The impact of the pneumococcal conjugate vaccines on the incidence of community-acquired alveolar pneumonia in premature compared with in term-born infants

Yaniv Faingelernt; Ron Dagan; Noga Givon-Lavi; Bart Adriaan van der Beek; Shalom Ben-Shimol; Eilon Shany; David Greenberg

doi:10.1016/j.vaccine.2021.12.025

The impact of the pneumococcal conjugate vaccines on the incidence of community-acquired alveolar pneumonia in premature compared with in term-born infants

Vaccine. 2022 Jan 28;40(4):568-573. doi: 10.1016/j.vaccine.2021.12.025. Epub 2021 Dec 29.

Authors

Yaniv Faingelernt¹, Ron Dagan², Noga Givon-Lavi¹, Bart Adriaan van der Beek³, Shalom Ben-Shimol¹, Eilon Shany⁴, David Greenberg¹

Affiliations

¹ The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel.
² The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: rdagan@bgu.ac.il.
³ The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
⁴ The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Neonatal department Soroka University Medical Center, Beer-Sheva, Israel.

PMID: 34973848
DOI: 10.1016/j.vaccine.2021.12.025

Abstract

Background: Preterm-born children are prone to respiratory infections and complications during infancy and early childhood. In Israel, pneumococcal conjugated vaccines (PCVs) were introduced in 2009-2010, with high vaccination coverage. We assessed the impact of PCV implementation on community-acquired alveolar pneumonia (CAAP) in children < 2 years old born prematurely, in comparison with term born infants.

Methods: We conducted a prospective, active, population-based surveillance of children < 2 years old with radiologically-proven CAAP, visiting the only regional medical center. CAAP incidence in the pre-PCV and post-PCV eras were compared in early premature (29-32 weeks gestational age [WGA]), late premature (33-36 WGA) and term-born infants (>36 WGA).

Results: Of 214,947 births during the study period, 6'791 CAAP episodes were diagnosed; 211, 653 and 5,806 were in early premature, late premature and term infants, respectively. After PCV implementation, overall CAAP visits were reduced by 44% (95% CI 36-51): 60%, 21% and 45% among those born early preterm, late preterm and at term, respectively (statistically significant for children born early preterm and at term). For outpatients, the respective rate reductions were 79%, 40% and 65% (statistically significant for the children born at term). Importantly, the mean annual rates in the post-PCV period became similar in all 3 groups. The rate reductions among the hospitalized children were lower those that among the non-hospitalized children, with reductions of 56%, 16% and 33% for the three groups, respectively (statistically significant for early preterm and at term children).

Conclusions: CAAP reduction trends after PCV implementation for preterm-born infants were similar to those for term-born infants. Whether this was because of similar direct PCV- protection, because of indirect (herd) protection or both, is unclear. Post-PCV implementation, the gaps in CAAP rates between infants born prematurely and at term were reduced.

Keywords: Community-acquired pneumonia, Streptococcus pneumoniae; Pneumococcal vaccine; Premature.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Humans
Incidence
Infant
Infant, Newborn
Pneumococcal Infections*
Pneumococcal Vaccines
Pneumonia*
Pneumonia, Pneumococcal*
Prospective Studies
Vaccines, Conjugate

Substances

Pneumococcal Vaccines
Vaccines, Conjugate