Impact of Universal Infant Immunization with Pneumococcal

(Streptococcus pneumonia) Conjugate Vaccines in Alaska Purpose: To describe and compare the impact of universal infant immunization with 7-valent pneumococcal conjugate vaccine (PCV7) on invasive Streptococcus pneumoniae infection, nasopharyngeal carriage, and antibiotic resistance in Alaskan Native and non-Native children and adults. Methods: The medical literature concerning the epidemiology of invasive pneumococcal disease (IPD) and the effects of pneumococcal conjugate vaccine on the incidence, nasopharyngeal carriage, and antibiotic resistance of S pneumoniae was reviewed with special emphasis on the effects in the Alaska Native population. Results: Alaska Native children experienced the highest incidence of IPD in the United States. The greatest difference in IPD was among children younger than 2 years for whom the annualized rate in Alaskan Native children (450/100,000 per year) was 3 times higher than for non-Native Alaskan children younger than 2 years who had rates similar to the overall US population. In the first 3 years after beginning routine vaccination with PCV7 (2001-2003), overall IPD decreased 67 percent in Alaska Native children younger than 2 years (from 403.2 per 100,000 in 1995-2000 to 134.3 per 100,000 per year in 2001-2003, P <.001). However, between 2001-2003 and 2004-2006, there was an 8