Declines in Pneumonia Mortality following the Introduction of Pneumococcal Conjugate Vaccines in Latin American and Caribbean Countries

Lucia H. De Oliveira, Kayoko Shioda*, Maria Tereza Valenzuela, Cara B. Janusz, Analía Rearte, Alyssa N. Sbarra, Joshua L. Warren, Cristiana M. Toscano, Daniel M. Weinberger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


BACKGROUND: Pneumococcal conjugate vaccines (PCVs) are recommended for use in pediatric immunization programs worldwide. Few data are available on their effect against mortality. We present a multicountry evaluation of the population-level impact of PCVs against death due to pneumonia in children < 5 years of age.

METHODS: We obtained national-level mortality data between 2000 and 2016 from 10 Latin American and Caribbean countries, using the standardized protocol. Time series models were used to evaluate the decline in all-cause pneumonia deaths during the postvaccination period while controlling for unrelated temporal trends using control causes of death.

RESULTS: The estimated declines in pneumonia mortality following the introduction of PCVs ranged from 11% to 35% among children aged 2-59 months in 5 countries: Colombia (24% [95% credible interval {CrI}, 3%-35%]), Ecuador (25% [95% CrI, 4%-41%]), Mexico (11% [95% CrI, 3%-18%]), Nicaragua (19% [95% CrI, 0-34%]), and Peru (35% [95% CrI, 20%-47%]). In Argentina, Brazil, and the Dominican Republic, the declines were not detected in the aggregated age group but were detected in certain age strata. In Guyana and Honduras, the estimates had large uncertainty, and no declines were detected. Across the 10 countries, most of which have low to moderate incidence of pneumonia mortality, PCVs have prevented nearly 4500 all-cause pneumonia deaths in children 2-59 months since introduction.

CONCLUSIONS: Although the data quality was variable between countries, and the patterns varied across countries and age groups, the balance of evidence suggests that mortality due to all-cause pneumonia in children declined after PCV introduction. The impact could be greater in populations with a higher prevaccine burden of pneumonia.

Translated title of the contributionDisminución de la mortalidad por neumonía tras la introducción de vacunas antineumocócicas conjugadas en países de América Latina y el Caribe
Original languageEnglish
Pages (from-to)306-313
Number of pages8
JournalClinical Infectious Diseases
Issue number2
StatePublished - 15 Jul 2021

Bibliographical note

Publisher Copyright:
© 2020 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America.


  • Argentina
  • Brazil
  • Child
  • Colombia
  • Dominican Republic
  • Honduras
  • Humans
  • Infant
  • Latin America/epidemiology
  • Mexico
  • Nicaragua
  • Peru
  • Pneumococcal Infections
  • Pneumococcal Vaccines
  • Pneumonia, Pneumococcal/epidemiology
  • Pneumonia/epidemiology
  • Vaccines, Conjugate


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