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Increase in Pneumococcal Infections That are Not Covered by Vaccine

Children, native of Alaska, are experiencing increased rates of serious infections caused by strains of pneumococcal bacteria that are not covered by the current childhood pneumococcal vaccine,// according to a study.

Before introduction of 7-valent pneumococcal conjugate vaccine (PCV7), Alaska Native children and adults experienced high rates of invasive pneumococcal disease (IPD) compared with non–Native Alaskans. Introduction of PCV7 into the routine childhood vaccination schedule in 2001 resulted in decreases in vaccine-type IPD and consequent decreases in all IPD among U.S. children, according to background information in the article. With the introduction of PCV7, one concern has been the potential for nonvaccine serotypes to emerge and diminish the disease prevention gains made through the use of PCV7.

Rosalyn J. Singleton, M.D., M.P.H., of the Centers for Disease Control and Prevention, Anchorage, and colleagues evaluated IPD in Alaska children for evidence of the emergence of nonvaccine serotype disease. The researchers conducted a statewide population-based laboratory surveillance of invasive Streptococcus pneumoniae infections (such as pneumonia, meningitis, or bacteremia [bacteria in the blood stream]) from January 1, 1995, through December 31, 2006.

The authors found that in the three years after introduction of PCV7 (2001-2003), IPD decreased 67 percent among Alaska Native children younger than 2 years and 61 percent in non–Native Alaska children in the same age group. Between 2001-2003 and 2004-2006, IPD rates did not change for non–Native Alaska children younger than 2 years but increased 82 percent among Alaska Native children so that the overall IPD reduction in these children was only 39 percent during 2004-2006 compared to before vaccine introduction. Since 2004, the invasive pneumococcal disease rate caused by nonvaccine serotypes has increased 140 percent compared with the prevaccine period (from 95.1 per 100
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