title: A current and historical perspective on disparities in US childhood pneumococcal conjugate vaccine adherence and in rates of invasive pneumococcal disease: Considerations for the routinely-recommended, pediatric PCV dosing schedule in the United States.
abstract: Previous research has suggested that reducing the US 4-dose PCV13 schedule to a 3-dose schedule may provide cost savings, despite more childhood pneumococcal disease. The study also stressed that dose reduction should be coupled with improved PCV adherence, however, US PCV uptake has leveled-off since 2008. An estimated 24-36% of US children aged 5-19 months are already receiving a reduced PCV schedule (i.e., missing ≥1 dose). This raises a practical concern that, under a reduced, 3-dose schedule, a similar proportion of children may receive ≤2 doses. It is also unknown if a reduced, 3-dose PCV schedule in the United States will afford the same disease protection as 3-dose schedules used elsewhere, given lower US PCV adherence. Finally, more assurance is needed that, under a reduced schedule, racial, socioeconomic, and geographic disparities in PCV adherence will not correspond with disproportionately higher rates of pneumococcal disease among poor or minority children.
authors.affiliation: a Pfizer Vaccines ; New York , NY USA.
authors.forename: John M
authors.initials: JM
authors.lastname: McLaughlin
authors.affiliation: a Pfizer Vaccines ; New York , NY USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Utt
authors.affiliation: a Pfizer Vaccines ; New York , NY USA.
authors.forename: Nina M
authors.initials: NM
authors.lastname: Hill
authors.affiliation: a Pfizer Vaccines ; New York , NY USA.
authors.forename: Verna L
authors.initials: VL
authors.lastname: Welch
authors.affiliation: a Pfizer Vaccines ; New York , NY USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Power
authors.affiliation: a Pfizer Vaccines ; New York , NY USA.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Sylvester
mesh_terms: D002675:Child, Preschool; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D055118:Medication Adherence; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D014481:United States / Q000453:epidemiology; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: pneumococcal conjugate vaccine (PCV), adherence, coverage, dosing schedule, disparities, race, minorities, socioeconomic status, pneumococcal disease, 2+1, 3+1