Impact of Universal Pneumococcal Vaccination on Hospitalizations for Pneumonia and Meningitis in Children in Montevideo, Uruguay

Background: In March 2008, Uruguay included PCV7 into the routine vaccination program, in a 2 + 1 schedule for children < 2 years of age. Catch-up immunization was offered to children born in 2007. Greater than 95% of children received their first and second doses. The aim of this study was to assess the effect of this strategy. Methods: Annual hospitalization rates (per 10,000 discharges) for community-acquired pneumonia (CAP) in children < 14 years of age and pneumococcal meningitis are described prior to PCV7 vaccination (2005-2007), during the year of implementation (2008) and following vaccine introduction (2009). Data regarding age, diagnosis, vaccination status, and pneumococcal serotype were obtained from Hospital Pereira Rossell databases and vaccination records. Results: Comparison of hospitalization rates for CAP and pneumococcal-CAP (P-CAP) between prevaccine years (2005-2007) and the year after vaccination (2009) decreased significantly in all children by 56% and 48.2%, respectively. Significant reduction was observed for vaccine serotype P-CAP (serotype 14 P-CAP decreased from 26.6 to 2.5 per 10,000 discharges) in children < 2 years of age. A significant reduction in pneumococcal meningitis of 59% was seen in this age group; median rates prevaccination decreased from 17 (12.2-24.9) to 7 (3-11.8) after the administration of vaccine. No vaccine failures for P-CAP or pneumococcal meningitis were seen in fully immunized children. Conclusions: One year after PCV7 introduction into the routine vaccination schedule of Uruguay, there was a rapid and significant reduction in rates of CAP, P-CAP, and pneumococcal meningitis in children < 2 years of age.