The 7- and 13-valent pneumococcal conjugate vaccines significantly decreased risk for hospitalization due to sinusitis or pneumonia among Swedish children aged younger than 2 years, according to study findings.
To assess the impact of PCV7 (Prevnar 7, Pfizer) and PCV13 (Prevnar 13, Pfizer) introduction on hospitalization for sinusitis, pneumonia and empyema, researchers analyzed hospital discharge diagnoses for children in Stockholm County in Sweden between July 2003 and June 2012.
During the study period, 678 children aged younger than 18 years were discharged from the hospital with a sinusitis diagnosis.
Prior to introduction of PCV7, children aged younger than 2 years had an incidence rate for sinusitis hospitalization of 70 per 100,000 person-years. This rate decreased to 24 hospitalizations per 100,000 person-years following the introduction of PCV7, considered the post-vaccination period (P=.06).
One year after PCV7 was introduced, children aged <2 years and children aged 2 to 5 years experienced a significant month-to-month decrease in incidence rates for sinusitis hospitalizations (P=.018 and P=.004, respectively). There was no change in sinusitis hospitalization incidence rates among children aged 5 to 18 years.
Of the 5,018 children diagnosed with pneumonia during the study period, 41% were aged younger than 2 years and 31% were aged 2 to 5 years.
Pneumonia hospitalization incidence rates significantly decreased from 450 hospitalizations per 100,000 person-years prior to PCV7 to 366 per 100,000 person-years (P<.001) among children aged younger than 2 years. Children aged 2 to 5 years also experience a decrease in pneumonia hospitalization incidence rates (P=.002). Children older than 5 years maintained incidence rates for pneumonia hospitalizations.
Incidence rates of empyema among children aged <2 years increased after the introduction of PCV7, but the change was not statistically significant: 4.4 vs. 2.5 hospitalizations per 100,000 person-years (RR=1.78; 95% CI, 0.55-6.63; P=.42).
Incidence rates for RSV infection and viral pneumonia hospitalizations significantly increased among children aged <2 years between the pre-PCV7 period (RR=1.37; 95% CI, 1.29-1.46; P<.001) and post-PCV7 period (RR=1.46; 95% CI, 1.08-1.97; P=.01).
“This study adds evidence that PCV vaccine (PCV7 and PCV13) prevents severe sinusitis and pneumonia, with implications for global child survival,” the researchers wrote. “Specifically, we are the first to show great effectiveness against sinusitis in children aged <5 years.”
Disclosure: Lindstrand reports financial relationships with GlaxoSmithKline and Pfizer.