The pneumococcal vaccine appears to have markedly reduced the overall burden of pediatric pneumonia, results of a large retrospective study suggest.
Rates of hospitalization and ambulatory medical visits for all-cause and pneumococcal pneumonia fell dramatically by 2004, 4 years after the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the routine childhood immunization schedule in the United States. Associated medical expenditures also dropped considerably, the researchers reported.
Studies have found substantial decreases in the incidence of invasive pneumococcal disease such as meningitis and septicemia after the PCV7 vaccine was introduced, but few have examined its effect on all-cause pneumonia and pneumococcal pneumonia in the general population, and none to date have tallied the economic effects.
Fangjun Zhou, Ph.D., and associates at the Centers for Disease Control and Prevention, Atlanta, analyzed data from more than 100 large health insurance plans covering about 500 million claims between 1997 and 2004, including more than 40,000 each year for children younger than 2 years, the population targeted by the vaccine.
They found a 52% decline in hospitalizations for all-cause pneumonia and a 58% decline in hospitalizations for pneumococcal pneumonia after use of the PCV7 vaccine became widespread. The mean length of stay per all-cause pneumonia hospitalization also decreased significantly. During the same period, the number of ambulatory visits for all-cause pneumonia declined by 41%, and the number of visits for pneumococcal pneumonia declined by 47%.
“This suggests that [Streptococcus] pneumoniae was a major contributor to the burden of pneumonia hospitalizations and ambulatory visits in children younger than 2 years,” they noted (Arch. Pediatr. Adolesc. Med. 2007;161:1162–8).
They estimated annual national medical expenditures for all-cause pneumonia hospitalizations and ambulatory visits for children younger than age 2 dipped by 45%, from roughly $688 million to $377 million. Annual medical expenditures for pneumococcal pneumonia treatment declined 27%, from $122 million to $89 million.
“Total net savings from the vaccine would be much greater if indirect costs such as work loss by parents or productivity loss by disability or death due to the disease were included,” said the investigators, none of whom reported any financial conflicts of interest.