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. 2024 Nov 20;24(1):755.
doi: 10.1186/s12887-024-05003-7.

Incidence of pneumococcal disease in children in Germany, 2014-2019: a retrospective cohort study

Jessica Weaver  1 , Tianyan Hu  1 , Bélène Podmore  2   3 , Rosemarie Barnett  2   4 , Dominik Obermüller  5 , Wolfgang Galetzka  5 , Nawab Qizilbash  2   3 , Dennis Haeckl  6 , Thomas Weiss  1 , Salini Mohanty  1 , Meghan White  7 , Timo Boellinger  8
Affiliations

Incidence of pneumococcal disease in children in Germany, 2014-2019: a retrospective cohort study

Jessica Weaver et al. BMC Pediatr. .

Abstract

Background: Novel, expanded valency pneumococcal conjugate vaccines (PCVs) are in development to reduce the burden of pneumococcal disease (PD) in children. To understand the potential value of new vaccines in Germany, this study estimated the residual burden of PD in children < 16 years old from 2014 to 2019, using administrative health data from a large German claims database.

Methods: Outpatient and inpatient cases of all-cause pneumonia (ACP), pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) were identified in the InGef database. Incidence rates (IRs) with 95% confidence intervals (CI) were calculated as number of episodes/person-years (PY) at risk. The Mann-Kendall test assessed time trends in incidence.

Results: There were no significant trends in IRs of IPD or PP from 2014 to 2019. For ACP, IRs declined from 2014 to 2019; 2,213 (CI 2,176-2,250) to 1,503 (CI 1,472-1,534) per 100,000 PY (p = 0.017). IRs of ACP and PP were highest among children aged 12-23 months; 4,672 (CI 4,584-4,762) and 20.8 (CI 15.3-27.5) per 100,000 PY, respectively. For IPD, children 5-11 months-old had the highest IRs, at 14.7 (CI 9.0-22.7) per 100,000 PY.

Conclusions: From 2014 to 2019 there were no discernible trends in the IRs of PP or IPD, but the IRs of ACP declined in children aged < 16 years. The highest IRs of ACP, PP and IPD were observed in children < 2 years of age, highlighting the importance of infant pneumococcal vaccination in the prevention of pediatric PD. The clinical burden of pediatric PD in Germany persists. Continued surveillance of changing pneumococcal burden, serotype distribution, antimicrobial resistance and vaccination status is critical to better understand the factors driving incidence of PD and to inform future vaccination strategies.

Keywords: Healthcare claims; Incidence.; Pneumococcal conjugate vaccine; Pneumococcal disease; Pneumonia.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All patient-level data in the InGef research database are de-identified to comply with German data protection regulations. Use of the study database for healthcare services research is therefore fully compliant with German federal law and, accordingly, Institutional Review Board/ethical approval and informed consent of the patient was not required. Participant consent for publication: Not applicable. Competing interests: All authors declare financial and non-financial conflicts of interest. TW, JW, MW and SM are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, who may own stock and/or hold stock options in Merck & Co., Inc., Rahway, NJ, USA. TB is an employee of MSD Sharp & Dohme GmbH, Germany, who may own stock and/or hold stock options in Merck & Co., Inc., Rahway, NJ, USA. TH was employed by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA at the time of this study. BP, RB and NQ are employed by OXON Epidemiology. DH is employed by WIG2. DO is employed by InGef and WG was employed by InGef at the time of this study.

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