Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control study

Objective: In Panama, the 13-valent pneumococcal conjugate vaccine (PCV13) was included in the primary immunization schedule in 2010 with a 3-dose schedule. The authors evaluated the effectiveness of PCV13 against severe community-acquired pneumonia in children of Panama after its introduction into...

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Main Authors: Jacqueline Levy, Rodrigo DeAntonio, Xavier Sáez-Llorens
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Jornal de Pediatria
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Online Access:http://www.sciencedirect.com/science/article/pii/S0021755725000762
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author Jacqueline Levy
Rodrigo DeAntonio
Xavier Sáez-Llorens
author_facet Jacqueline Levy
Rodrigo DeAntonio
Xavier Sáez-Llorens
author_sort Jacqueline Levy
collection DOAJ
description Objective: In Panama, the 13-valent pneumococcal conjugate vaccine (PCV13) was included in the primary immunization schedule in 2010 with a 3-dose schedule. The authors evaluated the effectiveness of PCV13 against severe community-acquired pneumonia in children of Panama after its introduction into the national immunization program. Methods: A retrospective matched case-control study was conducted at Hospital del Niño Doctor José Renán Esquivel, collecting data from children 2 to 59 months of age in years subsequent to the introduction of the PCV13 vaccine (2013–2015). Cases of severe community-acquired pneumonia had radiographically confirmed pneumonia (consolidated or with pleural effusion) or pneumonia with “other infiltrate” associated with CRP ≥ 40 mg/L with severity criteria according to the 2013 World Health Organization definition. Controls were children hospitalized for non-immune-preventable diseases matched by cases' age and admission date. Vaccine effectiveness was estimated as (1 - odds ratio) × 100 % with 95 % confidence intervals. Results: 78 paired cases with 198 controls were included. In the cases, the mean age was 13.7 ± 10.3 SD months, and the hospital stay was 9.7 + 6.1 days. Overall, the effectiveness of PCV13 against severe community-acquired pneumonia was 54.0 % (95 % CI 25.0–72.0 %, p < 0.05). Vaccine effectiveness among children under 1 year was 61 % (95 % CI: 23.0–81.0 %) and 43 % (95 % CI:16.0–74.0 %) for children 1 to 4 years. For children who received at least 1 PCV13 dose was 17.2 % (95 % CI: 8.8–33.7 %). Overcrowding and lack of vaccination against influenza were risk factors for lower vaccine effectiveness. Conclusions: PCV13 was effective in preventing severe cases of community-acquired pneumonia in children in Panama.
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spelling doaj-art-5a67e90b756e4e2f96d4756ef40aaa932025-08-20T02:36:30ZengElsevierJornal de Pediatria0021-75572025-07-01101460160710.1016/j.jped.2025.03.008Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control studyJacqueline Levy0Rodrigo DeAntonio1Xavier Sáez-Llorens2Hospital del Niño Doctor José Renán Esquivel, Provincia de Panamá, Panamá; The Panama Clinic, Provincia de Panamá, Panamá; Corresponding author.Centro de Vacunación e Investigación (CEVAXIN) The Panama Clinic, Provincia de Panamá, Panamá; Sistema Nacional de Investigación Panamá, Provincia de Panamá, PanamáHospital del Niño Doctor José Renán Esquivel, Provincia de Panamá, Panamá; Centro de Vacunación e Investigación (CEVAXIN) The Panama Clinic, Provincia de Panamá, Panamá; Sistema Nacional de Investigación Panamá, Provincia de Panamá, PanamáObjective: In Panama, the 13-valent pneumococcal conjugate vaccine (PCV13) was included in the primary immunization schedule in 2010 with a 3-dose schedule. The authors evaluated the effectiveness of PCV13 against severe community-acquired pneumonia in children of Panama after its introduction into the national immunization program. Methods: A retrospective matched case-control study was conducted at Hospital del Niño Doctor José Renán Esquivel, collecting data from children 2 to 59 months of age in years subsequent to the introduction of the PCV13 vaccine (2013–2015). Cases of severe community-acquired pneumonia had radiographically confirmed pneumonia (consolidated or with pleural effusion) or pneumonia with “other infiltrate” associated with CRP ≥ 40 mg/L with severity criteria according to the 2013 World Health Organization definition. Controls were children hospitalized for non-immune-preventable diseases matched by cases' age and admission date. Vaccine effectiveness was estimated as (1 - odds ratio) × 100 % with 95 % confidence intervals. Results: 78 paired cases with 198 controls were included. In the cases, the mean age was 13.7 ± 10.3 SD months, and the hospital stay was 9.7 + 6.1 days. Overall, the effectiveness of PCV13 against severe community-acquired pneumonia was 54.0 % (95 % CI 25.0–72.0 %, p < 0.05). Vaccine effectiveness among children under 1 year was 61 % (95 % CI: 23.0–81.0 %) and 43 % (95 % CI:16.0–74.0 %) for children 1 to 4 years. For children who received at least 1 PCV13 dose was 17.2 % (95 % CI: 8.8–33.7 %). Overcrowding and lack of vaccination against influenza were risk factors for lower vaccine effectiveness. Conclusions: PCV13 was effective in preventing severe cases of community-acquired pneumonia in children in Panama.http://www.sciencedirect.com/science/article/pii/S0021755725000762Severe pneumoniaChildrenPanamaPneumococcal conjugate vaccineCommunity-acquired pneumonia
spellingShingle Jacqueline Levy
Rodrigo DeAntonio
Xavier Sáez-Llorens
Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control study
Jornal de Pediatria
Severe pneumonia
Children
Panama
Pneumococcal conjugate vaccine
Community-acquired pneumonia
title Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control study
title_full Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control study
title_fullStr Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control study
title_full_unstemmed Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control study
title_short Effectiveness of pneumococcal conjugate 13-valent vaccine against severe pneumonia in Panama: a matched case-control study
title_sort effectiveness of pneumococcal conjugate 13 valent vaccine against severe pneumonia in panama a matched case control study
topic Severe pneumonia
Children
Panama
Pneumococcal conjugate vaccine
Community-acquired pneumonia
url http://www.sciencedirect.com/science/article/pii/S0021755725000762
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