Pneumonia After Implementation of the Pneumococcal Conjugate Vaccine Program in the Province of Quebec, Canada

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Abstract
Background: In Canada, a pneumococcal conjugate vaccine was licensed in 2001, and in the province of Quebec, a publicly-funded program was implemented for high-risk children in 2002, using a 4-dose schedule, and for all children in 2004, using a 3-dose schedule. Objectives: To describe the epidemiology of hospitalized pneumonia in the population aged <5 years. Methodology: Hospital discharge records with a main diagnosis of pneumonia, pleurisy, or empyema were analyzed regarding monthly frequencies by diagnostic categories, duration of stay, proportion of cases admitted to the intensive care unit, and case fatality. Results: Lobar pneumonia represented 32% of 25,319 all-cause pneumonia admissions during the period April 1997 to March 2006. Beginning in the spring of 2004, there was a marked decrease in the frequency of lobar pneumonia, whereas unspecified pneumonia tended to increase to a lesser extent. Compared with the pre-pneumococcal conjugate vaccine period, admissions for all-causes pneumonia decreased by 13% after program implementation and there was no increase in empyema cases. Conclusions: Results are reassuring as to the effectiveness of the pneumococcal vaccination program in Quebec.

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