title: Impact of the use of heptavalent pneumococcal conjugate vaccine on disease epidemiology in children and adults.
abstract: Pneumococcal conjugate vaccine was introduced for routine use in infants and toddlers in the United States in March 2000. We report on the impact of the introduction of this vaccine on disease epidemiology in young children as well as secondary effects due to herd immunity in unvaccinated children and adults. As of March 2003, 157,471 children had received one or more doses of PNCV7, but only 24% of those less than two years of age received all four doses as a result of shortages of vaccine. During the last year of observation, no cases of vaccine serotype disease were seen in children less than one year of age compared with an incidence ranging between 51.5 and 98.2 cases/100,000 person years (16-34 cases per year) in the years before vaccine introduction. Similar reductions were seen in children less than five years of age. There was no evidence of any concomittant increase in pneumococcal disease caused by non-vaccine serotypes. High-level resistance of pneumococci to penicillin fell from a peak of 15% in year 2000 to 5% in the first half of 2003.
authors.affiliation: Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16th floor, Oakland, CA 94612, USA. steve.black@kp.org
authors.forename: Steven
authors.initials: S
authors.lastname: Black
authors.forename: Henry
authors.initials: H
authors.lastname: Shinefield
authors.forename: Roger
authors.initials: R
authors.lastname: Baxter
authors.forename: Robert
authors.initials: R
authors.lastname: Austrian
authors.forename: Laura
authors.initials: L
authors.lastname: Elvin
authors.forename: John
authors.initials: J
authors.lastname: Hansen
authors.forename: Edwin
authors.initials: E
authors.lastname: Lewis
authors.forename: Bruce
authors.initials: B
authors.lastname: Fireman
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D015994:Incidence; D007223:Infant; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D014481:United States / Q000453:epidemiology
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines