Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumonia hospital admissions in Fiji: a time-series analysis

BackgroundIn October, 2012, Fiji introduced routine infant immunisation with a ten-valent pneumococcal conjugate vaccine (PCV10) using three primary doses and no booster dose (3 + 0 schedule). Data are scarce for the effect of PCV in Asia Pacific region. We aimed to evaluate PCV10 on pneumonia hospital admissions children younger than 5 years adults aged 55 older Fiji, after introduction.MethodsWe did time-series analysis assessing changes at public tertiary hospitals Fiji. Four outcomes were evaluated: all-cause pneumonia, severe or very hypoxic radiological pneumonia. Participants 2 months, 2–23 24–59 included. extracted from national admission database according International Classification Diseases-tenth revision codes J10·0-18·9, J21, J22 Medical records chest radiographs reviewed main reclassify as severe, hypoxic, per WHO definitions. Time-series analyses done synthetic control method multiple imputation adjust usage missing data.FindingsBetween Jan 1, 2007, Dec 31, 2017, ratio observed cases expected was 0·92 (95% CI 0·70–1·36) 0·86 (0·74–1·00) 0·74 (0·62–0·87) 1·90 (1·53–2·31) older, introduction. These findings indicate reduction among months an increase but change months. Among we declines 21% 5–35) 46% (33–56) 25% (9–38) Mortality reduced by 39% 5–62) bronchiolitis, asthma months.InterpretationThe introduction associated decrease 2–59 This is first study middle-income country region show filling gaps literature effects 3 schedules. data support decision making other low-income countries region.FundingDepartment Foreign Affairs Trade Australian Government. In data. Between The