Cynthia G. Whitney1, Monica M. Farley
2, James Hadler
2, Lee H. Harrison
2, Nancy M. Bennett
2, Ruth Lynfield
2, Arthur Reingold
2, Paul R. Cieslak
2, Tamara Pilishvili
1, Delois Jackson
1, Richard R. Facklam
1, James Jorgensen
2, and Anne Schuchat
1. (1) CDC, CDC Mailstop C23, 1600 Clifton Road NE, Atlanta, GA, USA, (2) Emerging Infections Program
KEYWORD1:
Streptococcus pneumoniae, pneumococcus, pneumococcal vaccine, conjugate vaccine, adults, children
BACKGROUND:
In early 2000, a protein-polysaccharide conjugate vaccine targeting seven pneumococcal serotypes was licensed for use in young children in the U.S.
OBJECTIVE:
We sought to measure the effect of vaccine introduction on burden of invasive disease in all age groups.
METHOD:
We examined population-based data from CDC’s Active Bacterial Core Surveillance to evaluate changes in burden of invasive disease, defined as isolation of S. pneumoniae from a normally sterile site. Isolates underwent serotyping and susceptibility testing. Data from seven areas with continuous participation during 1998-2001 (population 16 million) were used to assess trends.
RESULT:
Invasive disease dropped from an average rate of 24.3 cases/100,000 persons in 1998 and 1999 to 17.3/100,000 in 2001. The largest decline was seen in children <2 years. In this group, the rate of disease was 68% lower in 2001 than the average rate in 1998 and 1999 (59.0/100,000 versus 188.0/100,000, p<0.001); disease caused by vaccine and vaccine-related serotypes declined by 79% (p<0.001) and 50% (p<0.001), respectively. Disease rates also fell for adults; compared to baseline, the rate of disease in 2001 was 32% lower for adults 20-39 years (7.6/100,000 in 2001 versus 11.2/100,000 average in 1998 and 1999, p<0.001), 8% lower for persons 40-64 years (19.7/100,000 versus 21.5/100,000, p=0.03), and 18% lower for persons ³65 years (49.5/100,000 versus 60.1/100, p<0.001). Compared to 1999, the rate of disease caused by penicillin-nonsusceptible strains was 35% lower in 2001 (4.1/100,000 versus 6.3/100,000, p<0.001).
CONCLUSION:
Pneumococcal conjugate vaccine is preventing disease in young children, for whom the vaccine is indicated, and in adults. The vaccine provides an effective new tool for reducing disease caused by drug-resistant strains.
LEARNINGOBJECTIVES:
Session attendees will learn the early effect of conjugate vaccine introduction on invasive disease as well as questions that remain.
See more of Overview of Current Issues in Pneumococcal Disease, Pertussis and Anthrax
See more of The 37th National Immunization Conference
