Please cite this article in press as: Scotta MC, et al. Impact of 10-valent pneumococcal non-typeable Haemophilus influenzae pro- tein D conjugate vaccine (PHiD-CV) on childhood pneumonia hospitalizations in Brazil two years after introduction. Vaccine (2014), http://dx.doi.org/10.1016/j.vaccine.2014.06.042 ARTICLE IN PRESS G Model JVAC-15493; No. of Pages 5 Vaccine xxx (2014) xxx–xxx Contents lists available at ScienceDirect Vaccine j our na l ho me page: www.elsevier.com/locate/vaccine Impact of 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) on childhood pneumonia hospitalizations in Brazil two years after introduction Marcelo Comerlato Scotta a,e,∗,1 , Tiago Neves Veras b,2 , Paula Colling Klein a,1 , Virgínia Tronco a,1 , Fernando P. Polack c,d,e,3,4 , Rita Mattiello a,e,1 , Paulo M.C. Pitrez a,e,1 , Marcus H. Jones a,e,1 , Renato T. Stein a,e,1 , Leonardo A. Pinto a,1 a Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga 6690, 2nd floor, Porto Alegre 90610-000, RS Brazil b Jeser Amarante Faria Children’s Hospital, Araranguá Street, 554, Joinville 89204-310, SC, Brazil c Fundacion INFANT, Gavilán 94, (C1234BAA), Ciudad de Buenos Aires, Argentina d Vanderbilt University, 2201 West End Ave, Nashville 37235, TN, USA e Alianc ¸ a Infant, Argentina–Brasil (Comprises partnership between institutions “a” and “c”) a r t i c l e i n f o Article history: Received 21 September 2013 Received in revised form 26 April 2014 Accepted 11 June 2014 Available online xxx Keywords: Pneumococcal vaccines Pneumonia Child Hospitalization Brazil Conjugate vaccines a b s t r a c t Introduction: Pneumococcal disease is a major public health problem worldwide. From March to September of 2010, 10-valent pneumococcal non-typeable Haemophilus influenzae protein conjugate vaccine (PHiD-CV) was introduced in the Brazilian childhood National Immunization Program (NIP) in all 27 Brazilian states. The aim of the present study is to report national time-trends in incidence of hospital admissions for childhood pneumonia in Brazil before and after two years of introduction of this new pneumococcal conjugate vaccine. Methods: Analysis of hospitalization data of children aged 0–4 years in Brazilian public health system with an admission diagnosis of pneumonia from 2002 to 2012 was performed comparing pre (2002–2009) and post-vaccination periods (2011–2012). Hospital number of admission due to pneumonia and all non-respiratory diseases were obtained from DATASUS, the Brazilian government open-access public health database system. Incidence of pneumonia hospitalization was compared to incidence of all non- respiratory admissions. Results: Admission rates for pneumonia decreased steadily from 2010 to 2012. In children aged less than four years, incidence of pneumonia hospitalizations decreased 12.65% when pre (2002–2009) and post-vaccination introduction periods (2011–2012) were compared and adjusted for seasonality and secular-trend (p < 0.001). On the other hand, non-respiratory admission rates remained stable comparing both periods (p = 0.39). Conclusion: Childhood pneumonia hospitalization rates were fluctuating prior to 2010 and decreased significantly in the two years after PHiD-CV introduction. Conversely, rate of non-respiratory admissions has shown no decrease. These data are an evidence of the effectiveness and public health impact of this new pneumococcal vaccine. © 2014 Elsevier Ltd. All rights reserved. Abbreviations: PHiD-CV, 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine; NIP, National Immunization Program; PCV7, 7-valent pneumococcal conjugate vaccine; IPD, Invasive pneumococcal disease; PCV13, 13-valent pneumococcal conjugate vaccine. ∗ Corresponding author at: Corresponding author. Tel.: +555133203000 internal code 3353; fax: +55 51 3320 3312. E-mail addresses: marcelo.scotta@acad.pucrs.br (M.C. Scotta), tnveras@hotmail.com (T.N. Veras), paulack@gmail.com (P.C. Klein), virginiatronco@yahoo.com.br (V. Tronco), fernando.p.polack@vanderbilt.edu (F.P. Polack), rita.mattiello@pucrs.br (R. Mattiello), pmpitrez@pucrs.br (P.M.C. Pitrez), mhjones@pucrs.br (M.H. Jones), rstein@pucrs.br (R.T. Stein), leonardo.pinto@pucrs.br (L.A. Pinto). 1 Tel.: +55 51 3320 3000 internal code 3353. 2 Tel.: +55 47 3145 1600. 3 Tel.: +54 11 4634 0070. 4 Tel.: +1 615 322 7311. http://dx.doi.org/10.1016/j.vaccine.2014.06.042 0264-410X/© 2014 Elsevier Ltd. All rights reserved.