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Volume 21, Number 11—November 2015
Dispatch

Invasive Pneumococcal Disease 3 Years after Introduction of 10-Valent Pneumococcal Conjugate Vaccine, the Netherlands

Mirjam J. KnolComments to Author , Gertjan H.J. Wagenvoort, Elisabeth A.M. Sanders, Karin Elberse, Bart J. Vlaminckx, Hester E. de Melker, and Arie van der Ende
Author affiliations: National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M.J. Knol, E.A.M. Sanders, K. Elberse, H.E. de Melker); St. Antonius Hospital, Nieuwegein, the Netherlands (G.H.J. Wagenvoort, B.J. Vlaminckx); University Medical Center Utrecht, Utrecht, the Netherlands (E.A.M. Sanders); Amsterdam Medical Center, Amsterdam, the Netherlands (A. van der Ende); Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam (A. van der Ende)

Main Article

Table 1

Number of IPD cases and cumulative incidence ratios determined on the basis of sentinel surveillance data, the Netherlands*

Serotype and patient age group, y
 No. cases
Comparison, CIR (95% CI)
Pre-PCV7, 2004–2006
 Pre-PCV10, 2009–2011
 Early post-PCV10, 2011–2013
 3 years post-PCV10, 2013–2014
 Pre-PCV10 vs. pre-PCV7
 Early post-PCV10 vs. pre-PCV10
 3 years post-PCV10 vs. early post-PCV10
All
<2 75 30 15 5 0.43 (0.28–0.65) 0.51 (0.27–0.94) 0.69 (0.25–1.90)
2–4 25 12 9 4 0.53 (0.27–1.05) 0.75 (0.32–1.79) 0.89 (0.27–2.89)
5–17 22 23 17 8 1.04 (0.58–1.87) 0.75 (0.40–1.40) 0.95 (0.41–2.20)
18–49 197 184 201 73 0.96 (0.78–1.17) 1.10 (0.90–1.34) 0.73 (0.56–0.96)
50–64 273 326 341 134 1.09 (0.93–1.28) 1.03 (0.88–1.19) 0.78 (0.64–0.95)
>65 717 622 703 338 0.78 (0.70–0.87) 1.06 (0.95–1.18) 0.91 (0.80–1.03)
Total
 1,309
 1,197
 1,286
 562
0.90 (0.83–0.97)
 1.06 (0.98–1.15)
 0.87 (0.79–0.96)
PCV7
<2 50 1 2 0 0.02 (0.00–0.16) 2.03 (0.18–22.33) NC
2–4 18 2 1 0 0.12 (0.03–0.53) 0.50 (0.05–5.55) NC
5–17 11 6 2 1 0.54 (0.20–1.47) 0.34 (0.07–1.67) 1.01 (0.09–11.1)
18–49 63 35 17 2 0.57 (0.38–0.86) 0.49 (0.27–0.87) 0.24 (0.05–1.03)
50–64 120 53 25 7 0.40 (0.29–0.56) 0.46 (0.29–0.74) 0.56 (0.24–1.29)
>65 344 112 54 20 0.29 (0.24–0.36) 0.45 (0.33–0.62) 0.70 (0.42–1.17)
Total
 606
 209
 101
 30
0.34 (0.29–0.40)
 0.48 (0.38–0.61)
 0.59 (0.39–0.89)
Non-PCV7
<2 25 29 13 5 1.24 (0.73–2.12) 0.45 (0.24–0.87) 0.80 (0.28–2.23)
2–4 7 10 8 4 1.57 (0.60–4.13) 0.80 (0.32–2.04) 1.00 (0.30–3.32)
5–17 11 17 15 7 1.54 (0.72–3.30) 0.89 (0.44–1.78) 0.94 (0.38–2.31)
18–49 134 149 184 71 1.14 (0.90–1.44) 1.24 (1.00–1.54) 0.78 (0.59–1.02)
50–64 153 273 316 127 1.63 (1.34–1.99) 1.14 (0.97–1.33) 0.80 (0.65–0.98)
>65 373 510 649 318 1.24 (1.08–1.41) 1.19 (1.06–1.34) 0.93 (0.81–1.06)
Total
 703
 988
 1,185
 532
1.38 (1.26–1.52)
 1.19 (1.09–1.29)
 0.89 (0.81–0.99)
PCV10–7
<2 7 6 3 0 0.92 (0.31–2.73) 0.51 (0.13–2.02) NC
2–4 5 6 2 3 1.32 (0.40–4.33) 0.34 (0.07–1.66) 3.00 (0.50–18.0)
5–17 5 12 7 2 2.40 (0.84–6.81) 0.59 (0.23–1.49) 0.58 (0.12–2.77)
18–49 69 78 91 26 1.16 (0.84–1.60) 1.18 (0.87–1.59) 0.58 (0.37–0.89)
50–64 43 83 97 26 1.77 (1.22–2.55) 1.15 (0.86–1.54) 0.53 (0.35–0.82)
>65 115 114 119 47 0.90 (0.69–1.16) 0.98 (0.76–1.26) 0.75 (0.53–1.05)
Total
 244
 299
 319
 104
1.21 (1.02–1.43)
 1.06 (0.90–1.24)
 0.65 (0.52–0.81)
Non-PCV10
<2 18 23 10 5 NA 0.44 (0.21–0.92) 1.03 (0.35–3.03)
2–4 2 4 6 1 NA 1.51 (0.43–5.35) 0.33 (0.04–2.77)
5–17 6 5 8 5 NA 1.61 (0.53–4.93) 1.26 (0.41–3.85)
18–49 65 71 93 45 NA 1.32 (0.97–1.80) 0.98 (0.68–1.39)
50–64 110 190 219 101 NA 1.13 (0.93–1.37) 0.92 (0.72–1.16)
>65 258 396 530 271 NA 1.25 (1.10–1.43) 0.97 (0.84–1.12)
Total
 459
 689
 866
 428
NA
 1.25 (1.13–1.38)
 0.98 (0.88–1.11)
19A
<2 5 5 0 0 1.07 (0.31–3.70) 0.00 (NC) NC
2–4 0 2 1 0 NC 0.50 (0.05–5.55) NC
5–17 0 2 0 0 NC 0.00 (NC) NC
18–49 1 12 15 3 12.3 (1.60–94.6) 1.26 (0.59–2.69) 0.40 (0.12–1.39)
50–64 13 28 44 14 1.97 (1.02–3.81) 1.54 (0.96–2.48) 0.63 (0.35–1.15)
>65 25 63 94 33 2.28 (1.43–3.62) 1.40 (1.02–1.92) 0.66 (0.45–0.99)
Total 44 112 154 50 2.50 (1.77–3.55) 1.36 (1.07–1.74) 0.65 (0.47–0.89)

*PCV7, 7-valent pneumococcal conjugate vaccine; PCV10−7, serotypes present in PCV10 but not PCV7 (3 additional serotypes); PCV10, 10-valent pneumococcal conjugate vaccine; CIR, cumulative incidence ratio; NC, not calculated (numbers too low to be informative or relevant). NA, not applicable.

Main Article

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