LIMITED IMPACT OF THE 7-VALENT PNEUMOCOCCAL VACCINE ON PAEDIATRIC EMPYEMA IN THE NORTH OF ENGLAND
ESPID Education. Elemraid M. 06/07/11; 7795 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 7-valent pneumococcal conjugate vaccine (PCV-7) was introduced into the UK routine immunisation schedule in September 2006. A recent report has suggested a significant reduction on the incidence of empyema following introduction of the vaccine1. The objective of this study was to investigate the impact of the pneumococcal conjugate vaccination programme on the incidence of paediatric empyema in our region.

Methods: An 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 April 2010. Seasonality was accounted for by including monthly temperature measurements within the regression models.

Results: A total of 298 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. No significant impact was observed on the number of cases following the introduction of the PCV-7 vaccine (regression co-efficient 0.096, 95 % CI -0.038 - 0.23, p = 0.16).

Conclusions: The PCV-7 vaccine had no impact on the incidence of paediatric empyema in Northern England. These findings do not confirm a recent report of a decline in the incidence of paediatric empyema following the introduction of this vaccine.

1. Koshy E, et al. Thorax. 2010; 65(9): 770-4.
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 7-valent pneumococcal conjugate vaccine (PCV-7) was introduced into the UK routine immunisation schedule in September 2006. A recent report has suggested a significant reduction on the incidence of empyema following introduction of the vaccine1. The objective of this study was to investigate the impact of the pneumococcal conjugate vaccination programme on the incidence of paediatric empyema in our region.

Methods: An 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 April 2010. Seasonality was accounted for by including monthly temperature measurements within the regression models.

Results: A total of 298 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. No significant impact was observed on the number of cases following the introduction of the PCV-7 vaccine (regression co-efficient 0.096, 95 % CI -0.038 - 0.23, p = 0.16).

Conclusions: The PCV-7 vaccine had no impact on the incidence of paediatric empyema in Northern England. These findings do not confirm a recent report of a decline in the incidence of paediatric empyema following the introduction of this vaccine.

1. Koshy E, et al. Thorax. 2010; 65(9): 770-4.
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