IMPACT OF THE 13-VALENT PNEUMOCOCCAL VACCINE ON THE INCIDENCE OF PAEDIATRIC EMPYEMA IN THE NORTH OF ENGLAND
ESPID Education. Elemraid M. Jun 7, 2011; 7708 Disclosure(s): DAS has received research grants from GSK pharmaceuticals and Wyeth pharmaceuticals, the manufacturers of pneumococcal vaccines. JEC has received research funding from Wyeth.
Dr. Mohamed Elemraid
Dr. Mohamed Elemraid

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Abstract
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Background: The incidence of paediatric empyema has increased substantially in the UK since 1995. Paediatric empyema in the UK is predominantly a pneumococcal disease and a 13-valent pneumococcal conjugate vaccine (PCV-13) replaced the seven-valent vaccine in the UK routine immunisation schedule in April 2010. The 13 valent vaccine includes antigen for serotype 1, which has been the commonest cause of paediatric empyema in the UK. The objective of this study was to investigate the impact of the introduction of PCV-13 on the incidence of paediatric empyema.

Methods: A preliminary interrupted time-series analysis was performed using clinical data from empyema admissions for children aged up to 14 years in Northern England from May 1995 to November 2010. Seasonality was accounted for by including monthly temperature measurements within the regression models. Terms for the seven-valent vaccine were also included.

Results: A total of 313 patients were included in the study. The incidence of empyema increased from a mean monthly rate of 1.1 cases per million children in 1996 to 5.2 per million in 2009 and fell in 2010 to 3.2 per million. Introduction of the PCV-13 vaccine was associated with a significant reduction in the number of monthly cases of paediatric empyema (regression co-efficient -0.26, 95% CI -0.42 ─ -0.10, p=0.002).

Conclusions: We have documented a recent reduction in the incidence of paediatric empyema in the North of England, but it would be premature to conclude a causal relationship with introduction of the PCV-13 vaccine.
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