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"Rodger, Marguerite"
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Pneumococcal vaccination programs and the burden of invasive pneumococcal disease in Ontario, Canada, 1995–2011
•Routine pediatric PCV7 vaccination did not reduce in the incidence of IPD in adults in Toronto.•Use of PCV7 at 1 dose per child in the birth cohort resulted in significant reductions in PCV7 serotype IPD.•The case fatality rate of IPD decreased by 2% per year in Toronto between 1995 and 2011.•Post PCV13 program implementation, a substantial burden of IPD in adults will remain.
In 1995, a publicly funded pneumococcal vaccination program for 23-valent polysaccharide vaccine (PPV23) was introduced in Ontario. Conjugate vaccines were authorized in 2001 (PCV7), 2009 (PCV10) and 2010 (PCV13).
From 1995–2011, active, population-based surveillance for invasive pneumococcal disease (IPD) was conducted in Metropolitan Toronto and Peel Region, Canada.
6404 IPD cases were included. After PPV23 program implementation in 1995, IPD due to PPV23 strains decreased 49% in older adults prior to PCV7 introduction. Estimated PPV23 efficacy in vaccine eligible adults was 42.2% (95% CI; 28.6–53.2%). IPD incidence due to PCV7 serotypes in children <5 years decreased significantly after PCV7 authorization and before introduction of a publicly funded PCV7 program. Seven years after PCV7 program implementation, the incidence of IPD due to PCV7 serotypes decreased to zero in children and by 88% in adults, however, overall IPD incidence remained unchanged in adults. In 2011, the incidence of IPD was 4.5 per 100,000 in adults aged 15–64 and 19.9 per 100,000 in adults aged over 65 years, with 45 serotypes causing disease. Between 1995 and 2011, the case fatality rate of IPD in adults decreased 2% per year (95% CI, −0.9% to −3.2%). In multivariable analysis, predictors of mortality included older age, chronic conditions, nursing home residence, current smoking, bacteraemia, and illness due to serotypes 3,11A, 19A, and 19F.
While vaccination programs resulted in substantial public health benefits, herd immunity benefits of PCV7 were seen at low pediatric vaccination rates, and the case fatality rate of IPD has decreased, IPD will continue to be a cause of considerable morbidity and mortality in adults.
Journal Article
Autism spectrum disorder
\"Autism Spectrum Disorder is a term used to describe a group of developmental disorders that include autism, Asperger Syndrome, Pervasive Developmental Disorders, and others. Many people with these disorders struggle with social interaction and communication. This informative book provides insight into how people diagnosed with an autism spectrum disorder experience the world around them and promotes understanding and acceptance. A chapter for friends and family discusses how to handle autism spectrum disorder and its effects on siblings and relatives.\"-- Provided by publisher.
Book
Unspeakable: The Rise of the Gay and Lesbian Press in America
Moritz reviews \"Unspeakable: The Rise of the Gay and Lesbian Press in America\" by Rodger Steitmatter.
Book Review