Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Infect. 2012 Jul;65(1):17-24. doi: 10.1016/j.jinf.2012.02.017. Epub 2012 Mar 3.

The effect of underlying clinical conditions on the risk of developing invasive pneumococcal disease in England.

Author information

  • 1Immunisation, Hepatitis and Blood Safety Department, Health Protection Services, Colindale, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, United Kingdom. albertjan.vanhoek@hpa.org.uk

Abstract

OBJECTIVE:

To inform national policy making on the use of the 13-valent pneumococcal vaccine among risk groups we estimated the increased risk of invasive pneumococcal disease (IPD) outcomes among clinical risk groups. Three years of post 7-valent pneumococcal conjugate vaccine (PCV7) data was included to investigate the herd protection effects.

METHODS:

Over 22,000 IPD patients in England (March 2002-March 2009 - aged 2 and over) were linked to their hospitalisation records. The prevalence of risk factors in these patients was compared to the prevalence of risk factors in the general population.

RESULTS:

There was an increased odds ratio (OR) for hospitalisation (OR 11.7 2-15 years; 7.6 16-64; 2.7 65+) and death (OR 2.4 2-15 years, 3.9 16-64, 1.2 65+) from IPD among risk group. The most important risk factors that predict IPD are chronic liver disease, immunosuppression, and chronic respiratory diseases. Herd protection effects due to introduction of the 7-valent vaccine were identical in both patient groups as shown by the similar decline in the proportion of IPD caused by PCV7 serotypes in risk and non-risk groups.

CONCLUSIONS:

There is a marked increased risk of IPD among those with certain clinical conditions, suggesting potential benefit from a targeted vaccination approach. However, the indirect protection from conjugate vaccination of children suggests PCV vaccination of high-risk groups may not provide substantial additional benefit once herd immunity takes effect.

Copyright © 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

PMID:
22394683
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk