Impact of Pneumococcal Conjugate Vaccination of Children on Hospitalizations Resulting from Invasive Pneumococcal Diseases in the United States 公开
Liu, Chang (2014)
Published
Abstract
Abstract
Impact of Pneumococcal Conjugate Vaccination of Children on Hospitalizations Resulting from Invasive Pneumococcal Diseases in the United States
By Chang Liu
The incidence of invasive pneumococcal disease (IPD) declined after the introduction of a seven-valent pneumococcal conjugate vaccine (PCV7) in the United Sates in 2000. This vaccine was administrated to children less than 5 years of age. Other studies have shown that colder temperature and existing influenza virus increase the susceptibility to IPD. Using data from 10 states, we estimated the impact of PCV7 coverage in both the vaccinated and unvaccinated populations adjusting for influenza and temperature using linear regression, Poisson regression, negative binomial regression, and generalized additive models. Negative binomial regression outperformed the other models in terms of AIC and the differences between observed and fitted values. From the negative binomial models, we found significant reductions of 84% and 73% in IPD hospitalizations among the vaccinated population, children <2 years of age and children 2-4 years of age, respectively. Due to the herd immunity (indirect) effects, IPD hospitalizations significantly declined in the unvaccinated age groups. We found significant reductions of 46% in children 5-17 years of age, 54% in adults 18-39 years of age, 36% in adults 40-64 year of age, and 48% in adults ≥65 years of age. Our result also indicate a significant association with increases in temperature and decreases in IPD hospitalizations in age groups, 2-4 and ≥ 64. There was also significant association with increases in influenza case and increases in IPD cases in age groups 18-39, 40-64, and ≥ 64.
Table of Contents
Table of Contents Introduction………………………………………………..…………………………………..…1 Definition, Incidence and Symptoms of Invasive Pneumococcal Disease……………….……….1 Prevnar® or PCV7 vaccine……………………………………………...…………………………2 Statement of Research Question……………………...….………………………………………..3 Data and Methods ……………………………………………………………………..…………5 Data Source and Study Design……………………...……………….……………………5 Outcome Variables………………………………………………………………………6 Primary Explanatory Variables……………………………………………………………6 Secondary Explanatory Variables……………………..…………………………………..6 Epidemiology Measure……………………………………………………………………7 Log Linear Regression Modeling…………………………………………...….…………7 Poisson Regression Modeling……………………………………………………………..8 Negative Binomial Regression Modeling………………………………………...……….9 Generalized Additive Modeling………………………………………………………….10 Assessing the fit of the models………………………………………………..…………10 Results……………………………………………………………………...……………………12 Descriptive Statistics………………………………………………………………….….12 Log Linear Regression Model……………………………………...……………………13 Poisson Regression………………………………………………………………………14 Negative Binomial Regression……………………………………..……………………15 Generalized Additive Poisson Model……………………………………………………16 Assessing the fit of the models………………………………..…………………………17 Discussion…………………………………………….…………………………………………19 Conclusion……………………………………………………………………………….19 Limitation and Future Work………………………………………………………….….20 References…………………………………………………………………….…………………22 Figures………………………………………………………...…………………………………26 Tables……………………………………………………………………………………………32 Appendix A - SAS code …………………………………………..…………………………….45 Appendix A - R code …………………………………………………………………………65
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