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Epidemiol Infect. 2014 Feb;142(2):379-87. doi: 10.1017/S0950268813000794. Epub 2013 Apr 26.

Do community-level predictors of pneumococcal carriage continue to play a role in the conjugate vaccine era?

Author information

1
Section of Pediatric Infectious Diseases, Boston University Medical Center, Boston, MA, USA.
2
Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA.
3
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
4
Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA, USA.

Abstract

This paper examined whether previously identified community-level factors (high proportion of crowded households and/or persons below the poverty level) remained associated with childhood pneumococcal carriage in the heptavalent pneumococcal conjugate vaccine (PCV7) era. Using logistic regression, individual factors were used to develop base models to which community-level factors were added to evaluate impact on pneumococcal carriage within two paediatric study cohorts from Massachusetts (urban Boston, outside Boston). Six years after introduction of universal childhood PCV7 vaccination, we found no consistent evidence that census tract characteristics (e.g. population size and density, age and race distribution, percent participating in group childcare, parental education, percent lacking in-unit plumbing, poverty, and community stability) affected odds of pneumococcal carriage when added to individual predictors (e.g. younger age, current respiratory tract infections, and attendance in group childcare). How community-level factors influence pneumococcal carriage continues to change in the era of increasing immunization coverage.

PMID:
23731707
PMCID:
PMC3849242
DOI:
10.1017/S0950268813000794
[Indexed for MEDLINE]
Free PMC Article

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