Incidence of pneumococcal disease in children in Germany, 2014–2019: a retrospective cohort study

Jessica Weaver; Tianyan Hu; Bélène Podmore; Rosemarie Barnett; Dominik Obermüller; Wolfgang Galetzka; Nawab Qizilbash; Dennis Haeckl; Thomas Weiss; Salini Mohanty; Meghan White; Timo Boellinger

doi:10.1186/s12887-024-05003-7

Incidence of pneumococcal disease in children in Germany, 2014–2019: a retrospective cohort study

Jessica Weaver, Tianyan Hu, Bélène Podmore, Rosemarie Barnett, Dominik Obermüller, Wolfgang Galetzka, Nawab Qizilbash, Dennis Haeckl, Thomas Weiss, Salini Mohanty, Meghan White, Timo Boellinger

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Novel, expanded valency pneumococcal conjugate vaccines (PCVs) are in development to reduce the burden of pneumococcal disease (PD) in children. To understand the potential value of new vaccines in Germany, this study estimated the residual burden of PD in children < 16 years old from 2014 to 2019, using administrative health data from a large German claims database.

Methods: Outpatient and inpatient cases of all-cause pneumonia (ACP), pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) were identified in the InGef database. Incidence rates (IRs) with 95% confidence intervals (CI) were calculated as number of episodes/person-years (PY) at risk. The Mann-Kendall test assessed time trends in incidence.

Results: There were no significant trends in IRs of IPD or PP from 2014 to 2019. For ACP, IRs declined from 2014 to 2019; 2,213 (CI 2,176-2,250) to 1,503 (CI 1,472-1,534) per 100,000 PY (p = 0.017). IRs of ACP and PP were highest among children aged 12–23 months; 4,672 (CI 4,584-4,762) and 20.8 (CI 15.3–27.5) per 100,000 PY, respectively. For IPD, children 5–11 months-old had the highest IRs, at 14.7 (CI 9.0-22.7) per 100,000 PY.

Conclusions: From 2014 to 2019 there were no discernible trends in the IRs of PP or IPD, but the IRs of ACP declined in children aged < 16 years. The highest IRs of ACP, PP and IPD were observed in children < 2 years of age, highlighting the importance of infant pneumococcal vaccination in the prevention of pediatric PD. The clinical burden of pediatric PD in Germany persists. Continued surveillance of changing pneumococcal burden, serotype distribution, antimicrobial resistance and vaccination status is critical to better understand the factors driving incidence of PD and to inform future vaccination strategies.

Original language	English
Article number	755
Journal	BMC Pediatrics
Volume	24
Issue number	1
Early online date	20 Nov 2024
DOIs	https://doi.org/10.1186/s12887-024-05003-7
Publication status	Published - 31 Dec 2024

Data Availability Statement

The data that support the findings of this study are stored within the Institute for Applied Health Research Berlin GmbH (InGef, www.InGef.de). Restrictions apply to the availability of these data, and they are not publicly available, due to German data protection laws (Bundesdatenschutzgesetz). Analysis datasets can be assessed upon request, at InGef in Berlin ([email protected]), if required. Access to patient-level data is not possible and all analyses must be conducted by InGef. Requests for bespoke analyses/ aggregate results are reviewed and approved by InGef.

Keywords

Healthcare claims
Incidence
Pneumococcal conjugate vaccine
Pneumococcal disease
Pneumonia

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12887-024-05003-7Licence: CC BY

Cite this

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title = "Incidence of pneumococcal disease in children in Germany, 2014–2019: a retrospective cohort study",

abstract = "Background: Novel, expanded valency pneumococcal conjugate vaccines (PCVs) are in development to reduce the burden of pneumococcal disease (PD) in children. To understand the potential value of new vaccines in Germany, this study estimated the residual burden of PD in children < 16 years old from 2014 to 2019, using administrative health data from a large German claims database. Methods: Outpatient and inpatient cases of all-cause pneumonia (ACP), pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) were identified in the InGef database. Incidence rates (IRs) with 95% confidence intervals (CI) were calculated as number of episodes/person-years (PY) at risk. The Mann-Kendall test assessed time trends in incidence. Results: There were no significant trends in IRs of IPD or PP from 2014 to 2019. For ACP, IRs declined from 2014 to 2019; 2,213 (CI 2,176-2,250) to 1,503 (CI 1,472-1,534) per 100,000 PY (p = 0.017). IRs of ACP and PP were highest among children aged 12–23 months; 4,672 (CI 4,584-4,762) and 20.8 (CI 15.3–27.5) per 100,000 PY, respectively. For IPD, children 5–11 months-old had the highest IRs, at 14.7 (CI 9.0-22.7) per 100,000 PY. Conclusions: From 2014 to 2019 there were no discernible trends in the IRs of PP or IPD, but the IRs of ACP declined in children aged < 16 years. The highest IRs of ACP, PP and IPD were observed in children < 2 years of age, highlighting the importance of infant pneumococcal vaccination in the prevention of pediatric PD. The clinical burden of pediatric PD in Germany persists. Continued surveillance of changing pneumococcal burden, serotype distribution, antimicrobial resistance and vaccination status is critical to better understand the factors driving incidence of PD and to inform future vaccination strategies.",

keywords = "Healthcare claims, Incidence, Pneumococcal conjugate vaccine, Pneumococcal disease, Pneumonia",

author = "Jessica Weaver and Tianyan Hu and B{\'e}l{\`e}ne Podmore and Rosemarie Barnett and Dominik Oberm{\"u}ller and Wolfgang Galetzka and Nawab Qizilbash and Dennis Haeckl and Thomas Weiss and Salini Mohanty and Meghan White and Timo Boellinger",

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doi = "10.1186/s12887-024-05003-7",

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T1 - Incidence of pneumococcal disease in children in Germany, 2014–2019

T2 - a retrospective cohort study

AU - Weaver, Jessica

AU - Hu, Tianyan

AU - Podmore, Bélène

AU - Barnett, Rosemarie

AU - Obermüller, Dominik

AU - Galetzka, Wolfgang

AU - Qizilbash, Nawab

AU - Haeckl, Dennis

AU - Weiss, Thomas

AU - Mohanty, Salini

AU - White, Meghan

AU - Boellinger, Timo

PY - 2024/12/31

Y1 - 2024/12/31

N2 - Background: Novel, expanded valency pneumococcal conjugate vaccines (PCVs) are in development to reduce the burden of pneumococcal disease (PD) in children. To understand the potential value of new vaccines in Germany, this study estimated the residual burden of PD in children < 16 years old from 2014 to 2019, using administrative health data from a large German claims database. Methods: Outpatient and inpatient cases of all-cause pneumonia (ACP), pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) were identified in the InGef database. Incidence rates (IRs) with 95% confidence intervals (CI) were calculated as number of episodes/person-years (PY) at risk. The Mann-Kendall test assessed time trends in incidence. Results: There were no significant trends in IRs of IPD or PP from 2014 to 2019. For ACP, IRs declined from 2014 to 2019; 2,213 (CI 2,176-2,250) to 1,503 (CI 1,472-1,534) per 100,000 PY (p = 0.017). IRs of ACP and PP were highest among children aged 12–23 months; 4,672 (CI 4,584-4,762) and 20.8 (CI 15.3–27.5) per 100,000 PY, respectively. For IPD, children 5–11 months-old had the highest IRs, at 14.7 (CI 9.0-22.7) per 100,000 PY. Conclusions: From 2014 to 2019 there were no discernible trends in the IRs of PP or IPD, but the IRs of ACP declined in children aged < 16 years. The highest IRs of ACP, PP and IPD were observed in children < 2 years of age, highlighting the importance of infant pneumococcal vaccination in the prevention of pediatric PD. The clinical burden of pediatric PD in Germany persists. Continued surveillance of changing pneumococcal burden, serotype distribution, antimicrobial resistance and vaccination status is critical to better understand the factors driving incidence of PD and to inform future vaccination strategies.

AB - Background: Novel, expanded valency pneumococcal conjugate vaccines (PCVs) are in development to reduce the burden of pneumococcal disease (PD) in children. To understand the potential value of new vaccines in Germany, this study estimated the residual burden of PD in children < 16 years old from 2014 to 2019, using administrative health data from a large German claims database. Methods: Outpatient and inpatient cases of all-cause pneumonia (ACP), pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) were identified in the InGef database. Incidence rates (IRs) with 95% confidence intervals (CI) were calculated as number of episodes/person-years (PY) at risk. The Mann-Kendall test assessed time trends in incidence. Results: There were no significant trends in IRs of IPD or PP from 2014 to 2019. For ACP, IRs declined from 2014 to 2019; 2,213 (CI 2,176-2,250) to 1,503 (CI 1,472-1,534) per 100,000 PY (p = 0.017). IRs of ACP and PP were highest among children aged 12–23 months; 4,672 (CI 4,584-4,762) and 20.8 (CI 15.3–27.5) per 100,000 PY, respectively. For IPD, children 5–11 months-old had the highest IRs, at 14.7 (CI 9.0-22.7) per 100,000 PY. Conclusions: From 2014 to 2019 there were no discernible trends in the IRs of PP or IPD, but the IRs of ACP declined in children aged < 16 years. The highest IRs of ACP, PP and IPD were observed in children < 2 years of age, highlighting the importance of infant pneumococcal vaccination in the prevention of pediatric PD. The clinical burden of pediatric PD in Germany persists. Continued surveillance of changing pneumococcal burden, serotype distribution, antimicrobial resistance and vaccination status is critical to better understand the factors driving incidence of PD and to inform future vaccination strategies.

KW - Healthcare claims

KW - Incidence

KW - Pneumococcal conjugate vaccine

KW - Pneumococcal disease

KW - Pneumonia

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DO - 10.1186/s12887-024-05003-7

M3 - Article

AN - SCOPUS:85209808586

SN - 1471-2431

VL - 24

JO - BMC Pediatrics

JF - BMC Pediatrics

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ER -

Incidence of pneumococcal disease in children in Germany, 2014–2019: a retrospective cohort study

Abstract

Data Availability Statement

Keywords

ASJC Scopus subject areas

UN SDGs

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