Impact of 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) on childhood pneumonia hospitalizations in Brazil two years after introduction

Marcelo Comerlato Scotta; Tiago Neves Veras; Paula Colling Klein; Virgínia Tronco; Fernando P Polack; Rita Mattiello; Paulo M C Pitrez; Marcus H Jones; Renato T Stein; Leonardo A Pinto

doi:10.1016/j.vaccine.2014.06.042

Impact of 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) on childhood pneumonia hospitalizations in Brazil two years after introduction

Vaccine. 2014 Jul 31;32(35):4495-4499. doi: 10.1016/j.vaccine.2014.06.042. Epub 2014 Jun 21.

Authors

Affiliations

¹ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: [email protected].
² Jeser Amarante Faria Children's Hospital, Araranguá Street, 554, Joinville 89204-310, SC, Brazil. Electronic address: [email protected].
³ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil. Electronic address: [email protected].
⁴ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil. Electronic address: [email protected].
⁵ Fundacion INFANT, Gavilán 94, (C1234BAA), Ciudad de Buenos Aires, Argentina; Vanderbilt University, 2201 West End Ave, Nashville 37235, TN, USA; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: [email protected].
⁶ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: [email protected].
⁷ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: [email protected].
⁸ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: [email protected].
⁹ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil; Aliança Infant, Argentina-Brasil (Comprises partnership between institutions "a" and "c"). Electronic address: [email protected].
¹⁰ Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil. Electronic address: [email protected].

PMID: 24958703
DOI: 10.1016/j.vaccine.2014.06.042

Abstract

Introduction: Pneumococcal disease is a major public health problem worldwide. From March to September of 2010, 10-valent pneumococcal non-typeable Haemophilus influenzae protein conjugate vaccine (PHiD-CV) was introduced in the Brazilian childhood National Immunization Program (NIP) in all 27 Brazilian states. The aim of the present study is to report national time-trends in incidence of hospital admissions for childhood pneumonia in Brazil before and after two years of introduction of this new pneumococcal conjugate vaccine.

Methods: Analysis of hospitalization data of children aged 0-4 years in Brazilian public health system with an admission diagnosis of pneumonia from 2002 to 2012 was performed comparing pre (2002-2009) and post-vaccination periods (2011-2012). Hospital number of admission due to pneumonia and all non-respiratory diseases were obtained from DATASUS, the Brazilian government open-access public health database system. Incidence of pneumonia hospitalization was compared to incidence of all non-respiratory admissions.

Results: Admission rates for pneumonia decreased steadily from 2010 to 2012. In children aged less than four years, incidence of pneumonia hospitalizations decreased 12.65% when pre (2002-2009) and post-vaccination introduction periods (2011-2012) were compared and adjusted for seasonality and secular-trend (p<0.001). On the other hand, non-respiratory admission rates remained stable comparing both periods (p=0.39).

Conclusion: Childhood pneumonia hospitalization rates were fluctuating prior to 2010 and decreased significantly in the two years after PHiD-CV introduction. Conversely, rate of non-respiratory admissions has shown no decrease. These data are an evidence of the effectiveness and public health impact of this new pneumococcal vaccine.

Keywords: Brazil; Child; Conjugate vaccines; Hospitalization; Pneumococcal vaccines; Pneumonia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brazil / epidemiology
Child, Preschool
Female
Haemophilus Infections / immunology
Haemophilus Infections / prevention & control*
Health Policy
Hospitalization / statistics & numerical data*
Humans
Immunization Programs
Incidence
Infant
Infant, Newborn
Male
Pneumococcal Vaccines / administration & dosage
Pneumococcal Vaccines / immunology*
Pneumonia, Pneumococcal / immunology
Pneumonia, Pneumococcal / prevention & control*
Retrospective Studies

Substances

PHiD-CV vaccine
Pneumococcal Vaccines