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Michael Davidson, Alan J. Parkinson, Lisa R. Bulkow, Mary Anne Fitzgerald, Helen . Peters, Debra J. Parks, The Epidemiology of Invasive Pneumococcal Disease in Alaska, 1986-1990 Ethnic Differences and Opportunities for Prevention, The Journal of Infectious Diseases, Volume 170, Issue 2, August 1994, Pages 368–376, https://doi.org/10.1093/infdis/170.2.368
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Abstract
To assess prevention strategies for pneumococcal disease in Alaska, prospective surveillance during 1986-1990identified672invasivepneumococcalinfections,including315amongAlaska Natives. Age-adjusted annual incidence was 74 per 100,000 for Alaska Natives and 16 per 100,000 for nonnatives. The annual incidence in Alaska Native children <2 years old was 624 per 100,000; rates of 84 per 100,000 for meningitis and 290 per 100,000 for bacteremic pneumonia were 8-10 times higher than for other US groups. By age 75, cumulative incidence (7%) and mortality (1%) in Alaska Natives were almost 4 times higher than for nonnatives. Only 17% of Alaska Native adults with predisposing conditions and invasive infections previously received pneumococcal vaccine. For Alaska Natives, a proposed heptavalent conjugate pneumococcal vaccinewillincludeserotypesresponsiblefor85%ofinvasiveisolatesfromchildren <2 yearsbut only 32% of those from adults. The 23-valent polysaccharide pneumococcal vaccine, which contains >94% of serotypes identified in Alaska Native toddlers and adults, should be used more widely.