Incidence of pneumococcal disease in children ≤48 months old in the United States: 1998–2019

Vaccine, 2024

Pneumococcal disease (PD) is a major cause of pediatric morbidity and mortality, particularly among younger children. To better assess the real-world burden of PD, an Analysis Group team coauthored the first large-scale US study of how PD manifests by age group, insurance status, and sociodemographic characteristics in children aged 0–2 years during the study period (1998–2019). The study offers detailed insights into age-specific risks tied to waning immunity from maternal antibodies, vaccination habits, insurance status, and urbanicity.

The authors compared claims data for children aged 0–6, 7–12, 13–24, and 25–48 months who experienced episodes of invasive pneumococcal disease (IPD), all-cause pneumonia (ACP), or acute otitis media (AOM) from a population of 6.3 million commercially insured and 10.7 million Medicaid-insured patients. They found that incidence rates of IPD, ACP, and AOM decreased in children from 1998 to 2019. However, burden of disease remained substantial, especially among children aged 0–6 months and Medicaid-insured children. Incidence rates of IPD were higher in Medicaid-insured children and manifested most frequently among children aged 0–6 months, regardless of coverage type. Additionally, children 0–6 months old with ACP required hospitalization more often than older children, who were more likely to receive outpatient treatment. In contrast to more severe disease manifestations (i.e., IPD and ACP requiring hospitalization), incident rates of AOM were lowest in children aged 0–6 months and highest in children aged 7–12 months, regardless of the type of insurance coverage. Incidence rates for AOM were lower among Medicaid-covered children as compared to commercially insured children. Among the commercially insured population, incidence rates of IPD, ACP, and AOM were generally higher for children living in rural areas as compared to those living in urban areas.

The study, “Incidence of pneumococcal disease in children ≤48 months old in the United States: 1998–2019,” was published in Vaccine and was coauthored by Managing Principal James Signorovitch, Vice President Yan Song, Managers Nicolae Done and Qing Liu, and Associate Travis Wang. The study was featured in the Infectious Diseases Society of America (IDSA) Daily News Briefing with an article in Infectious Disease Advisor.

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Authors

Mohanty S, Done N, Liu Q, Song Y, Wang T, Gaburo K, Sarpong EM, White M, Weaver JP, Signorovitch J, Weiss T