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Emerg Infect Dis. Invasive Pneumococcal Disease after Routine Pneumococcal Conjugate Vaccination in Children, England and Wales

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  • Emerg Infect Dis. Invasive Pneumococcal Disease after Routine Pneumococcal Conjugate Vaccination in Children, England and Wales

    [Source: Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]
    Research

    Invasive Pneumococcal Disease after Routine Pneumococcal Conjugate Vaccination in Children, England and Wales


    Shamez N. Ladhani, Mary P.E. Slack, Nick J. Andrews, Pauline A. Waight, Ray Borrow, and Elizabeth Miller

    Author affiliations: Author affiliations: Health Protection Services Colindale, London, UK (S.N. Ladhani, M.P.E. Slack, N.J Andrews, P.A Waight, E. Miller); Health Protection Agency, Manchester, UK (R. Borrow)



    Abstract

    We assessed known risk factors, clinical presentation, and outcome of invasive pneumococcal disease (IPD) in children 3?59 months of age after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in England and Wales. During September 2006?March 2010, a total of 1,342 IPD episodes occurred in 1,332 children; 14.9% (198/1,332) had comorbidities. Compared with IPD caused by PCV7 serotypes (44/248; 17.7%), comorbidities were less common for the extra 3 serotypes in the 10-valent vaccine (15/299; 5.0%) but similar to the 3 additional PCV13 serotypes (45/336; 13.4%) and increased for the 11 extra serotypes in 23-valent polysaccharide vaccine (PPV23) (39/186; 21.0%) and non-PPV23 serotypes (38/138; 27.5%). Fifty-two (3.9%) cases resulted from PCV7 failure; 9 (0.7%) case-patients had recurrent IPD. Case-fatality rate was 4.4% (58/1,332) but higher for meningitis (11.0%) and children with comorbidities (9.1%). Thus, comorbidities were more prevalent in children with IPD caused by non-PCV13 serotypes and associated with increased case fatality.
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