title: The impact of conjugate pneumococcal vaccination on routine childhood vaccination and primary care use in 2 counties.
abstract: BACKGROUND
  Pneumococcal conjugate vaccine immunization recommendations were rapidly implemented by primary care providers. Before the recommendations, concern was expressed that adding pneumococcal conjugate vaccine might result in delays in other vaccinations or preventive services.
  
  
  OBJECTIVE
  The study objectives were to measure whether incorporation of pneumococcal conjugate vaccine by primary care providers delayed other vaccinations or added primary health care visits.
  
  
  METHODS
  In 2 counties surrounding Rochester and Nashville, we reviewed a representative sample of primary care charts for children born before and after licensure of pneumococcal conjugate vaccine. Receipt of vaccinations and health care visits were compared for the 2 age-matched cohorts.
  
  
  RESULTS
  We reviewed 1459 records from Rochester and 1857 records from Nashville. The pre-pneumococcal conjugate vaccine and post-pneumococcal conjugate vaccine cohorts had similar demographic characteristics. The median age for receipt of any vaccination was not older for the postvaccine cohort than for the prevaccine cohort in either community. The percentage of children up-to-date for vaccinations by 18 months for postvaccine versus prevaccine cohorts was similar in Rochester (72% in each cohort) and in Nashville (58% postvaccine and 65% prevaccine). The number of well-child care visits or other health care visits during the first 18 months of life was not statistically different between the 2 cohorts.
  
  
  CONCLUSIONS
  Implementation of pneumococcal conjugate vaccine was not associated with delays in other childhood vaccinations or more primary care visits.
authors.affiliation: Department of Pediatrics, Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA. peter_szilagyi@urmc.rochester.edu
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
authors.forename: Marie R
authors.initials: MR
authors.lastname: Griffin
authors.forename: Laura P
authors.initials: LP
authors.lastname: Shone
authors.forename: Richard
authors.initials: R
authors.lastname: Barth
authors.forename: Yuwei
authors.initials: Y
authors.lastname: Zhu
authors.forename: Stanley
authors.initials: S
authors.lastname: Schaffer
authors.forename: Sandra
authors.initials: S
authors.lastname: Ambrose
authors.forename: Jason
authors.initials: J
authors.lastname: Roy
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Poehling
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Walker
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schwartz
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014611:Vaccination / Q000706:statistics & numerical data*; D018074:Vaccines, Conjugate / Q000627:therapeutic use*
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate