{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:04:01Z","timestamp":1788311041121,"version":"build-2803163510"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["ISR 53047301"],"award-info":[{"award-number":["ISR 53047301"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We assessed the impact of pneumococcal conjugate vaccine (PCV) implementation on respiratory syncytial virus\u2013positive, community-acquired alveolar pneumonia (RSV-CAAP) in young children in southern Israel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was nested within a prospective population-based active surveillance system during 2004\u20132019. All children &amp;lt;60 months old residing in the region and served by the region's only hospital were included. A negative binomial regression model was used to evaluate the impact of PCV on the incidence of all-cause CAAP and RSV-CAAP and was the basis for estimating averted episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7640 all-cause CAAP episodes were observed; 50% were tested for RSV, of which 42% were positive. Shortly after PCV13 implementation, all-cause CAAP and RSV-CAAP rates markedly declined, stabilizing within 3\u20134 years. The mean annual hospitalization rates for all-cause CAAP and RSV-CAAP declined by 47% (95% CI: 40%\u201353%) and 29% (95% CI: \u22122% to 51%), respectively, during the late-PCV period, compared with the expected rates. This translated to a reduction in the mean annual incidence of 3.73 cases of all-cause CAAP\/1000 children (95% CI: 2.98\u20134.58) and 0.50 cases of RSV-CAAP per 1000 children (95% CI: \u2212.05 to 1.13). The highest incidences of averted cases occurred in children aged 12\u201323 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The observed dynamics of hospitalizations due to all-cause CAAP and RSV-CAAP following PCV implementation are consistent with the notion of a synergistic role of RSV and pneumococcus in CAAP in young children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf102","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T08:55:25Z","timestamp":1741251325000},"page":"e690-e699","source":"Crossref","is-referenced-by-count":3,"title":["Decline in Community-Acquired Alveolar Pneumonia Positive for Respiratory Syncytial Virus in Hospitalized Children Following Implementation of Pneumococcal Conjugate Vaccine (PCV) in Israel"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8888-1046","authenticated-orcid":false,"given":"Ron","family":"Dagan","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, The Shraga Segal Dept. of Microbiology, Immunology and Genetics, Ben Gurion University , Beer Sheva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart Adriaan","family":"van der Beek","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, The Shraga Segal Dept. of Microbiology, Immunology and Genetics, Ben Gurion University , Beer Sheva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tal","family":"Grupel","sequence":"additional","affiliation":[{"name":"The Edmond J. Safra Congenital Heart Center, Sheba Medical Center, Department of Pediatric Cardiology , Ramat Gan ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-1410","authenticated-orcid":false,"given":"David","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben Gurion University , Beer Sheva ,","place":["Israel"]},{"name":"Pediatric Infectious Disease Unit, Soroka University Medical Center , Beer Sheva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayelet","family":"Keren-Naus","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Virology, Soroka University Medical Center , Beer Sheva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalom","family":"Ben-Shimol","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Ben Gurion University , Beer Sheva ,","place":["Israel"]},{"name":"Pediatric Infectious Disease Unit, Soroka University Medical Center , Beer Sheva ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1178-8086","authenticated-orcid":false,"given":"Daniel M","family":"Weinberger","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health , New Haven, Connecticut ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,7]]},"reference":[{"key":"2026020907371303200_ciaf102-B1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1542\/peds.2007-3192","article-title":"Seasonal invasive pneumococcal disease in children: role of preceding respiratory viral 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