Impact of pneumococcal conjugate vaccine uptake on childhood pneumonia mortality across income levels in Brazil, Colombia, and Peru
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2020
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Background: Pneumococcal conjugate vaccines (PCVs) have
prevented deaths due to pneumonia among children. The effect may
differ between higher- and lower-income populations due to various
factors, such as differences in the distribution of pneumococcal
serotypes, healthcare access, and PCV uptake. This study aims to
evaluate an association between increasing PCV coverage and
population-level declines in death due to pneumonia and its variation
by socioeconomic status of subnational regions.
Methods: We analyzed municipality-level mortality data from 2005
and 2015 for children aged 2-23 months in Brazil, Colombia, and Peru.
We fit Poisson regression models to estimate the relationship
between changes in PCV uptake and deaths due to all-cause
pneumonia among subnational regions with different income levels.
We controlled for changes unrelated to PCV by using data on non respiratory deaths over time.
Results: Uptake of the third dose of PCV varied across subnational
regions and was higher in high-income regions. Higher uptake of PCV
was associated with larger declines in pneumonia mortality. This
association did not differ by income level of the region in Brazil and
Colombia. In Peru, low-income regions observed larger declines in
pneumonia deaths, but there was large uncertainty in the difference
between the low- and high-income regions. We estimated that, with 90% coverage, there would be 4-38% declines in all-cause pneumonia
mortality across income levels and countries.
Conclusions: Regions with higher PCV coverage experienced larger
declines in pneumonia deaths, regardless of the income level. Having
more reliable data on mortality records and vaccine uptake would
improve the reliability of vaccine impact estimates.
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Pneumococcal conjugate vaccine, Vaccine evaluation, Vaccine coverage, Vaccine uptake, Brazil, Colombia, Peru, Income level, Childhood pneumonia mortality
Citação
KAYOKO, Shioda et al. Impact of pneumococcal conjugate vaccine uptake on childhood pneumonia mortality across income levels in Brazil, Colombia, and Peru. Gates Open Research, Seatle, v. 4, e136, 2020. DOI: 10.12688/gatesopenres.13187.1. Disponível em: https://gatesopenresearch.org/articles/4-136/v1?s3BucketUrl=https%3A%2F%2Fgatesopenresearch.s3.eu-west-1.amazonaws.com>mKey=GTM-MKM3CSF&submissionUrl=%2Ffor-authors%2Fpublish-your-research&otid=275477bf-f17b-474f-befe-635d8fa9661a&immUserUrl=https%3A%2F%2Fgates-proxy.f1krdev.com%2Feditor%2Fmember%2Fshow%2F. Acesso em: 3 dez. 2024.