Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10237
Title: Impact of the 23-valent pneumococcal polysaccharide vaccination in pregnancy against infant acute lower respiratory infections in the Northern Territory of Australia.
Authors: Binks, Michael J
Moberley, Sarah A
Balloch, Anne
Leach, Amanda J
Nelson, Sandra
Hare, Kim M
Wilson, Cate
Nelson, Jane
Morris, Peter S
Ware, Robert S
Tang, Mimi L K
Torzillo, Paul J
Carapetis, Jonathan R
Mulholland, Kim
Andrews, Ross M
Affiliation: 1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia..
1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia..
2Murdoch Children's Research Institute, University of Melbourne, Royal Children's Hospital, Melbourne, Victoria Australia..
1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia..
Department of Health and Families, Darwin, Northern Territory Australia..
1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia..
1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia..
1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia..
1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia..
Menzies Health Institute Queensland, Griffith University, Gold Coast; Child Health Research Centre, School of Medicine, The University of Queensland, Queensland, Brisbane, Australia..
2Murdoch Children's Research Institute, University of Melbourne, Royal Children's Hospital, Melbourne, Victoria Australia..
5Royal Prince Alfred Hospital, Sydney, New South Wales Australia..
Telethon Kids Institute, University of Western Australia, Perth Children's Hospital, Perth, Western Australia Australia..
2Murdoch Children's Research Institute, University of Melbourne, Royal Children's Hospital, Melbourne, Victoria Australia..
1Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory 0810 Australia.. 7National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory Australia..
Issue Date: 2018
Citation: Pneumonia (Nathan Qld.) 2018; 10: 13
Abstract: Indigenous children in Australia's Northern Territory are densely colonised with the pneumococcus within weeks of birth antecedent to a high prevalence of acute lower respiratory infection (ALRI). We assessed the impact of the 23-valent pneumococcal polysaccharide vaccine (23vPPV) in pregnancy against infant ALRI in this setting. In an open label, allocation concealed, outcome-assessor blinded, randomised controlled trial conducted in the Northern Territory of Australia, healthy Indigenous women aged 17-39 years were randomised to receive the 23vPPV during pregnancy (n = 75; 30-36 weeks gestation), at birth (n = 75), or at 7 months post-partum (n = 77). Randomisation was stratified by community of residence. In a secondary analysis, we compared the incidence of ALRI hospitalisations and ALRI clinic presentations (ascertained from electronic medical records) among infants of pregnancy vaccinees versus infants of mothers not vaccinated in pregnancy (controls) in the first year of life. ALRI hospitalisation incidence was 12.3 per 100 child-years among infants of pregnancy vaccinees compared with 15.8 per 100 child-years among controls (hazard ratio (HR) 0.77, 95%CI 0.29-2.03). ALRI hospitalisations were more common among remote compared to urban infants (27.7 versus 8.6 per 100 child-years). Stratification by dwelling highlighted a differential antenatal vaccine effect against ALRI hospitalisations (urban HR 2.45, 95%CI 0.60-9.99; remote HR 0.21, 95%CI 0.04-1.08). ALRI clinic presentation incidence was similar among infants of pregnancy vaccinees and controls. In this small study, antenatal 23vPPV vaccination was not associated with a reduced incidence of infant ALRI hospitalisations or ALRI clinic presentations during the first year of life. A potential differential effect between urban and remote settings warrants further investigation. PneuMum; ClinicalTrials.gov NCT00714064.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10237
DOI: 10.1186/s41479-018-0057-2
ORCID: 0000-0001-5455-690X
ISSN: 2200-6133
Type: Journal Article
Subjects: 23-valent pneumococcal polysaccharide vaccine
Acute lower respiratory infection
Australia
Indigenous
Pregnancy
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