ArticleVaccine2016
Changes in empyema among U.S. children in the pneumococcal conjugate vaccine era.
Article in Vaccine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Complicated pneumococcal pneumonia in the era of higher-valent pneumococcal conjugate vaccines: a systematic literature review and meta-analysis, 2001-2022.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Pooled it
- Systematic review on the impact of the pneumococcal conjugate vaccine ten valent (PCV10) or thirteen valent (PCV13) on all-cause, radiologically confirmed and severe pneumonia hospitalisation rates and pneumonia mortality in children 0-9 years old.Journal of global health · 2023Pooled it
- Long-term cardiopulmonary function in children treated for empyema: comparison of chest drain with fibrinolytics and video-assisted thoracoscopic surgery.BMJ open respiratory research · 2026Article
- Article
- A Comprehensive Review of Pediatric Necrotizing Pneumonia.Children (Basel, Switzerland) · 2025Review
- Parapneumonic Effusion Versus Pulmonary Empyema in Children: Analysis of Risk Factors and Laboratory Predictors Through a Single Center Experience.Children (Basel, Switzerland) · 2025Article
- Use of Intrapleural Alteplase in the Treatment of Parapneumonic Effusion in Children: A Report of a 10-year Experience.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Pulmonary function in children post-empyema: spirometryERJ open research · 2025Article
- Pediatric Pleural Effusion and Pneumococcal Vaccination Trends in the Pre- and Post-COVID Era: A Single-Centre Retrospective Study.Children (Basel, Switzerland) · 2025Article
- Complicated Pediatric Pneumonia WithCase reports in infectious diseases · 2025Article
- Intrapericardial fibrinolysis and video-assisted thoracoscopic surgery in managing severe pediatric Streptococcus pneumoniae purulent complications.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2024Article
- Parapneumonic empyema in children: a scoping review of the literature.Italian journal of pediatrics · 2024Article
- 13-Valent pneumococcal conjugate vaccines vaccination innovative strategy in Weifang City, China: a case study.Infectious diseases of poverty · 2023Article
- Burden of all-cause and organism-specific parapneumonic empyema hospitalization rates prior to the SARS-CoV-2 pandemic in the United States.Respiratory medicine · 2023Article
- Analysis of 13-valent pneumococcal polysaccharide conjugate vaccine among children born in Hangzhou from 2017 to 2021.Frontiers in public health · 2023Article
- Therapy of parapneumonic empyema in children: a protocol for a scoping review of the literature.F1000Research · 2023Article
- Continued Vaccine Breakthrough Cases of Serotype 3 Complicated Pneumonia in Vaccinated Children, Portugal (2016-2019).Microbiology spectrum · 2022Article
- Differential Pneumococcal Growth Features in Severe Invasive Disease Manifestations.Microbiology spectrum · 2022Article
- The impact of pneumococcal conjugate vaccine on the prevalence and severity of hospitalizations for pneumonia in children.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Long-term Association of 13-Valent Pneumococcal Conjugate Vaccine Implementation With Rates of Community-Acquired Pneumonia in Children.JAMA pediatrics · 2019Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundParapneumonic empyema, a serious complication of pneumonia, started increasing among U.S. children before the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000, and continued afterwards. This increase was due in part to pneumococcal serotypes not included in PCV7 that were included in the new 13-valent (PCV13) vaccine introduced in 2010. We assessed changes in the incidence of empyema hospitalizations among U.S. children after PCV13 introduction.
methodsWe calculated annualized empyema hospitalization rates among U.S. children <18years using Nationwide Inpatient Sample and Census data (1997-2013) for four periods based on PCV7 and PCV13 introductions. Relative rates (RR) and 95% confidence intervals (CI) were calculated by age group and sex, comparing PCV7 [early-PCV7 (2001-2005) and late-PCV7 (2006-2009)] and PCV13 (2011-2013) periods with the pre-PCV7 period (1997-1999). Secondary analyses examined changes in pneumococcal, streptococcal, staphylococcal and unspecified empyema.
resultsAmong children <18years of age, annualized empyema hospitalization rates peaked at 3.6 per 100,000 in the late-PCV7 period compared with 2.1 per 100,000 in the pre-PCV7 period [RR: 1.70 (95% CI: 1.11-2.60)]. However, annualized rates in the post-PCV13 period declined to 2.0 per 100,000, similar to rates in the pre-PCV7 period. Empyema rates among children <2years were lower in the post-PCV13 period compared to the pre-PCV7 period [RR: 0.77 (95% CI: 0.61-0.96)], but rates in the two periods among children 2-4 and 5-17years were similar. Most empyema were of unspecified etiology. Pneumococcal and unspecified empyema declined after PCV13 introduction.
conclusionsAlthough empyema hospitalization rates among U.S. children peaked after PCV7 introduction, rates decreased substantially following the introduction of PCV13.
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