评估儿童肺炎球菌疫苗接种对哥伦比亚肺炎死亡率的影响：一项为期14年的分析。
Assessing the impact of childhood pneumococcal vaccination on pneumonia mortality in Colombia: a 14-year analysis.
作者信息
Parellada C I, Reyes L F, Urrego-Reyes J, Webster J L, Pungartnik P C, Dos Santos A C, Rojas M, de la Hoz F
机构信息
Outcomes Research Regional Latin America, MSD Brazil, São Paulo, SP, Brazil.
, Avenida Chucri Zaidan no. 296 São Paulo, São Paulo, 04583-110, Brazil.
出版信息
BMC Public Health. 2025 Sep 1;25(1):2990. doi: 10.1186/s12889-025-23631-1.
BACKGROUND
The 10-valent pneumococcal conjugate vaccine (PCV10) has been offered to all infants through Colombia’s National Immunization Program (NIP) since 2012, with catch-up vaccination until age 5. However, pneumococcal vaccination is not currently included in the NIP for other age groups, such as those ≥ 5 years with medical conditions or older adults. This study assessed the pediatric PCV10 effect on pneumonia mortality rate (MR) trends across different age groups from 2006 to 2019.
METHODS
This retrospective time-series study utilized the national death registration data. Deaths caused by pneumonia as the underlying cause of death were identified via ICD-10 codes and stratified by age groups (< 1, 1–4, 5–17, 18–49, 50–59, and ≥ 60 years). Crude MR, age-adjusted MR, and age-specific MRs per 100,000 population were calculated. Trends were assessed using joinpoint regression and expressed as annual percentage change (APC) and average APC in the pre-PCV10 (2006–2011), post-PCV10 (2013–2019), early post-PCV10 (2013–2016), and late post-PCV10 (2017–2019) periods.
RESULTS
From 2006 to 2019, there were 102,082 pneumonia-related deaths. The age-specific MR for infants < 1 year significantly decreased from 83.8 to 28.6 per 100,000 between 2006 and 2019 (APC:-6.9), while for children aged 1–4 years, it decreased from 9.3 to 3.8 (APC:-5.1). Other older age groups exhibited stable trends in the post-PCV10 period, except for adults aged ≥ 60 years, who had the highest age-specific MR (~ 112 per 100,000) over the study period, with an AAPC of 6.5% in the early post-PCV10 period, followed by stable trends in the late post-PCV10 period. The age-adjusted MR showed an increasing trend with an APC of 1.9% from 2008 to 2019.
CONCLUSIONS
Our study found decreasing age-specific MR trends in children under 5 in the post-PCV10 period; however, no evidence of indirect benefits was seen in unvaccinated age groups older than 5 years. The findings underscore the need to expand pneumococcal vaccination programs to other age groups, mainly adults ≥ 60 years.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12889-025-23631-1.
背景
自2012年起，10价肺炎球菌结合疫苗（PCV10）已通过哥伦比亚国家免疫规划（NIP）提供给所有婴儿，并对5岁以下儿童进行补种。然而，目前NIP并未将肺炎球菌疫苗接种纳入其他年龄组，如患有疾病的≥5岁儿童或老年人。本研究评估了2006年至2019年期间儿科PCV10对不同年龄组肺炎死亡率（MR）趋势的影响。
方法
这项回顾性时间序列研究利用了国家死亡登记数据。通过国际疾病分类第10版（ICD-10）编码确定以肺炎为根本死因的死亡病例，并按年龄组（<1岁、1-4岁、5-17岁、18-49岁、50-59岁和≥60岁）进行分层。计算每10万人口的粗死亡率、年龄调整死亡率和特定年龄死亡率。使用连接点回归评估趋势，并表示为PCV10接种前（2006-2011年）、PCV10接种后（2013-2019年）、PCV10接种后早期（2013-2016年）和PCV10接种后晚期（2017-2019年）的年度百分比变化（APC）和平均APC。
结果
2006年至2019年期间，共有102,082例与肺炎相关的死亡病例。2006年至2019年期间，<1岁婴儿的特定年龄死亡率从每10万83.8例显著降至28.6例（APC：-6.9），而1-4岁儿童的死亡率从9.3例降至3.8例（APC：-5.1）。除≥60岁的成年人外，其他年龄较大的年龄组在PCV10接种后期间呈现稳定趋势，≥60岁成年人在研究期间的特定年龄死亡率最高（约每10万112例），在PCV10接种后早期AAPC为6.5%，随后在PCV10接种后晚期呈稳定趋势。年龄调整死亡率呈上升趋势，2008年至2019年的APC为1.9%。
结论
我们的研究发现，在PCV10接种后期间，5岁以下儿童的特定年龄死亡率呈下降趋势；然而，在5岁以上未接种疫苗的年龄组中未发现间接益处的证据。研究结果强调有必要将肺炎球菌疫苗接种计划扩大到其他年龄组，主要是≥60岁的成年人。
补充信息
在线版本包含可在10.1186/s12889-025-23631-1获取的补充材料。
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