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Impact of a combined pediatric and adult pneumococcal immunization program on adult pneumonia incidence and mortality in Nicaragua.

Publication ,  Journal Article
Becker-Dreps, S; Amaya, E; Liu, L; Rocha, J; Briceño, R; Moreno, G; Alemán, J; Hudgens, MG; Woods, CW; Weber, DJ
Published in: Vaccine
January 1, 2015

BACKGROUND: In 2010, Nicaragua implemented an adult immunization program with the 23-valent pneumococcal polysaccharide vaccine (PPSV-23) and a pediatric immunization program with the 13-valent pneumococcal conjugate vaccine (PCV-13). We assessed incidence rates of ambulatory visits and hospitalizations for pneumonia and pneumonia-related mortality in adults over the age of 50 years before and after the program's implementation in the Department of León, Nicaragua. METHODS: We collected visit diagnoses from all 107 public health facilities between 2008 and 2012 in León. We compared incidence rates of ambulatory visits for pneumonia, pneumonia hospitalizations, and pneumonia-related mortality in the pre-vaccine (2008-2009) and vaccine (2011-2012) periods among older adults using Poisson regression with generalized estimating equations (GEE), controlling for age group, municipality, and proportions of adults who were immunized against influenza. Exposure time was estimated by official municipality population estimates. RESULTS: We did not observe lower incidence rates of ambulatory visits or hospitalizations for pneumonia among adults during the vaccine period versus the pre-vaccine period. However, pneumonia-related mortality was lower in the vaccine period versus the pre-vaccine period, with an adjusted incidence rate ratio (IRRa) of 0.73 (0.56, 0.94) among adults aged 50-64 years, and 0.55 (0.43, 0.70) among adults aged ≥65 years. CONCLUSIONS: These early results following introduction of a combined pediatric and adult pneumococcal immunization program in Nicaragua show a probable impact of the program on the reduction of pneumonia-related deaths in older adults, but a less clear impact on the reduction of health facility visits for pneumonia.

Duke Scholars

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Published In

Vaccine

DOI

EISSN

1873-2518

Publication Date

January 1, 2015

Volume

33

Issue

1

Start / End Page

222 / 227

Location

Netherlands

Related Subject Headings

  • Virology
  • Survival Analysis
  • Pneumonia
  • Pneumococcal Vaccines
  • Nicaragua
  • Middle Aged
  • Male
  • Infant
  • Incidence
  • Immunization Programs
 

Citation

APA
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ICMJE
MLA
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Becker-Dreps, S., Amaya, E., Liu, L., Rocha, J., Briceño, R., Moreno, G., … Weber, D. J. (2015). Impact of a combined pediatric and adult pneumococcal immunization program on adult pneumonia incidence and mortality in Nicaragua. Vaccine, 33(1), 222–227. https://doi.org/10.1016/j.vaccine.2014.10.073
Becker-Dreps, Sylvia, Erick Amaya, Lan Liu, Julio Rocha, Rafaela Briceño, Gilberto Moreno, Jorge Alemán, Michael G. Hudgens, Christopher W. Woods, and David J. Weber. “Impact of a combined pediatric and adult pneumococcal immunization program on adult pneumonia incidence and mortality in Nicaragua.Vaccine 33, no. 1 (January 1, 2015): 222–27. https://doi.org/10.1016/j.vaccine.2014.10.073.
Becker-Dreps S, Amaya E, Liu L, Rocha J, Briceño R, Moreno G, et al. Impact of a combined pediatric and adult pneumococcal immunization program on adult pneumonia incidence and mortality in Nicaragua. Vaccine. 2015 Jan 1;33(1):222–7.
Becker-Dreps, Sylvia, et al. “Impact of a combined pediatric and adult pneumococcal immunization program on adult pneumonia incidence and mortality in Nicaragua.Vaccine, vol. 33, no. 1, Jan. 2015, pp. 222–27. Pubmed, doi:10.1016/j.vaccine.2014.10.073.
Becker-Dreps S, Amaya E, Liu L, Rocha J, Briceño R, Moreno G, Alemán J, Hudgens MG, Woods CW, Weber DJ. Impact of a combined pediatric and adult pneumococcal immunization program on adult pneumonia incidence and mortality in Nicaragua. Vaccine. 2015 Jan 1;33(1):222–227.
Journal cover image

Published In

Vaccine

DOI

EISSN

1873-2518

Publication Date

January 1, 2015

Volume

33

Issue

1

Start / End Page

222 / 227

Location

Netherlands

Related Subject Headings

  • Virology
  • Survival Analysis
  • Pneumonia
  • Pneumococcal Vaccines
  • Nicaragua
  • Middle Aged
  • Male
  • Infant
  • Incidence
  • Immunization Programs