Impact of the 7-valent pneumococcal conjugate vaccine on the incidence of childhood pneumonia

In September 2006, the 7-valent pneumococcal conjugate vaccine (PCV7) was added to the UK immunization programme. We aimed to evaluate the impact of PCV7 on the incidence of all-cause community-acquired pneumonia (CAP) in children. A prospective survey was undertaken in 2008-2009 at 11 hospitals in North East England of children aged 0-16 years with radiologically confirmed pneumonia. Data were compared to those from a similar survey undertaken in the same hospitals in 2001-2002. A total of 542 children were enrolled, of which 74% were aged < 5 years. PCV7 uptake was 90.7%. The incidence of pneumonia was 11.8/10000 [95% confidence interval (CI) 10.9-12.9], and the hospitalization rate was 9.9/10000 (95% CI 9.0-10.9). Compared to 2001, there was a 19% (95% CI 8-29) reduction in the rate of CAP in those aged < 5 years, and in those < 2 years a 33.1% (95% CI 20-45) reduction in the incidence of CAP and 38.1% (95% CI 24-50) reduction in hospitalization rates. However, for those unvaccinated aged >= 5 years, there was no difference in the incidence of CAP and hospitalization rate between both surveys. Since 2001, the overall reduction in incidence was 17.7% (95% CI 8-26) and for hospitalization 18.5% (95% CI 8-28). For the < 5 years age group there was a lower incidence of CAP in PCV7-vaccinated children (25.2/10000, 95% CI 22.6-28.2) than in those that were not vaccinated (37.4/10000, 95% CI 29.2-47.1). In conclusion, PCV7 has reduced both incidence and rate of hospitalization of pneumonia in children, particularly in the < 2 years age group.