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J Infect Dis. 2019 Aug 9;220(6):956-960. doi: 10.1093/infdis/jiz212.

Infant Pneumococcal Carriage During Influenza, RSV, and hMPV Respiratory Illness Within a Maternal Influenza Immunization Trial.

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School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia.
Seattle Children's Hospital, Washington.
Department of Pediatrics, University of Washington, Seattle.
Department of Laboratory Medicine, University of Washington, Seattle.
Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia.
International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Nepal Nutrition Intervention Project - Sarlahi, Kathmandu, Nepal.
Division of Allergy and Infectious Diseases, University of Washington, Seattle.


In this post-hoc analysis of midnasal pneumococcal carriage in a community-based, randomized prenatal influenza vaccination trial in Nepal with weekly infant respiratory illness surveillance, 457 of 605 (75.5%) infants with influenza, respiratory syncytial virus (RSV), or human metapneumovirus (hMPV) illness had pneumococcus detected. Pneumococcal carriage did not impact rates of lower respiratory tract disease for these 3 viruses. Influenza-positive infants born to mothers given influenza vaccine had lower pneumococcal carriage rates compared to influenza-positive infants born to mothers receiving placebo (58.1% versus 71.6%, P = 0.03). Maternal influenza immunization may impact infant acquisition of pneumococcus during influenza infection. Clinical Trials Registration. NCT01034254.


RSV; hMPV; influenza; maternal immunization; pneumococcus; vaccine

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