Effectiveness of 7-valent pneumococcal conjugate vaccine against radiologically diagnosed pneumonia in indigenous infants in Australia

O’Grady, K. F., Carlin, J. B., Chang, A. B., Torzillo, P. J., Nolan, T. M., Ruben, A. and Andrews, R. M. (2010) Effectiveness of 7-valent pneumococcal conjugate vaccine against radiologically diagnosed pneumonia in indigenous infants in Australia. World Health Organization. Bulletin, 88 2: 139-146. doi:10.2471/BLT.09.068239


Author O’Grady, K. F.
Carlin, J. B.
Chang, A. B.
Torzillo, P. J.
Nolan, T. M.
Ruben, A.
Andrews, R. M.
Title Effectiveness of 7-valent pneumococcal conjugate vaccine against radiologically diagnosed pneumonia in indigenous infants in Australia
Journal name World Health Organization. Bulletin   Check publisher's open access policy
ISSN 0042-9686
0043-9686
Publication date 2010-02
Sub-type Article (original research)
DOI 10.2471/BLT.09.068239
Open Access Status DOI
Volume 88
Issue 2
Start page 139
End page 146
Total pages 8
Place of publication Geneva, Switzerland
Publisher World Health Organization
Language eng
Formatted abstract
Objective
To evaluate the effectiveness of the 7-valent pneumococcal conjugate vaccine (PCV7) in preventing pneumonia, diagnosed radiologically according to World Health Organization (WHO) criteria, among indigenous infants in the Northern Territory of Australia.

Methods

We conducted a historical cohort study of consecutive indigenous birth cohorts between 1 April 1998 and 28 February
2005. Children were followed up to 18 months of age. The PCV7 programme commenced on 1 June 2001. All chest X-rays taken within 3 days of any hospitalization were assessed. The primary endpoint was a first episode of WHO-defined pneumonia requiring hospitalization. Cox proportional hazards models were used to compare disease incidence.

Findings

There were 526 pneumonia events among 10 600 children – an incidence of 3.3 per 1000 child-months; 183 episodes (34.8%) occurred before 5 months of age and 247 (47.0%) by 7 months. Of the children studied, 27% had received 3 doses of vaccine by 7 months of age. Hazard ratios for endpoint pneumonia were 1.01 for 1 versus 0 doses; 1.03 for 2 versus 0 doses; and 0.84 for 3 versus 0 doses.

Conclusion

There was limited evidence that PCV7 reduced the incidence of radiologically confirmed pneumonia among Northern Territory indigenous infants, although there was a non-significant trend towards an effect after receipt of the third dose. These findings might be explained by lack of timely vaccination and/or occurrence of disease at an early age. Additionally, the relative contribution of vaccine-type pneumococcus to severe pneumonia in a setting where multiple other pathogens are prevalent may differ with respect to other settings where vaccine efficacy has been clearly established.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Clinical Medical Virology Centre Publications
 
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Created: Tue, 20 Sep 2011, 15:00:00 EST by Dr Kerry-ann O'grady on behalf of Child Health Research Centre