444. Invasive Pneumococcal Disease after the Introduction of 13-Valent Conjugate Vaccine in Children, New York City, 2007-2012
Session: Poster Abstract Session: Pneumococcal Vaccine in Children and Adults
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • IDSAPoster_9-24-13.pdf (351.0 kB)
  • Background:

    Streptococcus pneumoniae is a leading cause of pneumonia, bacteremia, and meningitis.  In February 2010, 13-valent pneumococcal conjugate vaccine (PCV13) was licensed to replace 7-valent pneumococcal conjugate vaccine (PCV7) for routine use in children aged <5 years.  PCV13 contains the seven serotypes in PCV7 and six additional serotypes. 


    Invasive pneumococcal disease (IPD) was defined as isolation of S. pneumoniae from a normally sterile body site in a New York City (NYC) resident aged <5 years from 2007-2012.  IPD cases were identified by laboratory reporting of positive pneumococcal cultures.  Medical charts were reviewed for demographic and clinical information.  Serotyping was conducted by the Quellung test method.  IPD incidence rates from pre-PCV13 (2007-2009 average) to post introduction of PCV13 (2011-2012 average) were calculated.  PCV13 coverage, defined as age-appropriate vaccination per the Advisory Committee on Immunization Practices, was calculated using NYC’s immunization information system. 


    There were 468 confirmed IPD cases in 2007-2012.  IPD incidence decreased by 65% (p=0.01) from 19.1 cases per 100,000 (2007-2009) to 6.7 cases per 100,000 (2011-2012).  PCV-13 type incidence decreased by 82% (p=0.004), from 13.9 cases per 100,000 (2007-2009) to 2.8 cases per 100,000 (2011-2012).  The largest decrease in incidence was seen in children aged <12 months (78%, p=0.007), followed by 64% (p=0.03) and 55% (p=0.03) reductions among children aged 12-35 months and 36-59 months, respectively.  Incidence decreased in all racial/ethnic groups with reductions of 70% in non-Hispanic blacks (p=0.009), 63% in Hispanics (p=0.05), 63% in non-Hispanic whites (p=0.04), and 54% in Asians/Pacific Islanders (p=0.08).  Sixty-five percent and 83% of children aged <5 years were up to date with PCV13 by the end of 2011 and 2012, respectively.


    Incidence of IPD in NYC children aged <5 years decreased among all age categories and race/ethnicity groups in 2011-2012.  The decline was driven by a reduction in PCV13-type IPD.  The decline in IPD was temporally associated with introduction and increased uptake of PCV13 vaccine in NYC.  Surveillance data suggest a substantial impact of PCV13 on rates of IPD among children in NYC.

    Andrea Farnham, MPH1, Christopher Zimmerman, MD, MPH2, Geetha Nattanmai3, Sherly Jose3, Vassiliki Papadouka, PhD, MPH4, Jane Zucker, MD, MSc5 and Jennifer Rosen, MD5, (1)Immunization, New York City Department of Health and Mental Hygiene, Queens, NY, (2)CDC, Atlanta, GA, (3)Wadsworth Center, Bacteriology Laboratory, New York State Department of Health, Albany, NY, (4)New York City Department of Health and Mental Hygiene, Queens, NY, (5)Bureau Of Immunization, New York City Department of Health and Mental Hygiene, Long Island City, NY


    A. Farnham, None

    C. Zimmerman, None

    G. Nattanmai, None

    S. Jose, None

    V. Papadouka, None

    J. Zucker, None

    J. Rosen, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.