1000 pediatric emergency department visits until May 2014, then a slight increase since June 2014 (0.9% per month [95% CI, 0.4%-1.4% per month]), until 3.8 cases of CAP per 1000 pediatric emergency department visits in May 2017. There were marked immediate decreases in cases of CAP with pleural effusion (-48% [95% CI, -84% to -12%]), CAP requiring hospitalization (-30% [95% CI, -56% to -5%]), and CAP with high inflammatory biomarkers (-30% [95% CI, -54% to -6%]), without any rebound thereafter. The changes associated with PCV13 use 7 years after implementation remain substantial, especially for CAP with pleural effusion, CAP requiring hospitalization, and CAP with high inflammatory biomarkers. Emerging non-PCV13 serotypes may be less likely involved in severe CAP than invasive pneumococcal disease.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T16:48:23Z