title: Hospitalizations for pneumonia, invasive diseases and otitis in Tuscany (Italy), 2002-2014: Which was the impact of universal pneumococcal pediatric vaccination?
abstract: Streptococcus pneumoniae is the main causative organism of acute media otitis in children and meningitis and bacterial pneumonia in the community. Since 2008 in Tuscany, central Italy, the pneumococcal conjugate vaccine (7-valent vaccine, switched to 13-valent vaccine in 2010) was actively offered free of charge to all newborns. Aim of the study is to evaluate the impact of pneumococcal pediatric vaccination in the Tuscan population on hospitalizations potentially caused by S. pneumoniae, during pre-vaccination (PVP, 2002-2007) and vaccination period (VP, 2009-2014). We analyzed hospital discharge records (HDRs) of all hospitals in Tuscany from 2002 to 2014. Hospitalizations potentially due to pneumococcal diseases were 347, 221. The general hospitalization rate was 716/100,000 inhabitants during PVP and 753/100,000 in VP, with a decrease of 29.1% in the age-group 0-9 y ("target" of the vaccination program) and an increase of 75.7% in subjects >64 y of age. During VP, admission days and hospitalization costs increased (6.2% and 24.2%, respectively), especially in patients >64 y (12.9% and 33.8%, respectively); in children <10 y decreased by 21.2% and 12.8%, respectively. The pneumococcal pediatric vaccination resulted in the decrease of hospitalizations in younger but the expected indirect effect in the elderly was not reported, justifying the Tuscan recommendation to extend the vaccination to subjects > 64 y.
authors.affiliation: a Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Boccalini
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Ornella
authors.initials: O
authors.lastname: Varone
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Chellini
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pieri
authors.affiliation: b Specialization Medical School of Hygiene and Preventive Medicine, University of Florence , Florence , Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Sala
authors.affiliation: a Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Berardi
authors.affiliation: a Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonanni
authors.affiliation: a Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bechini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology* / Q000517:prevention & control; D013296:Streptococcus pneumoniae; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines
keywords: Italy; PCV13; PCV7; hospitalization; pneumococcal diseases; vaccination