Published online October 2, 2006
PEDIATRICS Vol. 118 No. 4 October 2006, pp. 1394-1402 (doi:10.1542/peds.2006-0314)
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ARTICLE

The Impact of Conjugate Pneumococcal Vaccination on Routine Childhood Vaccination and Primary Care Use in 2 Counties

Peter G. Szilagyi, MD, MPHa, Marie R. Griffin, MD, MPHb,c, Laura P. Shone, DrPH, MSWa, Richard Bartha, Yuwei Zhu, MD, MSd, Stanley Schaffer, MD, MSa, Sandra Ambrose, MBAa, Jason Roy, PhDa, Katherine A. Poehling, MD, MPHb,e, Kathryn M. Edwards, MDe, Frances J. Walker, MSPHf, Benjamin Schwartz, MDf for the New Vaccine Surveillance Network

a Department of Pediatrics, Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, New York
b Departments of Preventive Medicine
c Medicine
d Biostatistics
e Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
f National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia

BACKGROUND. Pneumococcal conjugate vaccine immunization recommendations were rapidly implemented by primary care providers. Before the recommendations, concern was expressed that adding pneumococcal conjugate vaccine might result in delays in other vaccinations or preventive services.

OBJECTIVES. The study objectives were to measure whether incorporation of pneumococcal conjugate vaccine by primary care providers delayed other vaccinations or added primary health care visits.

DESIGN AND METHODS. In 2 counties surrounding Rochester and Nashville, we reviewed a representative sample of primary care charts for children born before and after licensure of pneumococcal conjugate vaccine. Receipt of vaccinations and health care visits were compared for the 2 age-matched cohorts.

RESULTS. We reviewed 1459 records from Rochester and 1857 records from Nashville. The pre–pneumococcal conjugate vaccine and post–pneumococcal conjugate vaccine cohorts had similar demographic characteristics. The median age for receipt of any vaccination was not older for the postvaccine cohort than for the prevaccine cohort in either community. The percentage of children up-to-date for vaccinations by 18 months for postvaccine versus prevaccine cohorts was similar in Rochester (72% in each cohort) and in Nashville (58% postvaccine and 65% prevaccine). The number of well-child care visits or other health care visits during the first 18 months of life was not statistically different between the 2 cohorts.

CONCLUSIONS. Implementation of pneumococcal conjugate vaccine was not associated with delays in other childhood vaccinations or more primary care visits.

Key Words: conjugate pneumococcal vaccination • PCV7 • vaccination practices

Abbreviations: PCV7—pneumococcal conjugate vaccine • WCC—well-child care

Accepted May 23, 2006.




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