1. Do community-level predictors of pneumococcal carriage continue to play a role in the conjugate vaccine era?
- Author
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HSU, KK, RIFAS-SHIMAN, SL, SHEA, KM, KLEINMAN, KP, LEE, GM, LAKOMA, M, PELTON, SI, FINKELSTEIN, JA, and HUANG, SS
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Biotechnology ,Infectious Diseases ,Prevention ,Pneumonia & Influenza ,Pneumonia ,Lung ,Immunization ,Vaccine Related ,3.4 Vaccines ,Prevention of disease and conditions ,and promotion of well-being ,Infection ,Boston ,Carrier State ,Child ,Preschool ,Family Characteristics ,Female ,Heptavalent Pneumococcal Conjugate Vaccine ,Humans ,Infant ,Infant ,Newborn ,Male ,Massachusetts ,Pneumococcal Infections ,Pneumococcal Vaccines ,Residence Characteristics ,Vaccines ,Conjugate ,pneumococcal conjugate vaccine ,community risk factors ,Streptococcus pneumoniae ,Colonization ,Pneumococcus vaccine ,heptavalent pneumococcal conjugate vaccine ,vaccine ,article ,bacterial strain ,child ,child health ,cohort analysis ,community assessment ,community living ,female ,health education ,human ,logistic regression analysis ,lowest income group ,male ,pneumococcal infection ,population density ,population size ,poverty ,predictor variable ,public health ,risk factor ,serotype ,social status ,United States ,vaccination ,demography ,family size ,heterozygote ,infant ,microbiology ,newborn ,preschool child ,statistics ,Public Health and Health Services ,Epidemiology ,Veterinary sciences ,Clinical sciences - 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.
- Published
- 2014