title: The epidemiology of childhood pneumococcal disease in the United States in the era of conjugate vaccine use.
abstract: In 2000, a heptavalent pneumococcal conjugate vaccine was licensed and included in the schedule of routine childhood immunizations in the United States. The vaccine contains the serotypes most commonly associated with invasive and noninvasive pneumococcal infection in children and the serotypes most commonly expressing antibiotic resistance. Since the introduction of the vaccine, the incidence of invasive pneumococcal disease has declined dramatically in the United States, particularly among children younger than 2 years of age. The incidences of pneumonia and acute otitis media also have declined, but less substantially. Several factors may blunt the future effectiveness of the vaccine, however, particularly the emergence of noninvaccine pneumococcal serotypes and the propensity for pathogenic pneumococci to switch their capsular types, evading vaccine-conferred immunity.
authors.affiliation: Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH 44102, USA. pxt2@case.edu
authors.forename: Philip
authors.initials: P
authors.lastname: Toltzis
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jacobs
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D016667:Bacterial Capsules / Q000276:immunology; D002675:Child, Preschool; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007223:Infant; D022401:Meningococcal Vaccines / Q000276:immunology*; D010033:Otitis Media / Q000453:epidemiology / Q000382:microbiology; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000276:immunology; D014481:United States / Q000453:epidemiology; D018074:Vaccines, Conjugate
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate