title: Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel.
abstract: Postlicensure surveillance of pneumonia incidence can be used to estimate whether pneumococcal conjugate vaccines (PCVs) affect incidence. We used Poisson regression models that control for baseline seasonality to determine the impact of PCVs and the possible effects of variations in virus activity in Israel on these surveillance estimates. PCV was associated with significant declines in radiologically confirmed alveolar pneumonia (RCAP) among patients <6 months, 6-17 months, and 18-35 months of age (-31% [95% CI -51% to -15%], -41% [95% CI -52 to -32%], and -34% [95% CI -42% to -25%], respectively). Respiratory syncytial virus (RSV) activity was associated with strong increases in RCAP incidence, with up to 44% of cases attributable to RSV among infants <6 months of age and lower but significant impacts in older children. Seasonal variations, particularly in RSV activity, masked the impact of 7-valent PCVs, especially for young children in the first 2 years after vaccine introduction.
authors.affiliation: Yale School of Public Health, New Haven,Connecticut 06520-8034, USA. daniel.weinberger@yale.edu
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Weinberger
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
authors.forename: Yonat
authors.initials: Y
authors.lastname: Shemer-Avni
authors.forename: Jacob
authors.initials: J
authors.lastname: Bar-Ziv
authors.forename: Wladimir J
authors.initials: WJ
authors.lastname: Alonso
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
mesh_terms: D002675:Child, Preschool; D062665:Epidemiological Monitoring; D006801:Humans; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D015233:Models, Statistical; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D016012:Poisson Distribution; D011650:Pulmonary Alveoli / Q000821:virology; D011859:Radiography; D012044:Regression Analysis; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology*; D012621:Seasons; D018074:Vaccines, Conjugate
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Israel; RSV; alveolar pneumonia; influenza; pneumococcal conjugate vaccines; pneumonia; regression model; respiratory syncytial virus; surveillance; viruses