Routine infant vaccination of pneumococcal conjugate vaccines has decreased pneumonia across all age groups in Northern Spain

Figures & data

Figure 1. The region of Galicia and the disease reporting units.

Box 1. ICD 9 codes of cases used in identifying cases.

All-cause pneumonia

480 Viral pneumonia

481 Pneumococcal pneumonia (Streptococcus pneumoniae, pneumonia)

482 Other bacterial pneumonia

483 Pneumonia due to other specified organism

484 Pneumonia in infectious diseases classified elsewhere

485 Bronchopneumonia, organism unspecified

486 Pneumonia, organism unspecified

487 Influenza

487.0 Influenza with pneumonia, any form

Pneumococcal pneumoniae

481 Pneumococcal pneumonia [Streptococcus pneumoniae pneumonia]

Invasive Pneumococcal disease

320.1 Pneumococcal meningitis

038.2 Pneumococcal septicemia [Streptococcus pneumoniae septicemia]

481 Pneumococcal pneumonia [Streptococcus pneumoniae pneumonia]

Table 1. Average number of hospitalization across different vaccination period (pre-PCV, early vaccination using PCV7, and routine vaccination using PCV13), disaggregated into different age groups.

Period	Pre-PCV 1998-2003	Early 2005-2009	Routine 2011-2015	% change*	p value**
All-cause pneumonia
POPULATION	5639	5937	7834	+32.0%	***
< 5	596	596	373	−37.4%	***
5-14	193	206	152	−26.2%	0.061
15-24	110	81	53	−34.6%	0.061
24-44	398	422	368	−12.8%	0.095
45-64	817	875	1048	+19.8%	***
> 64	3525	3759	5840	+55.4%	***
Pneumococcal pneumonia
POPULATION	1734	1594	671	−57.9%	***
< 5	222	130	23	−82.3%	***
5-14	63	48	12	−75.0%	***
15-24	27	22	6	−72.7%	***
24-44	112	114	43	−43.0%	***
45-64	220	228	112	−50.9%	***
> 64	1090	1051	476	−54.7	***
Pneumococcal invasive diseases
POPULATION	1778	1666	741	−55.5%	****
< 5	227	137	25	−81.8%	***
5-14	65	49	13	−73.5%	***
15-24	28	24	6	−75.0%	***
24-44	118	124	51	−73.0%	***
45-64	230	245	130	−46.9%	***
> 64	1110	1086	515	−52.5%	***

*% change comparing private market use and routine immunization.

**p-value according to one-way ANOVA

***p < 0.0001

Table 2. Average hospitalization rates (case/10,000) across different vaccination period (pre-PCV, early vaccination using PCV7, and routine vaccination using PCV13), disaggregated into different age groups.

Period	Pre-PCV 1998-2003	Early 2005-2009	Routine 2011-2015	% change*	p value**
All cause pneumonia
POPULATION	20.6	21.4	28.4	+32.7%	***
< 5 year	67.5	57.4	34.3	−40.2%	***
5-14	8.0	9.8	7.0	−28.6%	0.031
15-24	2.8	2.7	2.2	−18.5%	0.103
24-44	5.0	4.9	4.6	−6.1%	0.246
45-64	12.6	12.2	13.9	+13.9%	0.018
> 64	63.0	62.8	90.9	+44.7%	***
Pneumococcal pneumonia
POPULATION	6.3	5.7	2.4	−57.9%	***
< 5	25.2	12.6	2.1	−83.3%	***
5-14	2.6	2.3	0.5	−78.3%	***
15-24	0.7	0.8	0.2	−75.0%	***
24-44	1.4	1.3	0.5	−61.5%	***
45-64	3.4	3.2	1.5	−53.1%	***
> 64	19.5	17.6	7.4	−58.0%	***
Invasive diseases
POPULATION	6.5	6.0	2.7	−55.0%	***
< 5	25.8	13.3	2.3	−82.7%	***
5-14	2.7	2.3	0.6	−73.9%	***
15-24	0.7	0.8	0.3	−62.5%	***
24-44	1.5	1.5	0.6	−60.0%	***
45-64	3.5	3.4	1.7	−50.0%	***
> 64	19.9	18.1	8.0	−55.8%	***

*% change comparing private market use and routine immunization.

**p-value according to one-way ANOVA

***p < 0.0001

Figure 2. All-cause pneumonia (a), pneumococcal pneumonia (b) and pneumococcal invasive diseases (c) hospitalizations in all age groups according to vaccination periods: pre-vaccination (1998–2003), early vaccination period, PCV7 (2005–2009) and routine vaccination period, PCV13 (2011–2013).