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Routine infant vaccination with the seven-valent pneumococcal conjugate vaccine was introduced in the USA in 2002. National sample data for the years 1997–99 and 2001–04 (Lancet 2007;369:1179–86; see also Comment, ibid: 1144–5) have shown the extent of the decline in hospital admissions of young children for pneumonia since then. Among children less than 2 years old hospital admissions for pneumonia of any cause fell by 39% by 2004. The vaccine prevented about 41 000 such hospital admissions in 2004 and admissions for pneumococcal pneumonia fell by 65%. Reductions of 17–18% in admissions of older children for pneumonia of any cause did not reach statistical significance but there was a significant 26% reduction among young adults aged 18–39 years, attributed to a herd immunity effect of the vaccine. As a control measure it was noted that hospital admissions for dehydration did not change during the study period.

In the UK neonatal screening for cystic fibrosis could be cost-saving. Data from the UK cystic fibrosis database were analysed and yearly treatment costs analysed for 184 patients diagnosed by neonatal screening and 950 patients diagnosed clinically in 2002 (Lancet 2007;369:1187–95; see also Comment: ibid: 1146–7). Median and mean yearly costs were significantly lower in the neonatal screening group (US $352 and $7228) than in the clinically diagnosed group (US $2442 and $12 008). …

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