What is the role of vaccination in the prevention of pediatric pneumococcal infections?

Updated: Jan 14, 2019
  • Author: Meera Varman, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

The recent inclusion of the pneumococcal conjugate vaccine in the routine pediatric immunization schedule has markedly decreased the incidence of invasive pneumococcal disease. The vaccine is about 50-60% efficacious in reducing otitis media caused by the vaccine strains of S pneumoniae compared with 80-100% in preventing invasive disease. In children younger than 5 years, IPD has decreased from 98.7 cases per 100,000 population in 1998-99 to 23.4 cases per 100,000 population in 2005, with 77% reduction. [6, 7] An increase in serotype 19A from 2.6 cases in 98-99 to 9.3 cases in 2005 has been reported in this age group.

A study by Greenhow et al that retrospectively reviewed 57,733 blood cultures from children 3 to 36 months old reported that the incidence of Streptococcus pneumoniae bacteremia decreased from 74.5 per 100,000 children to 3.5 per 100,000 in the post-PCV-13 period, a 95.3% reduction. [8]  

A study that compared the pneumococcal prevaccination period of 2005-2008 to 2014 reported that incidence of otitis media decreased from 41.5% in children < 5 and 20.9% in children >5. The study also reported significant reductions in sinusitis and other upper respiratory tract infections and a decreased incidence of pneumonia by 28.6% in children < 5. [48]


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