066 - ADULT ALL-CAUSE AND PNEUMOCOCCAL PARAPNEUMONIC EMPYEMA HOSPITALIZATION RATES IN THE ERA OF WIDESPREAD PCVS USE IN THE US (ID 729)
Abstract
Background
Parapneumonic empyema, a severe pneumonia complication, increased among US adults after the introduction of 7-valent pneumococcal conjugate vaccine (PCV7), though the impact of PCV13 introduction for children and adults remains unclear. We examined parapneumonic and pneumococcal empyema hospitalization rates among US adults during the PCV13 eras.
Methods
National Inpatient Sample and Census Data were used to calculate national annual all-cause empyema (with evidence of a thoracentesis-related procedure) and pneumococcal parapneumonic empyema hospitalization rates among adults. We examined age-specific rates by vaccine era in the late PCV7 era (2006-2009), early PCV13 era (2011-September 2015) and the late PCV13 era (October 2015-2019) and examined yearly rates within each era.
Results
Rates of all-cause parapneumonic empyema with thoracentesis-related procedures increased in the early PCV13 era compared to the late PCV7 era and declined after transition to ICD10 in 2015 (Figure and Table). Pneumococcal empyema hospitalization rates declined in every adult age group after introduction of PCV13 for US children in 2010 (Table). A modest reduction in pneumococcal empyema among adults age 65 years or greater was observed during the early PCV13 era, though rates appear to increase during the late PCV13 era (Figure).
Conclusions
The rate of all-cause parapneumonic empyema hospitalizations among US adults has remained relatively stable in the last 15 years. Modest declines were observed in pneumococcal parapneumonic empyema in all age groups following PCV13 introduction in 2010. It is challenging to interpret changes after the PCV13 recommendation in US adults due to the ICD10 coding scheme change in 2015.
