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Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis

BACKGROUND: Pneumonia is the most serious form of acute respiratory infection and Streptococcus pneumoniae is a leading cause of pediatric bacterial pneumonia. Pneumococcal conjugate vaccines were introduced in the United States (US) in 2000 (7-valent [PCV7]) and 2010 (13-valent [PCV13]). This study...

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Autores principales: Hu, Tianyan, Sarpong, Eric M., Song, Yan, Done, Nicolae, Liu, Qing, Lemus-Wirtz, Esteban, Signorovitch, James, Mohanty, Salini, Weiss, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074783/
https://www.ncbi.nlm.nih.gov/pubmed/37016411
http://dx.doi.org/10.1186/s41479-023-00109-5
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author Hu, Tianyan
Sarpong, Eric M.
Song, Yan
Done, Nicolae
Liu, Qing
Lemus-Wirtz, Esteban
Signorovitch, James
Mohanty, Salini
Weiss, Thomas
author_facet Hu, Tianyan
Sarpong, Eric M.
Song, Yan
Done, Nicolae
Liu, Qing
Lemus-Wirtz, Esteban
Signorovitch, James
Mohanty, Salini
Weiss, Thomas
author_sort Hu, Tianyan
collection PubMed
description BACKGROUND: Pneumonia is the most serious form of acute respiratory infection and Streptococcus pneumoniae is a leading cause of pediatric bacterial pneumonia. Pneumococcal conjugate vaccines were introduced in the United States (US) in 2000 (7-valent [PCV7]) and 2010 (13-valent [PCV13]). This study estimated annual incidence rates (IRs) of all-cause pneumonia (ACP) among US children aged < 18 years before and after the introduction of PCV7 and PCV13. METHODS: ACP episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using diagnosis codes. Annual IRs were calculated overall and by inpatient and outpatient settings as the number of episodes per 100,000 person-years (PY) for all children aged < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual pneumonia IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were used to assess immediate and gradual changes in monthly pneumonia IRs, adjusting for seasonality. RESULTS: In the commercially-insured population, ACP IRs declined between the pre-PCV7 period (1998–1999) and late PCV13 period (2014–2018) from 5,322 to 3,471 episodes per 100,000 PY for children aged < 2 years, from 4,012 to 3,794 episodes per 100,000 PY in children aged 2–4 years but increased slightly from 1,383 to 1,475 episodes per 100,000 PY in children aged 5–17 years. The ITS analyses indicated significant decreases in monthly ACP IRs in the early PCV7 period (2001–2005) among younger children and in the early PCV13 period (2011–2013) among all children. Increases were observed in the late PCV7 period (2006–2009) among all age groups, but were only significant among older children. IRs of inpatient ACP decreased across all age groups, but outpatient pneumonia IRs remained stable during the study timeframe, even increasing slightly in children aged 5–17 years. More prominent declines were observed for Medicaid-insured children across all age groups; however, Medicaid IRs were higher than IRs of commercially-insured children during the entire study timeframe. CONCLUSIONS: ACP disease burden remains high in US children of all ages despite overall reductions in incidence rates during 1998–2018 following the introduction of PCV7 and PCV13. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41479-023-00109-5.
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spelling pubmed-100747832023-04-06 Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis Hu, Tianyan Sarpong, Eric M. Song, Yan Done, Nicolae Liu, Qing Lemus-Wirtz, Esteban Signorovitch, James Mohanty, Salini Weiss, Thomas Pneumonia (Nathan) Research BACKGROUND: Pneumonia is the most serious form of acute respiratory infection and Streptococcus pneumoniae is a leading cause of pediatric bacterial pneumonia. Pneumococcal conjugate vaccines were introduced in the United States (US) in 2000 (7-valent [PCV7]) and 2010 (13-valent [PCV13]). This study estimated annual incidence rates (IRs) of all-cause pneumonia (ACP) among US children aged < 18 years before and after the introduction of PCV7 and PCV13. METHODS: ACP episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using diagnosis codes. Annual IRs were calculated overall and by inpatient and outpatient settings as the number of episodes per 100,000 person-years (PY) for all children aged < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual pneumonia IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were used to assess immediate and gradual changes in monthly pneumonia IRs, adjusting for seasonality. RESULTS: In the commercially-insured population, ACP IRs declined between the pre-PCV7 period (1998–1999) and late PCV13 period (2014–2018) from 5,322 to 3,471 episodes per 100,000 PY for children aged < 2 years, from 4,012 to 3,794 episodes per 100,000 PY in children aged 2–4 years but increased slightly from 1,383 to 1,475 episodes per 100,000 PY in children aged 5–17 years. The ITS analyses indicated significant decreases in monthly ACP IRs in the early PCV7 period (2001–2005) among younger children and in the early PCV13 period (2011–2013) among all children. Increases were observed in the late PCV7 period (2006–2009) among all age groups, but were only significant among older children. IRs of inpatient ACP decreased across all age groups, but outpatient pneumonia IRs remained stable during the study timeframe, even increasing slightly in children aged 5–17 years. More prominent declines were observed for Medicaid-insured children across all age groups; however, Medicaid IRs were higher than IRs of commercially-insured children during the entire study timeframe. CONCLUSIONS: ACP disease burden remains high in US children of all ages despite overall reductions in incidence rates during 1998–2018 following the introduction of PCV7 and PCV13. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41479-023-00109-5. BioMed Central 2023-04-05 /pmc/articles/PMC10074783/ /pubmed/37016411 http://dx.doi.org/10.1186/s41479-023-00109-5 Text en © Merck & Co., Inc., Rahway, NJ, USA and its affiliates 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Hu, Tianyan
Sarpong, Eric M.
Song, Yan
Done, Nicolae
Liu, Qing
Lemus-Wirtz, Esteban
Signorovitch, James
Mohanty, Salini
Weiss, Thomas
Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis
title Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis
title_full Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis
title_fullStr Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis
title_full_unstemmed Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis
title_short Incidence of non-invasive all-cause pneumonia in children in the United States before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis
title_sort incidence of non-invasive all-cause pneumonia in children in the united states before and after the introduction of pneumococcal conjugate vaccines: a retrospective claims database analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074783/
https://www.ncbi.nlm.nih.gov/pubmed/37016411
http://dx.doi.org/10.1186/s41479-023-00109-5
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