title: Early impact of 10-valent pneumococcal conjugate vaccine in childhood pneumonia hospitalizations using primary data from an active population-based surveillance.
abstract: BACKGROUND
  In Brazil, 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in 2010 in the childhood routine immunization program. We used primary data to evaluate the effect of PCV10 on the reduction of hospital admissions due to community-acquired pneumonia (CAP).
  
  
  METHODS
  Active population-based surveillance studies on pneumonia hospitalizations in children aged <36 months were conducted before and after PCV10 introduction in Central Brazil. The surveillances comprised all 17 pediatric hospitals of the study area, which provide assistance for public and private health insurances. Linear regression was performed to detect any trend in pneumonia monthly rates previously to vaccine introduction. PCV10 post-vaccination impact (Nov/2011 to Oct/2013) on clinical and X-Ray confirmed pneumonia was estimated as the relative and the absolute reduction (prevented burden) in pneumonia admission rates, taking as baseline the pre-vaccination period (May/2007 to Apr/2009).
  
  
  RESULTS
  Overall, males presented higher rates of pneumonia hospitalization, compared to females. The relative rate reduction for clinical and X-Ray confirmed pneumonia was 13.1%, and 25.4%, respectively for children aged 2-23 months. The highest prevented burden was observed in age-groups 2-11 months, respectively 853/100,000 (from 6788/100,000 to 5935/100,000), and 729/100,000 (from 2871/100,000 to 2142/100,000), for clinical and X-Ray confirmed pneumonia.
  
  
  CONCLUSIONS
  This study provides evidence for the impact of PCV10 in clinical and X-Ray confirmed pneumonia in routine vaccination program in Brazil, after 3 years of vaccine introduction. Extended follow-up studies should confirm the benefit of vaccination through herd effect given the high burden of pneumonia in our setting.
authors.affiliation: Department of Tropical Medicine and Dermatology, Federal University of Goiás, Goiânia, Goiás, Brazil; Department of Medicine, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil. Electronic address: sasgambatti@gmail.com.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Sgambatti
authors.affiliation: Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Ruth
authors.initials: R
authors.lastname: Minamisava
authors.affiliation: Department of Community Health, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Ana Luiza
authors.initials: AL
authors.lastname: Bierrenbach
authors.affiliation: Department of Community Health, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Cristiana Maria
authors.initials: CM
authors.lastname: Toscano
authors.affiliation: Department of Nursing, Pontifical Catholic University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: Vieira
authors.affiliation: Department of Community Health, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Policena
authors.affiliation: Department of Community Health, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Ana Lucia
authors.initials: AL
authors.lastname: Andrade
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000517:prevention & control*; D011159:Population Surveillance; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: C586648:10-valent pneumococcal conjugate vaccine; D022242:Pneumococcal Vaccines
keywords: Children; Community-acquired pneumonia; Hospitalization; Pneumococcal vaccine; Pneumonia surveillance; Vaccine impact