1. Outpatient Visits and Antibiotic Use Due to Higher-Valency Pneumococcal Vaccine Serotypes.
- Author
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King, Laura, Andrejko, Kristin, Kabbani, Sarah, Tartof, Sara, Hicks, Lauri, Cohen, Adam, Kobayashi, Miwako, and Lewnard, Joseph
- Subjects
Streptococcus pneumoniae ,acute otitis media ,antibiotic ,outpatient ,pediatric ,pneumococcal conjugate vaccine ,pneumonia ,sinusitis ,Humans ,Pneumococcal Vaccines ,Anti-Bacterial Agents ,Child ,Preschool ,Infant ,Pneumococcal Infections ,Streptococcus pneumoniae ,Child ,Serogroup ,Otitis Media ,Female ,Adolescent ,Male ,Outpatients ,United States ,Vaccines ,Conjugate ,Incidence ,Ambulatory Care ,Sinusitis ,Infant ,Newborn - Abstract
BACKGROUND: In 2022-2023, 15- and 20-valent pneumococcal conjugate vaccines (PCV15/PCV20) were recommended for infants. We aimed to estimate the incidence of outpatient visits and antibiotic prescriptions in US children (≤17 years) from 2016-2019 for acute otitis media, pneumonia, and sinusitis associated with PCV15- and PCV20-additional (non-PCV13) serotypes to quantify PCV15/20 potential impacts. METHODS: We estimated the incidence of PCV15/20-additional serotype-attributable visits and antibiotic prescriptions as the product of all-cause incidence rates, derived from national health care surveys and MarketScan databases, and PCV15/20-additional serotype-attributable fractions. We estimated serotype-specific attributable fractions using modified vaccine-probe approaches incorporating incidence changes post-PCV13 and ratios of PCV13 versus PCV15/20 serotype frequencies, estimated through meta-analyses. RESULTS: Per 1000 children annually, PCV15-additional serotypes accounted for an estimated 2.7 (95% confidence interval, 1.8-3.9) visits and 2.4 (95% CI, 1.6-3.4) antibiotic prescriptions. PCV20-additional serotypes resulted in 15.0 (95% CI, 11.2-20.4) visits and 13.2 (95% CI, 9.9-18.0) antibiotic prescriptions annually per 1000 children. PCV15/20-additional serotypes account for 0.4% (95% CI, 0.2%-0.6%) and 2.1% (95% CI, 1.5%-3.0%) of pediatric outpatient antibiotic use. CONCLUSIONS: Compared with PCV15-additional serotypes, PCV20-additional serotypes account for > 5 times the burden of visits and antibiotic prescriptions. Higher-valency PCVs, especially PCV20, may contribute to preventing pediatric pneumococcal respiratory infections and antibiotic use.
- Published
- 2024