期刊
THORAX
卷 73, 期 3, 页码 262-269出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/thoraxjnl-2017-210440
关键词
pneumonia; bacterial infection; respiratory infection; empyema
资金
- National Institute for Health and Welfare (THL)
- Health Sciences, Faculty of Social Sciences, University of Tampere, Finland
- Integrated Monitoring of Vaccine in Europe (I-MOVE+) project from European Union [634446]
Introduction Limited data are available on population-level herd effects of infant 10-valent pneumococcal conjugate vaccine (PCV10) programmes on pneumonia. We assessed national trends in pneumococcal and all-cause pneumonia hospitalisations in adults aged 18 years, before and after infant PCV10 introduction in 2010. Methods Monthly hospitalisation rates of International Statistical Classification of Diseases, 10th revision (ICD-10)-coded primary discharge diagnoses compatible with pneumonia from 2004-2005 to 2014-2015 were calculated with population denominators from the population register. Trends in pneumonia before and after PCV10 introduction were assessed with interrupted time-series analysis. Rates during the PCV10 period were estimated from adjusted negative binomial regression model and compared with those projected as continuation of the pre-PCV10 trend. All-cause hospitalisations were assessed for control purposes. Results Before PCV10, the all-cause pneumonia rate in adults aged >= 18 years increased annually by 2.4%, followed by a 4.7% annual decline during the PCV10 period. In 2014-2015, the overall all-cause pneumonia hospitalisation rate was 109.3/100 000 (95% CI 96.5 to 121.9) or 15.4% lower than the expected rate. A significant 6.7% decline was seen in persons aged >= 65 years (131.5/100 000), which translates to 1456 fewer pneumonia hospitalisations annually. In comparison, hospitalisations other than pneumonia decreased by 3.5% annually throughout the entire study period. Conclusion These national data suggest that herd protection from infant PCV10 programme has reversed the increasing trend and substantially decreased all-cause pneumonia hospitalisations in adults, particularly the elderly.
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