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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 18, Issue 2, Pages 121-127
Original Article

The Burden of Pneumococcal Disease in the Canadian Population Before Routine Use of the Seven-Valent Pneumococcal Conjugate Vaccine

Adrienne Morrow,1 Philippe De Wals,1 Geneviève Petit,2 Maryse Guay,3 and Lonny James Erickson4

1Department of Social and Preventive Medicine, Laval University, Quebec City, Canada
2Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
3Department of Community Health Sciences, University of Sherbrooke, Sherbrooke, Canada
4Quebec Agency for Health Services and Technology Assessment, Montreal, Quebec, Canada

Received 26 July 2006; Accepted 26 July 2006

Copyright © 2007 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: In the United States, implementation of the seven-valent conjugate vaccine into childhood immunization schedules has had an effect on the burden of pneumococcal disease in all ages of the population. To evaluate the impact in Canada, it is essential to have an estimate of the burden of pneumococcal disease before routine use of the vaccine.

METHODS: The incidence and costs of pneumococcal disease in the Canadian population in 2001 were estimated from various sources, including published studies, provincial databases and expert opinion.

RESULTS: In 2001, there were 565,000 cases of pneumococcal disease in the Canadian population, with invasive infections representing 0.7%, pneumonia 7.5% and acute otitis media 91.8% of cases. There were a total of 3000 deaths, mainly as a result of pneumonia and largely attributable to the population aged 65 years or older. There were 54,330 life-years lost due to pneumococcal disease, and 37,430 quality-adjusted life-years lost due to acute disease, long-term sequelae and deaths. Societal costs were estimated to be $193 million (range $155 to $295 million), with 82% borne by the health system and 18% borne by families. Invasive pneumococcal infections represented 17% of the costs and noninvasive infections represented 83%, with approximately one-half of this proportion attributable to acute otitis media and myringotomy.

CONCLUSIONS: The burden of pneumococcal disease before routine use of the pneumococcal conjugate vaccine was substantial in all age groups of the Canadian population. This estimate provides a baseline for further analysis of the direct and indirect impacts of the vaccine.