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The impact of childhood pneumococcal vaccination on hospital admissions in England: a whole population observational study

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Shiri, Tinevimbo ORCID: https://orcid.org/0000-0002-9092-3268, McCarthy, Noel D and Petrou, Stavros (2019) 'The impact of childhood pneumococcal vaccination on hospital admissions in England: a whole population observational study'. BMC Infectious Diseases, Vol 19, Issue 510.

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Abstract

Background
Pneumococcal infections are major causes of morbidity and mortality worldwide. We use routine hospital admissions data and time-series modelling analysis to estimate the impact of the seven and thirteen valent pneumococcal conjugate vaccines (PCV7 and PCV13) on hospital admissions due to pneumococcal disease in England.
Methods
Hospital admissions for pneumococcal meningitis, bacteraemia and pneumonia between January 1, 2003 and December 31, 2015 were identified from the national Hospital Episode Statistics database for all age groups in England. We model the impact of pneumococcal vaccination using interrupted time series analysis. Hospital admissions prior to vaccine introduction were extrapolated to predict the expected number of admissions in the absence of pneumococcal vaccines. Admissions avoided over time were estimated by comparing the fitted interrupted time series and the expected model for no vaccination in a Bayesian framework.
Results
Overall, there were 43 531 (95% credible interval (CrI): 36 486 – 51 346) fewer hospital admissions due to bacteraemia, meningitis and pneumonia in England during the period from 2006 to 2015 than would have been expected if pneumococcal vaccines had not been implemented, with the majority of hospital admissions avoided due to pneumonia. Among young children reductions in meningitis were more common, while among adults reductions in pneumonia admissions were relatively more important, with no evidence for reduced bacteraemia and meningitis among older adults. We estimated that 981 (95% CrI: 391 – 2 018), 749 (95% CrI: 295 – 1 442) and 1 464 (95% CrI: 793 – 2 522) bacteraemia, meningitis and pneumonia related hospital admissions, respectively, were averted in children <2 years of age.
Conclusions
Substantial reductions in hospital admissions for bacteraemia, meningitis and pneumonia in England were estimated after the introduction of childhood vaccination, with indirect effects being responsible for most of the hospital admissions avoided.

Item Type: Article
Subjects: QW Microbiology and Immunology > Immunotherapy and Hypersensitivity > QW 806 Vaccination
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 217 Pneumococcal infections
WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 200 General works
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12879-019-4119-8
Depositing User: Stacy Murtagh
Date Deposited: 12 Jun 2019 12:42
Last Modified: 13 Jun 2019 14:09
URI: https://archive.lstmed.ac.uk/id/eprint/10982

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