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Adobe Flash Player is required to view this feature. If you are using an operating system that does not support Flash, we are working to bring you alternative formats. Original Article Decline in Invasive Pneumococcal Disease after the Introduction of Protein–Polysaccharide Conjugate Vaccine Cynthia G. Whitney, M.D., M.P.H., Monica M. Farley, M.D., James Hadler, M.D., M.P.H., Lee H. Harrison, M.D., Nancy M.
Bennett, M.D., Ruth Lynfield, M.D., Arthur Reingold, M.D., Paul R. Cieslak, M.D., Tamara Pilishvili, M.P.H., Delois Jackson, M.S.A., Richard R. Facklam, Ph.D., James H. Jorgensen, Ph.D., and Anne Schuchat, M.D., for the Active Bacterial Core Surveillance of the Emerging Infections Program Network N Engl J Med 2003; 348:1737-1746 DOI: 10.1056/NEJMoa022823. Results The rate of invasive disease dropped from an average of 24.3 cases per 100,000 persons in 1998 and 1999 to 17.3 per 100,000 in 2001. The largest decline was in children under two years of age. In this group, the rate of disease was 69 percent lower in 2001 than the base-line rate (59.0 cases per 100,000 vs.
188.0 per 100,000, P. Figure 2 Percent Changes in the Rates of Invasive Pneumococcal Disease, According to Age Group and the State in Which the Active Bacterial Core Surveillance Site Was Located. The percent decline was calculated by comparing the incidence in 2001 with the average incidence in 1998 and 1999. Within states, the decline among children under 2 years old correlated significantly with the decline among persons 20 to 39 years of age (r=0.89, P=0.008), but not with the decline among persons 40 to 64 years of age (r=–0.09, P=0.85) or 65 years or older (r=0.36, P=0.42). In early 2000, a 7-valent protein–polysaccharide pneumococcal conjugate vaccine (Prevnar, Wyeth Lederle Vaccines) was licensed for use in infants and young children in the United States. This was the first vaccine that promised efficacy against pneumococcal disease for this high-risk group. In the second half of 2000, recommendations for routine use of the vaccine in all infants and children under two years of age and in high-risk children two through four years of age were published, and distribution of the vaccine through public programs began.
By August 2001, a shortage was reported. Controlled clinical trials have shown that the vaccine, when given as a four-dose regimen to infants, is highly efficacious against invasive disease and somewhat efficacious against otitis media and pneumonia. Conjugate vaccines reduce nasopharyngeal carriage of vaccine-type strains but often increase the frequency of carriage of non–vaccine-type strains. A Later Version Of Itunes Is Already Installed On This Computer. The efficacy of the vaccine in infants given fewer than four doses or in older children is unknown. Jaane Kya Chahe Mann Mp3 Song Free Download. Because the vaccine does not include most of the 90 pneumococcal serotypes, an increase in disease caused by serotypes not included in the vaccine or not related to those in the vaccine is possible; this effect was seen during a clinical trial evaluating its efficacy against otitis media. Whether vaccination of young children will reduce carriage and subsequently affect disease in other age groups is unclear.