Abstract: The objectives of this study were to describe a series of children
with invasive pneumococcal disease (IPD), evaluate the proportion with defined
risks for pneumococcal disease and to assess the impact of the new UK
pneumococcal vaccination schedule in preventing IPD. We conducted a review of
case notes of children aged 0–16 years admitted to a large district
general/teaching hospital in East Birmingham from September 1993-December 2004.
Fifty-six children were identified with IPD; case notes were available for 54
children (55 episodes). The median age at diagnosis was 15 months
(inter-quartile range 8–37.5 months). Only 14 (26%) had pre-existing risk
factors for developing IPD. A significant age difference was found between
those with co-existing risk factors and those without (median 37 months vs. 11
months; P<0.05). Twenty-one (72%) of the cases where serotypes were
known, had serotypes covered by the 7-valent conjugate pneumococcal vaccine and
28 (97%) covered by the polysaccharide vaccine. However most would not have
benefited from the polysaccharide vaccine since 32 (59%) were less than 2
years of age at the time of the episode of IPD. Targeted pneumococcal
vaccination might prevent less than 26% of cases of IPD in children.
Incorporating the conjugate pneumococcal vaccine into the universal vaccination
program might prevent 70% of IPD in children.