Do community-level predictors of pneumococcal carriage continue to play a role in the conjugate vaccine era?

View Abstract

This paper examined whether previously identified community-level factors (high proportion of crowded households and/or persons below the poverty level) remained associated with childhood pneumococcal carriage in the heptavalent pneumococcal conjugate vaccine (PCV7) era. Using logistic regression, individual factors were used to develop base models to which community-level factors were added to evaluate impact on pneumococcal carriage within two paediatric study cohorts from Massachusetts (urban Boston, outside Boston). Six years after introduction of universal childhood PCV7 vaccination, we found no consistent evidence that census tract characteristics (e.g. population size and density, age and race distribution, percent participating in group childcare, parental education, percent lacking in-unit plumbing, poverty, and community stability) affected odds of pneumococcal carriage when added to individual predictors (e.g. younger age, current respiratory tract infections, and attendance in group childcare). How community-level factors influence pneumococcal carriage continues to change in the era of increasing immunization coverage.

Abbreviation
Epidemiol. Infect.
Publication Date
2014-02-01
Volume
142
Issue
2
Page Numbers
379-87
Pubmed ID
23731707
Medium
Print-Electronic
Full Title
Do community-level predictors of pneumococcal carriage continue to play a role in the conjugate vaccine era?
Authors
Hsu KK, Rifas-Shiman SL, Shea KM, Kleinman KP, Lee GM, Lakoma M, Pelton SI, Finkelstein JA, Huang SS