Hospitalized Children and Adolescents with Community-Acquired Pneumonia: Clinical and Epidemiological Profile After the Introduction of the 10-Valent Pneumococcal Conjugate Vaccine

Objective: To characterize the clinical, radiological, and epidemiological profile of patients hospitalized with community-acquired pneumonia (CAP), compare the characteristics of vaccinated and unvaccinated children and identify factors associated with prolonged hospitalization. Methods: A retrospective, monocentric cohort study was conducted at the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), a University Pediatric Hospital affiliated with the Universidade Federal do Rio de Janeiro (UFRJ), from January 2013 to December 2018. The study included children and adolescents aged 29 days to 14 years hospitalized with CAP. Data on demographics, clinical presentation, radiological findings, vaccination status, comorbidities, and hospitalization outcomes were analyzed. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with prolonged hospitalization (>10 days). Results: Among 185 patients analyzed, 58.9% were male and 89.7% were under 5 years of age. Comorbidities were present in 61.5% of patients, with neurological disorders being the most frequent (22.0%). 10-valent pneumococcal conjugate vaccine (PCV10) vaccination coverage was 75.6%. Vaccinated patients had significantly higher median age (22 vs. 15 months; P = .048) and daycare attendance (32.5% vs. 7.7%; P = .012), but lower occurrence of neurological disorders (17.8% vs. 33%; P = .041) and other comorbidities (13.6% vs. 30.8%; P = .014). Alveolar consolidation was the most common radiological finding, and pleural effusion was the most frequent complication (21.9%). The median hospitalization duration was 11 days. In the multivariate analysis, neurological disorders and pleural effusion were independent predictors of prolonged hospitalization (>10 days). Conclusion: Despite high PCV10 vaccination coverage, severe CAP requiring hospitalization continues to occur, particularly in patients with underlying comorbidities. Neurological disorders and pleural effusion were significant predictors of prolonged hospitalization. Cite this article as: Santana BP, D’Elia C, Sant’Anna CC, Sant’Anna MFBP. Hospitalized children and adolescents with community-acquired pneumonia: clinical and epidemiological profile after the introduction of the 10-valent pneumococcal conjugate vaccine. Cerrahpaşa Med J 2026, 50, 0093, doi:10.5152/cjm.2026.25093.