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Abstract

Geographic variation and large population differences in medical care utilization among children < 2 years old in three study populations suggest that the benefits of vaccination may vary by region and by population. In the Tennessee Medicaid population, temporal trends and year-to-year variability of pneumococcal-related outcomes were observed from 1995 to 1999. In this population a 10% decline in otitis media visits after the introduction of pneumococcal conjugate vaccine could be detected by trend analysis.