High pneumonia lifetime-ever incidence in Beijing children compared with locations in other countries, and implications for national PCV and Hib vaccination
<div><p>Objectives</p><p>To compare the proportion of Beijing children who have ever had pneumonia (<i>%Pneumonia</i>) to those in other locations, and to estimate by how much national vaccine coverage with Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Influenzae Type b (Hib) could reduce Beijing <i>%Pneumonia</i>.</p><p>Methods</p><p><i>%Pneumonia</i> was obtained for each age group from 1 to 8 years inclusive from 5,876 responses to a cross-sectional questionnaire. Literature searches were conducted for world-wide reports of <i>%Pneumonia</i>. Previous vaccine trials conducted worldwide were used to estimate the pneumococcal (<i>S</i>. <i>pneumoniae</i>) and Hib (<i>H</i>. <i>influenzae)</i> burdens and <i>%Pneumonia</i> as well as the potential for PCV and Hib vaccines to reduce Beijing children’s <i>%Pneumonia</i>.</p><p>Findings</p><p>The majority of pneumonia cases occurred by the age of three. The cumulative <i>%Pneumonia</i> for 3–8 year-old Beijing children, 26.9%, was only slightly higher than the 25.4% for the discrete 3 year-old age group, similar to trends for Tianjin (China) and Texas (USA). Beijing’s <i>%Pneumonia</i> is disproportionally high relative to its Gross National Income (GNI) per capita, and markedly higher than <i>%Pneumonia</i> in the US and other high GNI per capita countries. Chinese diagnostic guidelines recommend chest X-ray confirmation while most other countries discourage it in favor of clinical diagnosis. Literature review shows that chest X-ray confirmation returns far fewer pneumonia diagnoses than clinical diagnosis. Accordingly, Beijing’s <i>%Pneumonia</i> is likely higher than indicated by raw numbers. Vaccine trials suggest that national PCV and Hib vaccination could reduce Beijing’s <i>%Pneumonia</i> from 26.9% to 19.7% and 24.9% respectively.</p><p>Conclusion</p><p>National PCV and Hib vaccination programs would substantially reduce Beijing children’s pneumonia incidence.</p></div
