Hayley Hughes1, Edward F. Mitchel
2, Richard Barth
3, Peter G. Szilagyi
4, Ben Schwartz
5, Kathryn M. Edwards
6, and Marie R. Griffin
6. (1) National Immunization Program/Epidemiology and Surveillance Division, Centers for Disease Control and Prevention, 1600 Clifton Road, NE MS-E61, Atlanta, GA, USA, (2) Vanderbilt University Medical Center, Vanderbilt University, A-1124 MCN, Nashville, TN, USA, (3) University of Rochester of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Box 632, Rochester, NY, USA, (4) University of Rochester of Medicine and Dentistry, Division of General Pediatrics, University of Rochester, 601 Elmwood Avenue, Box 632, Rochester, NY, USA, (5) NIP, ESD, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA, USA, (6) Vanderbilt University Medical Center, Preventive Medicine, Vanderbilt University, A-1124 MCN, Nashville, TN, USA
KEYWORDS:
pneumococcal conjugate vaccine, outcomes, population
BACKGROUND:
Pre-licensure trials indicate that pneumococcal conjugate vaccine (PCV) will decrease the incidence of pneumonia, otitis media, and invasive pneumococcal disease. PCV may have broader effects, reducing use of diagnostic procedures and antibiotics.
OBJECTIVE(S):
Describe medical care associated with pneumococcal disease in children aged <2 years enrolled in the Tennessee Medicaid Program (1995-1999) or Blue Cross/Blue Shield of Rochester, NY insurance plan (1998-1999) in order to provide baseline rates for evaluation of the impact of PCV, licensed February 2000 and recommended for routine use.
METHOD(S):
Computerized insurance databases were used to ascertain the number of medical care visits and associated diagnoses classified as pneumococcal (invasive pneumococcal or pneumococcal pneumonia) or other acute respiratory illness (invasive bacterial, pneumonia, otitis media, and others). In addition specific procedure codes and antibiotic prescriptions potentially associated with acute respiratory illnesses were identified.
RESULT(S):
For every 1000 children aged <2 years enrolled in Tennessee Medicaid there was an average annual rate of 0.9 hospitalizations, 0.3 emergency department visits, and 1.4 other outpatient visits coded as pneumococcal disease, and 103 hospitalizations, and 500 emergency department visits and 2989 other outpatient visits for other acute respiratory conditions. In addition, there were 634 chest x-rays, 34 tympanostomy tubes placed, 45 blood cultures, 25 lumbar punctures and 2986 antibiotic courses per 1000 children. There were no consistent trends in these outcomes over the 5 years. Similar data are available for the Rochester population.
CONCLUSIONS(S):
There is a large burden of illness associated with acute respiratory disease in young children. Future studies will estimate the proportion prevented by PCV using time series analyses, and including years after introduction of vaccine.
LEARNING OBJECTIVES:
Insurance databases can be an important source of information on the impact of new vaccines on specific populations.
See more of Evaluating New Respiratory Vaccines in Children: Results of the New Vaccine Surveillance Network
See more of The 36th National Immunization Conference
