Efficacy of Haemophilus influenzae type b conjugate vaccines and persistence of disease in disadvantaged populations.
The purpose of this study was to evaluate the effectiveness study was to evaluate the effectiveness of Haemophilus influenzae type b (Hib) conjugate vaccines among children aged 2 to 18 months and to determine risk factors for invasive Hib disease during a period of declining incidence (1991-1994).
A prospective population-based case-control study was conducted in a multistate US population of 15.5 million.
A laboratory-based active surveillance system was used for case detection.
In a multivariate analysis, having a single-parent mother (odds ratio [OR]=4.3,95% confidence interval, [CI]=1.2,14.8) and household crowding (OR=3.5,95% CI=1.03,11.7) were risk factors fo Hib disease independent of vaccination status.
After adjustment for these risk factors, the protective efficacy of 2 or more Hib vaccine doses was 86% (95% CI=16%, 98%). Among undervaccinated subjects, living with a smoker (P=02) and several indicators of lower socioeconomic status were risk factors for Hib disease.
Hip disease still occurs at low levels in the United States, predominantly in socioeconomically disadvantages populations.
Low immunization coverage may facilitate continuing transmission of Hib.
Special efforts to achieve complete and timely immunization in disadvantaged populations are needed.
Mots-clés Pascal : Statut socioéconomique, Pauvreté, Vaccination, Haemophilus influenzae, Pasteurellaceae, Bactérie, Nourrisson, Homme, Etude cas témoin, Etats Unis, Amérique du Nord, Amérique, Bactériose, Infection, Méningite, Prévention, Evaluation, Programme sanitaire
Mots-clés Pascal anglais : Socioeconomic status, Poverty, Vaccination, Haemophilus influenzae, Pasteurellaceae, Bacteria, Infant, Human, Case control study, United States, North America, America, Bacteriosis, Infection, Meningitis, Prevention, Evaluation, Sanitary program
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0164881
Code Inist : 002B05A02. Création : 16/11/1999.