Introduction:

in June 2010, the Community of Madrid introduced the 13-valent pneumococcal conjugate vaccine in the childhood vaccination schedule. Due to budgetary restrictions, public funding for the vaccine was withdrawn between July 2012 and March 2015. Our objective was to assess the impact of defunding on vaccination coverage and on the incidence of acute otitis media, pneumonia and invasive pneumococcal disease in a low-income population, comparing these figures with those reported for the whole region.

Methods and materials:

Retrospective cohort study of pneumococcal disease and vaccination coverage in children born between May 2012 and October 2014 served by the Entrevías Primary Care Centre.

Results:

We found a decrease in vaccination coverage (66%, 95% CI: 57.3 to 71.4%) compared to the average in the Community of Madrid (77%). There were no cases of invasive pneumococcal disease, and the incidence of pneumonia and acute otitis media was independent of vaccination status. The only factor associated to the incidence of acute otitis was attendance to childcare centres.

Conclusions:

The defunding of the conjugate vaccine against thirteen pneumococcal serotypes caused a decrease in vaccination coverage in children from a low-income population. In this study, we did not find an increase in the incidence of pneumococcal disease, which may be due to the persistence of the herd effect or to an insufficient sample size.

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