{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:18:30Z","timestamp":1777414710005,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001868","name":"National Science Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In Taiwan, the incidence of invasive pneumococcal disease (IPD) in children declined after the catch\u2010up primary vaccination programs and the full national immunization program (NIP) with PCV13. The objective of the study was to investigate the clinical outcomes of pediatric community\u2010acquired pneumonia (CAP) before and after the NIP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included patients aged 3 months to 17 years who were diagnosed with CAP and treated at the National Taiwan University Hospital between 2007 and 2019. Patients were assigned to three birth cohorts according to their birth years and vaccination eligibility: non\u2010NIP, catch\u2010up, and full NIP. We compared the rates of severe outcomes, including case fatality and pathogens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 6557 patients who met the CAP criteria were enrolled during the study period. The case\u2010fatality rate decreased from 3.2% (94\/2984) in the non\u2010NIP cohort to 0.3% (7\/2176) in the catch\u2010up cohort and 0.8% (11\/1397) in the full NIP cohort (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Furthermore, there was a significant decrease in invasive ventilation from the non\u2010NIP (17.9%) to both catch\u2010up (6.8%) and full NIP cohorts (9.1%). The rate of IPD declined from the non\u2010NIP cohort to the catch\u2010up cohort (1.8% vs. 0.6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and from the catch\u2010up to the full NIP cohort (0.6% vs. 0.07%, <jats:italic>p<\/jats:italic>\u2009=\u20090.014). In contrast, the rates of infections with other pathogens increased after NIP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The introduction of PCV13 showed significant reduction in case\u2010fatality and IPD rates. The increasing rates of other pathogens warrant further surveillance for their clinical significance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26651","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T11:40:54Z","timestamp":1693309254000},"page":"3246-3254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of pediatric community\u2010acquired pneumonia before and after national pneumococcal immunization in Taiwan"],"prefix":"10.1002","volume":"58","author":[{"given":"I\u2010Fan","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Pediatrics Taipei Hospital, Ministry of Health and Welfare New Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I\u2010Fan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics College of Medicine, National Taiwan University Hospital, National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun\u2010Chung","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics College of Medicine, National Taiwan University Hospital, National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3729-153X","authenticated-orcid":false,"given":"Chia\u2010Ching","family":"Chou","sequence":"additional","affiliation":[{"name":"Institute of Applied Mechanics National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tu\u2010Hsuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Chi\u2010Mei Medical Center Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting\u2010Yu","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics College of Medicine, National Taiwan University Hospital, National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5240-2808","authenticated-orcid":false,"given":"Chun\u2010Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics College of Medicine, National Taiwan University Hospital, National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2632-1956","authenticated-orcid":false,"given":"Luan\u2010Yin","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics College of Medicine, National Taiwan University Hospital, National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feipei","family":"Lai","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Electronics and Bioinformatics National Taiwan University Taipei Taiwan"},{"name":"Department of Computer Science and Information Engineering National Taiwan University Taipei Taiwan"},{"name":"Department of Electrical Engineering National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li\u2010Min","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics College of Medicine, National Taiwan University Hospital, National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61204-6"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/648593"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30052-5"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu524"},{"key":"e_1_2_11_6_1","unstructured":"Centers for Disease Control and Prevention. 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