Diseases > Pneumococcal
Reporting Invasive Pneumococcal Disease in Children <5 Years Who Have Received Pneumococcal Conjugate Vaccine

In October 2000, the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) recommended the use of PCV7 (7-valent, pneumococcal polysaccharide-protein conjugate vaccine, PrevnarTM) among all children aged 2-23 months and for children aged 24-59 months who are at increased risk for pneumococcal disease (e.g., children with sickle cell disease, human immunodeficiency virus infection, and other immunocompromising or chronic medical conditions). Since PCV7 was licensed for use, CDC has received several reports of invasive pneumococcal disease among infants and children who had received at least one dose of PCV7.

Cases following vaccination are to be expected, since vaccine efficacy was 97% for invasive disease with pneumococcal serotypes included in the vaccine and 89% for all serotypes.

In order to monitor vaccine issues, the Respiratory Diseases Branch (RDB) at CDC has developed a tracking system to determine the serotype of these invasive pneumococcal isolates, record host conditions that may contribute to PCV7 failure, and monitor for vaccine lots that may be associated with decreased protection. We will limit cases to children less than five years of age with invasive pneumococcal infections who have received at least one dose of PCV7. This tracking system is consistent with the 2000 CSTE position statement on invasive pneumococcal disease, which recommends that invasive pneumococcal disease in children less than 5 years old be placed under national surveillance. The position statement can be reviewed on the Council for State and Territorial Epidemiologists (CSTE) web page (http://www.cste.org/ps/2000/2000-id-06.htm).

Please use the instruction sheet and the supplemental case report form. When a child <5 years of age who has received at least one dose of PCV7 is diagnosed with invasive pneumococcal disease, defined as the isolation of S. pneumoniae from a normally sterile site (e.g., CSF, blood, joint fluid, pleural fluid), we ask that a PCV7 failure case report form be completed and sent along with the isolate and form CDC 50.34 (CDC lab report form) through the State Health Department to the Streptococcus laboratory, Respiratory Diseases Branch, CDC. Cases of suspected PCV7 failure may also be reported to the Vaccine Adverse Events Reporting System (VAERS), though reporting such cases is not required. However, if a clinically significant adverse event occurs after immunization with PCV7, it should be reported to VAERS (http://www.vaers.org).

We are grateful for your assistance in collecting these isolates and the clinical information. We expect that the actual number of reports for any one state will be small.

For questions, call:
Duty Officer
Respiratory Diseases Branch, C23
Centers for Disease Control and Prevention
1600 Clifton Road, Atlanta, GA 30333
(404) 639-2215

* The text version is provided for those that require text-only documents for screen-reader devices. Please contact NIPINFO@cdc.gov via email, if you need any additional files in text-only format.

This page last modified on September 12, 2002