title: Impact of pneumococcal vaccine on hospital admission with lower respiratory infection in children resident in South Auckland, New Zealand.
abstract: OBJECTIVE
  To assess the change in admission rates for all Lower Respiratory Infection (LRI) including pneumonia for children resident in Counties Manukau District Health Board (CMDHB) with the introduction of the Pneumococcal Conjugate Vaccine 7 valent (PCV7) in June 2008.
  
  
  METHODS
  National Minimum dataset ICD10 coded LRI admissions to any NZ hospital August 2001-July 2011 for children <2 year resident in CMDHB were analysed using Poisson regression, omitting 1 August 2008 to 31 July 2009, the first-year post vaccine introduction.
  
  
  RESULTS
  Pneumonia but not bronchiolitis admissions have been declining since 2001. Pneumonia admissions decreased significantly after PCV7 introduction (incidence risk ratio (IRR) (95% CI) 1.51 (1.08-1.77), additional to the gradual decline since 2001. There was significant decline for Pacific children post PCV7 introduction IRR 1.70(1.39, 2.07) but not for Maori children, IRR 1.05 (0.78-1.40). Maori and Pacific children are at increased risk of admission with LRI compared to European children (relative risk (RR) (95%CI) 4.6 (4.3-5.0) and 5.0(3.7-5.3) respectively) as are those living in Decile 9, 10 compared with those from other deciles, RR 1.43 (1.36-1.50).
  
  
  CONCLUSIONS
  The introduction of PCV7 is associated with reduced admissions for pneumonia in young children yet there has been less impact for Maori in CMDHB.
authors.affiliation: Middlemore Hospital, Private Bag 93311, Otahuhu, Manukau 1640, Auckland, New Zealand. Adrian.Trenholme@middlemore.co.nz.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Vogel
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Trenholme
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Stewart
authors.forename: Emma
authors.initials: E
authors.lastname: Best
authors.forename: Charissa
authors.initials: C
authors.lastname: McBride
authors.forename: Diana R
authors.initials: DR
authors.lastname: Lennon
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011014:Pneumonia / Q000453:epidemiology / Q000276:immunology*; D012141:Respiratory Tract Infections / Q000150:complications / Q000276:immunology*; D018570:Risk Assessment; D018074:Vaccines, Conjugate / Q000008:administration & dosage
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate