681. Effectiveness of pneumococcal heptavalent conjugate vaccine for the prevention of community-acquired pneumonia using a 2+1 Infant Schedule in Québec, Canada
Session: Oral Abstract Session: Pneumococcal Vaccine for All Ages
Friday, October 4, 2013: 11:45 AM
Room: The Moscone Center: 200-212
Background:

In the province of Quebec, Canada, a 7-valent pneumococcal conjugate vaccine (PCV-7) was offered to all children less than 5 years of age, and a 2+1 schedule (2, 4, and 12 months) was recommended for routine immunization of low-risk infants in December 2004. The aim of the study was to evaluate PCV-7 effectiveness against community-acquired pneumonia (CAP) in children < 5 years, according to WHO standardized pneumonia classification criteria.

Methods:

A case-control study was carried out in the region of Eastern Township during the 2005-2007 program implementation period. Each case (children 2-59 months of age, hospitalized with X-ray-confirmed CAP) were matched with 4 healthy controls according to age and 6-digit postal code. Data were collected from electronic patient files, immunization records and a telephone interview. PCV-7 effectiveness was computed using conditional logistic regression models adjusting for potential confounders.

Results:

A total of 151 CAP cases (76% of total cases) and 604 controls were included. In multivariable analysis, factors associated with CAP risk were: asthma OR=4.6 (95% CI: 2.5-8.6; p<0.001), Caucasian ethnicity OR=0.2 (95% CI: 0.1-0.6; p=0.003), passive smoking OR=2.2 (95% CI: 1.3-3.6; p=0.003), IPD-risk medical condition OR=3.5 (95% CI: 1.7-7.2; p=0.001), and household with ≥ 3 children < 5 years of age OR=2.9 (95% CI: 1.5-5.2; p=0.14). Overall PCV-7 protection (≥ 1 dose) against CAP was 35% (95% CI: -7-60%; p=0.08). Among children ≥ 2 years of age, vaccine effectiveness was 58.3 % (95% CI: 11.1-80.4%; p=0.024) with ≥ 1 dose, and 67.8 % (95% CI: 12.5-88.1%, p=0.026) with ≥ 2 doses.

Conclusion:

This study confirms the field effectiveness of a 2+1 PCV-7 schedule for CAP prevention using standardized radiological criteria and controlling for confounding factors

Jeannette Ndaya-Tshibangu1, Louis Valiquette, MD, MSc2, Philippe De Wals, MD, PHD3, Thomas Lemaitre, MSc4, Genevieve Petit, MD, MSc5, Jean Paul Praud, MD, MSc4, Genevieve Deceuninck, MD, MSc6 and Arnaud Gagneur, MD, PhD4, (1)Center of Clinical Research Etienne Lebel, university of Sherbrooke, Sherbrooke, QC, Canada, (2)Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, QC, Canada, (3)Univ. Laval, Quebec, QC, Canada, (4)Pediatrics, University of Sherbrooke, Sherbrooke, QC, Canada, (5)Department of Social and Preventive Medicine, University of Sherbrooke, Sherbrooke, QC, Canada, (6)Quebec University Hospital Research Centre, Quebec city, QC, Canada

Disclosures:

J. Ndaya-Tshibangu, None

L. Valiquette, Pfizer: Collaborator, Investigator and Speaker's Bureau, Research grant and Speaker honorarium
Wyeth: Investigator and Speaker's Bureau, Research grant and Speaker honorarium

P. De Wals, GlaxoSmithKline: Grant Investigator and Scientific Advisor, Consulting fee and Research grant
Novartis: Grant Investigator and Scientific Advisor, Reimbursement travel expenses and Research grant
Pfizer: Grant Investigator, Grant recipient

T. Lemaitre, None

G. Petit, None

J. P. Praud, None

G. Deceuninck, None

A. Gagneur, None

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