Effect of Community‐Wide Conjugate Pneumococcal Vaccine Use in Infancy on Nasopharyngeal Carriage through 3 Years of Age: A Cross‐Sectional Study in a High‐Risk Population

作者：Eugene V. Millar, Katherine L. O'Flynn O'Brien, James Watt, Melinda A. Bronsdon, Jean H. Dallas, Cynthia G. Whitney, Raymond Reid, Mathuram Santosham · 发表于：Clinical Infectious Diseases · 年份：2006 · DOI：10.1086/504802 · 被引用次数：112 · 研究领域：Pneumonia and Respiratory Infections、Respiratory viral infections research、Bacterial Infections and Vaccines

BACKGROUND: A 7-valent pneumococcal conjugate vaccine (PnCRM7) has been shown to be highly effective in preventing invasive pneumococcal disease. Pneumococcal conjugate vaccines also protect against nasopharyngeal carriage of vaccine serotypes, but the duration of protection against nasopharyngeal carriage is not known. METHODS: A group-randomized efficacy trial of PnCRM7 (vaccine serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F) was conducted on the Navajo and White Mountain Apache reservations from April 1997 to October 2000. A group C meningococcal conjugate vaccine was used as the control vaccine. Infants enrolled between 6 weeks and 7 months of age received 3 doses of vaccine 2 months apart and a fourth dose at 12-15 months of age. Vaccinees were enrolled in a nasopharyngeal carriage study from February 2001 to January 2002 to assess the duration of protection against pneumococcal carriage induced by PnCRM7. RESULTS: We included 749 children in the analysis, including 468 children vaccinated with PnCRM7 and 281 children vaccinated with group C meningococcal conjugate vaccine. The median age was 3.3 years (range, 1-7 years), and the median time since last dose of study vaccine was 27 months (range, 12-48 months). Frequencies of overall pneumococcal carriage were similar among PnCRM7 and group C meningococcal conjugate vaccine recipients (63.9% vs. 60.5%, respectively). The absolute frequency of vaccine-type pneumococcal carriage was lower among PnCRM7 recipients (10.3%) than am...