SUSTAINED IMPACT OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE INTRODUCTION ON HOSPITALIZATIONS WITH ALL-CAUSE AND PNEUMOCOCCAL PARAPNEUMONIC EMPYEMA AMONG US CHILDREN (ID 421)
- Andrew D. Wiese, United States of America
- Andrew D. Wiese, United States of America
- Marie R. Griffin, United States of America
- Carlos Grijalva, United States of America
Abstract
Background
Parapneumonic empyema, a severe pneumonia complication, decreased shortly after 13-valent pneumococcal conjugate vaccine (PCV13) introduction among young US children but not among older children. We assessed the long-term impact of PCV13 introduction among US children encompassing the transition to the ICD10 coding system.
Methods
We used the National Inpatient Sample and Census Data to calculate national annual all-cause and pneumococcal parapneumonic empyema hospitalization rates among children <18 years (1997-2017). We examined rates during the late PCV13 era (2016-2017) after transition to ICD10 codes compared to pre-PCV7 (1997-1999), PCV7 (2001-2009) and early-PCV13 era (2011-2015) rates. We also examined changes in thoracentesis-related procedures.
Results
All-cause and pneumococcal parapneumonic empyema, as well as thoracentesis-related procedure rates reached historical lows in the late PCV13 era (Table). After initial declines following PCV13 introduction, rates have remained relatively stable (Figure). Modest, mostly downward, fluctuations were noted post-ICD10 transition.
Conclusions
Parapneumonic empyema rates in US children increased following PCV7 introduction but decreased and reached historic lows following PCV13 introduction. The change in coding from ICD9 to ICD10 did not appear to influence trends, though further assessment is warranted. Our findings support the ongoing surveillance of all-cause and pneumococcal empyema in the ICD10 coding era.