Impact of Pneumococcal Conjugate Vaccines (PCV) on the incidence of community acquired pneumonia (CAP) in the UK

Abstract

Aims/Objectives: Heptavalent PCV (PCV7) was introduced into the UK vaccination schedule in September 2006 followed by 13-valent PCV (PCV13) in April 2010. In the US and Europe PCV7 reduced the incidence of invasive pneumococcal disease in children aged <5 years. Hospital pneumonia admission rates in England declined by 19% in the 2 years post-introduction (Koshy et al., 2010). We assessed the impact of PCVs on primary care diagnoses of CAP and associated antibiotic prescribing in children. Methods: A descriptive cohort study was conducted using The Health Improvement Network database of anonymised patient health records for 5% of the UK population. The study population comprised children aged <16 years with ≥6 months’ data and ≥1 pneumonia diagnosis recorded between 1 January 2002 and 31 December 2010. The duration of an episode of CAP was defi ned as 30 days. Annual incidences of CAP and antibiotic prescribing were calculated. Results: CAP incidence declined by 13.3% for children aged <16 years between January 2006 and December 2010 from 1.07 episodes/1000 person-years (PY) to 0.92/1000 PY; the largest reductions were in younger age bands (28.3% in <2 years; 20.3% in 2-5 years; 27.8% in 6-10 years). Antibiotic prescribing decreased by 10.3% overall; however the steepest decline (44.2%) was seen in children aged <2 years from 0.74 treated-episodes/1000 PY in 2006 to 0.41/1000 PY in 2010. Conclusion: PCVs have reduced the incidence of CAP diagnoses and antibiotic prescribing for CAP since their introduction; this is most evident in the main target group of young children <2 years.