Do community-level predictors of pneumococcal carriage continue to play a role in the conjugate vaccine era?

Epidemiol Infect. 2014 Feb;142(2):379-87. doi: 10.1017/S0950268813000794. Epub 2013 Apr 26.

Abstract

This paper examined whether previously identified community-level factors (high proportion of crowded households and/or persons below the poverty level) remained associated with childhood pneumococcal carriage in the heptavalent pneumococcal conjugate vaccine (PCV7) era. Using logistic regression, individual factors were used to develop base models to which community-level factors were added to evaluate impact on pneumococcal carriage within two paediatric study cohorts from Massachusetts (urban Boston, outside Boston). Six years after introduction of universal childhood PCV7 vaccination, we found no consistent evidence that census tract characteristics (e.g. population size and density, age and race distribution, percent participating in group childcare, parental education, percent lacking in-unit plumbing, poverty, and community stability) affected odds of pneumococcal carriage when added to individual predictors (e.g. younger age, current respiratory tract infections, and attendance in group childcare). How community-level factors influence pneumococcal carriage continues to change in the era of increasing immunization coverage.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Boston / epidemiology
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Child, Preschool
  • Family Characteristics
  • Female
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Massachusetts / epidemiology
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines / therapeutic use*
  • Residence Characteristics / statistics & numerical data
  • Vaccines, Conjugate / therapeutic use

Substances

  • Heptavalent Pneumococcal Conjugate Vaccine
  • Pneumococcal Vaccines
  • Vaccines, Conjugate