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Jennifer M. Stancil, MD; Timothy R. Peters, MD; Laurence B. Givner, MD; Katherine A. Poehling, MD, MPH

Arch Pediatr Adolesc Med. 2009;163(5):422-425.

Objective  To estimate the potential effect of the acceleration of administration of the first dose of pneumococcal conjugate vaccine from 2 months to 6 weeks of age.

Design  Prediction model using data from a retrospective cohort study.

Setting  Published data from 8 states that participated in Active Bacterial Core Surveillance of the Emerging Infections Program Network for pneumococcus before pneumococcal conjugate vaccine introduction (July 1, 1997- June 30, 2000).

Participants  A total of 759 739 live births under surveillance.

Intervention  Estimating the potential benefit of administration of the first dose of the pneumococcal conjugate vaccine at 6 weeks of age instead of 2 months of age.

Main Outcome Measures  Estimation of reduction in the rate of invasive pneumococcal disease in infants 61 to 90 days of age.

Results  The estimated direct effect of the acceleration of administration of the first dose of pneumococcal conjugate vaccine from 2 months to 6 weeks of age when this vaccine was first introduced could have reduced the burden of invasive pneumococcal disease in infants 61 to 90 days of age by 39.9%, 56.0%, and 72.1% for respective vaccine efficacies of 50%, 70%, and 90%. This translates into preventing an estimated 73, 103, and 133 cases of invasive pneumococcal disease per year among approximately 4 112 052 live births in the United States.

Conclusions  The acceleration of administration of the pneumococcal conjugate vaccine from 2 months to 6 weeks of age could reduce the burden of invasive pneumococcal disease among infants. This observation may be important when a new conjugate vaccine becomes available, particularly among populations with prevalent invasive pneumococcal disease from a serotype included in the new vaccine.

Author Affiliations: Departments of Pediatrics (Drs Stancil, Peters, Givner, and Poehling) and Epidemiology and Prevention (Dr Poehling), Wake Forest University School of Medicine, Winston-Salem, North Carolina.

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