Pneumococcal Vaccine Proves Very Effective After Only 2 Years in Norway
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Pneumococcal Vaccine Proves Very Effective After Only 2 Years in Norway

NEW YORK -- July 9, 2008 -- Two years after the introduction of a 7-valent pneumococcal conjugate vaccine (Prevenar [PCV-7]) in the childhood vaccination programme in Norway, a strong decline in serious pneumococcal infections in young children has been reported, according to an analysis published in the June 19 issue of Vaccine.

A major reason for the introduction of the pneumococcal vaccine into the childhood vaccination programme was a steady increase in the number of cases of severe pneumococcal infection among young children in Norway.

"Having summed up the experience gained from the first 2 years after introducing the vaccine, the results confirm that it works as well as intended," said coauthor Marianne R. Bergsaker, Division of Infectious Disease Control, Norwegian Institute of Public Health, Bergen, Norway.

"Among all children under 2 years, in the first 2 years after the introduction of the vaccine there was a 70% decline of serious pneumococcal infections caused by the targeted serotypes, compared with pre-introduction figures."

The Norwegian Childhood Vaccination Programme administered the vaccine in a 2-in-1 dose schedule, with immunisations administered at 3, 5, and 12 months of age.

"Our experience shows that a 3-dose programme is sufficient to give the children good protection," said Bergsaker. "A 3-dose programme is also advantageous because the vaccine can be administered at the same time as other vaccines in the … programme."

Within the first year of introduction, there was already high acceptance of the vaccine. Of the children who were offered the vaccine in 2006, 95% had at least 1 dose, 90% received 2 doses, and 80% received all 3 doses.

Of the children who received at least 2 doses, none has had serious pneumococcal infections. "We have so far failed to find an example of what is called vaccine failure for children who have received 2 or more vaccine doses," said Bergsaker.

The effectiveness of the PCV-7 vaccination programme was assessed using data on invasive pneumococcal disease (IPD) incidence obtained from the Norwegian Surveillance System for Communicable Diseases, serotype distribution from the National Reference Laboratory for Pneumococci, and vaccine coverage and vaccination status from the Norwegian National Vaccination Register.

The incidence rate of IPD among children aged less than 2 years rapidly declined. The rate of vaccine serotype IPD in this age group fell from an average of 47.1 cases/100,000 population in the 2 years prior to PCV-7 introduction to 13.7 cases/100,000 population in 2007.

The incidence rate of nonvaccine serotype IPD remained stable. The vaccine programme effectiveness was estimated to be 74%.

SOURCE: Norwegian Institute of Public Health

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