DECLINE OF PEDIATRIC ADMISSIONS WITH HAEMOPHILUS-INFLUENZAE TYPE-B INNEW-YORK-STATE, 1982 THROUGH 1993 - RELATION TO IMMUNIZATIONS

Objectives: To evaluate the impact of vaccination for Haemophilus infl uenzae type b (Hib) on pediatric hospital admissions in New York State , and to identify risk factors in children who continue to be admitted for Hib invasive disease, Methods: Retrospective review of hospitaliz ations in New York state from 1982 through 1993 and a survey of immuni zation records from physician offices in Monroe County, New York, Resu lts: In 1982, 769 children were admitted to New York state hospitals f or Hib-related conditions; by 1993, this had decreased to 133. Signifi cant declines during the study period occurred in the age-adjusted adm ission rates for Hib meningitis, septicemia, pneumonia, and epiglottit is, but not for arthritis and osteomyelitis, In 1993 alone, 712 admiss ions, 18 deaths, and 135 episodes of morbidity were avoided, Since 199 1, the rates of admissions for Hib-related conditions have remained fa irly constant, Minority subjects continue to be twice as likely as whi te subjects to be admitted for invasive Hib disease (0.44 vs 0.17/100, 000), Children living in urban Rochester also are more likely to be ad mitted and less likely to be completely immunized against Hib (61%) th an those living in suburban areas (82%), Conclusions: Although Hib vac cine has had a major impact on hospital admissions for Hib-related con ditions, the goal of completely eliminating Hib disease will require p rograms targeted at groups at high risk, such as minorities and those living in cities.