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Pneumococcal vaccination programme followed by sustained declines in all cause pneumonia

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f4526 (Published 17 July 2013) Cite this as: BMJ 2013;347:f4526

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Infant vaccination programmes in the US introduced a seven valent pneumococcal vaccine in 2000, a move that was followed by a rapid and significant decline in invasive pneumococcal disease in both vaccinated infants and unvaccinated adults. A new analysis of hospital inpatient data confirms enduring declines in hospital admissions for all cause pneumonia too, laying to rest fears that other pathogens would simply replace pneumococcal strains sensitive to the vaccine.

Downward trends in all cause pneumonia were most obvious at the extremes of age. Between 1997 and 2009, annual hospital admission rates fell by 551.1 per 100 000 (43.2% reduction, 95% CI 34.9% to 51.6%) in infants under 2 years and by 1300.8 per 100 000 (22.8%, 17.3% to 28.4%) in adults over 85 years. Reductions in other age groups were more modest but still significant in children aged 2-4 years and adults aged 18-39 and over 65.

The authors analysed discharge data from 1050 US hospitals in 44 states. The PCV7 vaccine is the likeliest explanation for the observed reductions, which are consistent with the results of clinical trials and with trends reported in other countries, such as Australia, where PCV7 has been introduced, they write.

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Cite this as: BMJ 2013;347:f4526