Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis
Summary: Background: In October, 2012, Fiji introduced routine infant immunisation with a ten-valent pneumococcal conjugate vaccine (PCV10) using three primary doses and no booster dose (3 + 0 schedule). Data are scarce for the effect of PCV in the Asia and Pacific region. We aimed to evaluate the...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-01-01
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| Series: | The Lancet Global Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214109X20304216 |
| _version_ | 1819078675529728000 |
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| author | Rita Reyburn, MSc Evelyn Tuivaga, MBBS Cattram D Nguyen, PhD Felisita T Ratu, BPHN Devina Nand, MSc Joe Kado, MMed Lisi Tikoduadua, MBBS Kylie Jenkins, MPH Margaret de Campo, MPH Mike Kama, MPH Rachel Devi, MPH Eric Rafai, MPH Daniel M Weinberger, PhD E Kim Mulholland, ProfMD Fiona M Russell, ProfPhD |
| author_facet | Rita Reyburn, MSc Evelyn Tuivaga, MBBS Cattram D Nguyen, PhD Felisita T Ratu, BPHN Devina Nand, MSc Joe Kado, MMed Lisi Tikoduadua, MBBS Kylie Jenkins, MPH Margaret de Campo, MPH Mike Kama, MPH Rachel Devi, MPH Eric Rafai, MPH Daniel M Weinberger, PhD E Kim Mulholland, ProfMD Fiona M Russell, ProfPhD |
| author_sort | Rita Reyburn, MSc |
| collection | DOAJ |
| description | Summary: Background: In October, 2012, Fiji introduced routine infant immunisation with a ten-valent pneumococcal conjugate vaccine (PCV10) using three primary doses and no booster dose (3 + 0 schedule). Data are scarce for the effect of PCV in the Asia and Pacific region. We aimed to evaluate the effect of PCV10 on pneumonia hospital admissions in children younger than 5 years and adults aged 55 years and older in Fiji, 5 years after vaccine introduction. Methods: We did a time-series analysis assessing changes in pneumonia hospital admissions at three public tertiary hospitals in Fiji. Four pneumonia outcomes were evaluated: all-cause pneumonia, severe or very severe pneumonia, hypoxic pneumonia, and radiological pneumonia. Participants aged younger than 2 months, 2–23 months, 24–59 months, and 55 years and older were included. Data were extracted from the national hospital admission database according to International Classification of Diseases-tenth revision codes J10·0-18·9, J21, and J22 for all-cause pneumonia. Medical records and chest radiographs were reviewed for the main tertiary hospital to reclassify hospital admissions in children aged younger than 2 years as severe or very severe, hypoxic, or radiological pneumonia as per WHO definitions. Time-series analyses were done using the synthetic control method and multiple imputation to adjust for changes in hospital usage and missing data. Findings: Between Jan 1, 2007, and Dec 31, 2017, the ratio of observed cases to expected cases for all-cause pneumonia was 0·92 (95% CI 0·70–1·36) for children aged younger than 2 months, 0·86 (0·74–1·00) for children aged 2–23 months, 0·74 (0·62–0·87) for children aged 24–59 months, and 1·90 (1·53–2·31) in adults aged 55 years and older, 5 years after PCV10 introduction. These findings indicate a reduction in all-cause pneumonia among children aged 24–59 months and an increase in adults aged 55 years and older, but no change among children aged younger than 2 months. Among children aged 2–23 months, we observed declines of 21% (95% CI 5–35) for severe or very severe pneumonia, 46% (33–56) for hypoxic pneumonia, and 25% (9–38) for radiological pneumonia. Mortality reduced by 39% (95% CI 5–62) for all-cause pneumonia, bronchiolitis, and asthma admissions in children aged 2–23 months. Interpretation: The introduction of PCV10 was associated with a decrease in pneumonia hospital admissions in children aged 2–59 months. This is the first study in a middle-income country in the Asia and Pacific region to show the effect of PCV on pneumonia, filling gaps in the literature on the effects of PCV10 and 3 + 0 schedules. These data support decision making on PCV introduction for other low-income and middle-income countries in the region. Funding: Department of Foreign Affairs and Trade of the Australian Government. |
| first_indexed | 2024-12-21T19:16:52Z |
| format | Article |
| id | doaj.art-c65095a9eb0e44b5a5b9ff4a4eaad450 |
| institution | Directory Open Access Journal |
| issn | 2214-109X |
| language | English |
| last_indexed | 2024-12-21T19:16:52Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Global Health |
| spelling | doaj.art-c65095a9eb0e44b5a5b9ff4a4eaad4502022-12-21T18:53:03ZengElsevierThe Lancet Global Health2214-109X2021-01-0191e91e98Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysisRita Reyburn, MSc0Evelyn Tuivaga, MBBS1Cattram D Nguyen, PhD2Felisita T Ratu, BPHN3Devina Nand, MSc4Joe Kado, MMed5Lisi Tikoduadua, MBBS6Kylie Jenkins, MPH7Margaret de Campo, MPH8Mike Kama, MPH9Rachel Devi, MPH10Eric Rafai, MPH11Daniel M Weinberger, PhD12E Kim Mulholland, ProfMD13Fiona M Russell, ProfPhD14Murdoch Children's Research Institute, Melbourne, VIC, AustraliaMinistry of Health and Medical Services, Suva, FijiMurdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, Melbourne, VIC, AustraliaMinistry of Health and Medical Services, Suva, FijiMinistry of Health and Medical Services, Suva, FijiFiji National University, Suva, FijiMinistry of Health and Medical Services, Suva, FijiAustralia's support to the Fiji Health Sector, Suva, FijiLondon School of Hygiene & Tropical Medicine, London, UKMinistry of Health and Medical Services, Suva, FijiMinistry of Health and Medical Services, Suva, FijiMinistry of Health and Medical Services, Suva, FijiEpidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USAMurdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, Melbourne, VIC, Australia; London School of Hygiene & Tropical Medicine, London, UKMurdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, Melbourne, VIC, Australia; Correspondence to: Prof Fiona M Russell, Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, Melbourne 3052, VIC, AustraliaSummary: Background: In October, 2012, Fiji introduced routine infant immunisation with a ten-valent pneumococcal conjugate vaccine (PCV10) using three primary doses and no booster dose (3 + 0 schedule). Data are scarce for the effect of PCV in the Asia and Pacific region. We aimed to evaluate the effect of PCV10 on pneumonia hospital admissions in children younger than 5 years and adults aged 55 years and older in Fiji, 5 years after vaccine introduction. Methods: We did a time-series analysis assessing changes in pneumonia hospital admissions at three public tertiary hospitals in Fiji. Four pneumonia outcomes were evaluated: all-cause pneumonia, severe or very severe pneumonia, hypoxic pneumonia, and radiological pneumonia. Participants aged younger than 2 months, 2–23 months, 24–59 months, and 55 years and older were included. Data were extracted from the national hospital admission database according to International Classification of Diseases-tenth revision codes J10·0-18·9, J21, and J22 for all-cause pneumonia. Medical records and chest radiographs were reviewed for the main tertiary hospital to reclassify hospital admissions in children aged younger than 2 years as severe or very severe, hypoxic, or radiological pneumonia as per WHO definitions. Time-series analyses were done using the synthetic control method and multiple imputation to adjust for changes in hospital usage and missing data. Findings: Between Jan 1, 2007, and Dec 31, 2017, the ratio of observed cases to expected cases for all-cause pneumonia was 0·92 (95% CI 0·70–1·36) for children aged younger than 2 months, 0·86 (0·74–1·00) for children aged 2–23 months, 0·74 (0·62–0·87) for children aged 24–59 months, and 1·90 (1·53–2·31) in adults aged 55 years and older, 5 years after PCV10 introduction. These findings indicate a reduction in all-cause pneumonia among children aged 24–59 months and an increase in adults aged 55 years and older, but no change among children aged younger than 2 months. Among children aged 2–23 months, we observed declines of 21% (95% CI 5–35) for severe or very severe pneumonia, 46% (33–56) for hypoxic pneumonia, and 25% (9–38) for radiological pneumonia. Mortality reduced by 39% (95% CI 5–62) for all-cause pneumonia, bronchiolitis, and asthma admissions in children aged 2–23 months. Interpretation: The introduction of PCV10 was associated with a decrease in pneumonia hospital admissions in children aged 2–59 months. This is the first study in a middle-income country in the Asia and Pacific region to show the effect of PCV on pneumonia, filling gaps in the literature on the effects of PCV10 and 3 + 0 schedules. These data support decision making on PCV introduction for other low-income and middle-income countries in the region. Funding: Department of Foreign Affairs and Trade of the Australian Government.http://www.sciencedirect.com/science/article/pii/S2214109X20304216 |
| spellingShingle | Rita Reyburn, MSc Evelyn Tuivaga, MBBS Cattram D Nguyen, PhD Felisita T Ratu, BPHN Devina Nand, MSc Joe Kado, MMed Lisi Tikoduadua, MBBS Kylie Jenkins, MPH Margaret de Campo, MPH Mike Kama, MPH Rachel Devi, MPH Eric Rafai, MPH Daniel M Weinberger, PhD E Kim Mulholland, ProfMD Fiona M Russell, ProfPhD Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis The Lancet Global Health |
| title | Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis |
| title_full | Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis |
| title_fullStr | Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis |
| title_full_unstemmed | Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis |
| title_short | Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis |
| title_sort | effect of ten valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in fiji a time series analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2214109X20304216 |
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