Rosalyn Singleton1, Jay Butler
2, Thomas Hennessy
2, Deborah Hurlburt
2, Lisa Bulkow
2, Debra Parks
2, and Alan Parkinson
2. (1) Alaska Native Tribal Health Consortium, Arctic Investigations Program - Centers for Disease Control, 4055 Tudor Centre Dr, Anchorage, USA, (2) Centers for Disease Control, National Centers for Infectious Dis, Arctic Investigations Program - Centers for Disease Control, 4055 Tudor Centre Dr, Anchorage, AK, USA
KEYWORDS:
Alaska Native
pneumococcal
vaccine
BACKGROUND:
Alaska Native children are disproportionately affected by invasive pneumococcal disease (IPD) with rates of infection more than 3-fold higher than non-Native Alaskans. Pneumococcal conjugate vaccine (PCV-7) became available in Alaska for routine infant immunization through a statewide program in January 2001.
OBJECTIVE:
To compare IPD case counts and the proportion of disease caused by PCV-7 vaccine serotypes during 1999-2000 with those from 2001 – October 31, 2002, after utilization of PCV-7 vaccine.
METHOD:
Vaccine coverage for Alaska Native children was determined from computerized records at state and tribal health facilities. Pneumococcal isolates from normally sterile body sites were received by CDC from all clinical labs in Alaska as part of ongoing surveillance.
RESULT:
By October 2002, 70% of Alaska Natives aged 3-15 months and 39% of children aged 16-27 months had received age-appropriate vaccination with PCV-7. Among children aged < 2 years, annual rates of IPD/100,000 persons declined from 358.9 in 1999-2000 to 33.9 in 2001-02 for PCV-7 serotypes (p<0.001) while rates for other serotypes remained stable (73.9 and 67.8, respectively). Seven cases occurred in children aged < 2 years who received ³1 dose of PCV-7; only one of these infections was caused by a PCV-7 serotype (19F). The proportion of cases caused by PCV-7 serotypes declined from 83% to 33% (p=.006) among children aged <2 years; and declined from 76% to 20% (p=.039) for children 2-17 years; but did not change for adults >17 years (23 and 30% respectively).
CONCLUSION:
Despite vaccine shortage, rates of IPD caused by PCV-7 serotypes among Alaska Natives aged <2 years declined by 90% during the first 22 months of a statewide program for infant immunization. A decline in PCV-7 serotypes in older children suggests indirect benefits of vaccine (herd immunity); however, a similar decline in the proportion of cases caused by PCV-7 serotypes was not observed among adults.
LEARNING OBJECTIVES:
Demonstrate the impact of PCV-7 vaccination on pneumococcal disease rates in Alaska Native children.
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