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5 /26-2..». « Mendes RE, Costello AJ, Jacobs MR, Biek D, Critchley IA, Jones RN. Serotype distribution and antimicrobial susceptibility of USA Streptococcus pneumoniae isolates collected prior to and post introduction of 3-valent pneumococcal conjugate vaccine. Diagnostic microbiology and infectious disease. 204; 80: Chinchankar N, Mane M, Bhave S, Bapat S, Bavdekar A, Pandit A, et al. Diagnosis and outcome of acute bacterial meningitis in early childhood. Indian Pediatrics. 2002; 39: Dash N, Ameen AS, Sheek-Hussein MM, Smego Jr RA. Epidemiology of meningitis in Al-Ain, United Arab Emirates, International Journal of Infectious Diseases. 2007; : World Health Organization. Measuring impact of Streptococcus pneumoniae and Haemophilus influenzae type b conjugate vaccination. Geneva, Switzerland: WHO Press; 202, Shetty S, Cohen AL, Edmond K, Ojo L, Loo J, O'Loughlin R, et al. A Systematic Review and Critical Evaluation of Invasive Haemophilus influenzae Type B Disease Burden Studies in Asia From the Last Decade: Lessons Learned for Invasive Bacterial Disease Surveillance. The Pediatric Infectious Disease Journal. 200; 29: World Health Organization, Principles and considerations for adding a vaccine to a national immunization programme. Geneva, Switzerland: WHO Press; 204, Hajjeh RA, Privor-Dumm L, Edmond K, O'Loughlin R, Shetty S, Griffiths UK, et al. Supporting new vaccine introduction decisions: Lessons learned from the Hib Initiative experience. Vaccine.200; 28: Karami M. Implementing surveillance system for Streptococcus pneumoniae and Haemophilus Influenzae related diseases in ) ( Shetty S, 200 Fleming JA, 20 Arifeen SE, 2009 Anh DD, 2006 Shah AS, 2009 Hamadan Province: A Feasibility Study [Research Project]. Hamadan University of Medical Sciences, Hamadan, Iran; Karami M, Zahraei SM, Gouya MM. Perspective of Iranian Vaccine-Preventable Diseases Surveillance System in the Era of Newly Introduced Pentavalent Vaccine: Possibility of Implementing a Sentinel Hospital-Based Surveillance System. Iranian Journal of Public Health. 205; 44: Karami M, Alikhani MY. Serotype Replacement and Nasopharyngeal Carriage Due to the Introduction of New Pneumococcal Conjugate Vaccine to National Routine Immunization. Jundishapur J Microbiol. 205; 8: e Fleming JA, Dieye Y, Ba O, wa Mutombo BM, Diallo N, Faye PC, et al. Effectiveness of Haemophilus influenzae type b conjugate vaccine for prevention of meningitis in Senegal. The Pediatric infectious disease journal. 20; 30: Arifeen SE, Saha SK, Rahman S, Rahman KM, Rahman SM, Bari S, et al. Invasive pneumococcal disease among children in rural Bangladesh: Results from a population-based surveillance. Clinical Infectious Diseases. 2009; 48(SUPPL. 2): S03-S3. 3- Anh DD, Kilgore PE, Kennedy WA, Nyambat B, Long HT, Jodar L, et al. Haemophilus influenzae type B meningitis among children in Hanoi, Vietnam: Epidemiologic patterns and estimates of H. influenzae type B disease burden. American Journal of Tropical Medicine and Hygiene. 2006; 74: Shah AS, Deloria Knoll M, Sharma PR, Moisi JC, Kulkarni P, Lalitha MK, et al. Invasive pneumococcal disease in Kanti Children's Hospital, Nepal, as Observed by the South Asian Pneumococcal Alliance Network. Clinical Infectious Diseases. 2009; 48(SUPPL2) :S23-S8.

6 27/ Iranian Journal of Epidemiology 207; 2(4): Original Article Methods of Measuring and Monitoring the Impact of Pentavalent and Streptococcus Pneumonia Vaccines in Iran Karami M,2, Zahraei SM 3, Gouya MM 4 -Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran 2- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran 3- Vaccine Preventable Diseases Department, Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran 4- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran Corresponding author: Karami M, ma.karami@umsha.ac.ir Background and Objectives: The Haemophilus influenzae (Hib) conjugate vaccine (HibCV) using a pentavalent formulation was introduced to the Iranian routine immunization program from November 204. Iran is preparing to include Pneumococcal conjugate vaccines (PCV), as well. Measuring and monitoring the impact of HibCV and PCV are necessary to provide evidence for introduction and sustained administration of this vaccine. Methods: We addressed the possibility of implementing the "3-tiered approach to IB VPD surveillance" as proposed by the World Health Organization using a feasibility study. Expert opinions were asked to address published literature regarding the study design and methods of measuring the impact of newly introduced vaccines. Results: There are different methods and study designs to measure the impact of new vaccines, including population based active surveillance systems and vaccine effectiveness studies. The results of the feasibility study and expert opinions highlighted the superiority of a sentinel hospital-based surveillance system in Iran. Conclusion: It is necessary to conduct some systematic reviews and meta-analyses to provide evidence for the trend of Hib and Streptococcus pneumonia related diseases, i.e. invasive bacterial diseases including meningitis, pneumonia, and sepsis. To monitor indirect effects of the PCV vaccine, implementing periodic surveys on the prevalence of nasopharyngeal carriers are recommended. Keywords: Haemophilus influenza, Streptococcus pneumonia, Pneumococcal conjugate vaccine, Immunization, Children