Effects of pneumococcal conjugate vaccine 2 years after its introduction, the Netherlands

In the Netherlands, the 7-valent pneumococcal conjugate vaccine (PCV-7) was implemented in a 3+1-dose schedule in the national immunization program for infants born after April 1, 2006. To assess the vaccine's effectiveness, we compared disease incidence before and after vaccine implementation...

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Bibliographic Details
Published in:Emerging infectious diseases 2010-05, Vol.16 (5), p.816-823
Main Authors: Rodenburg, Gerwin D, de Greeff, Sabine C, Jansen, Angelique G C S, de Melker, Hester E, Schouls, Leo M, Hak, Eelko, Spanjaard, Lodewijk, Sanders, Elisabeth A M, van der Ende, Arie
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
bacteria
Child
Child, Preschool
Heptavalent Pneumococcal Conjugate Vaccine
Humans
Incidence
Infant
Middle Aged
Netherlands - epidemiology
pneumococcal infections
Pneumococcal Infections - epidemiology
Pneumococcal Infections - etiology
Pneumococcal Infections - physiopathology
Pneumococcal Infections - prevention & control
pneumococcal vaccines
Pneumococcal Vaccines - therapeutic use
Population Surveillance
Serotyping
Streptococcus pneumoniae - immunology
Streptococcus pneumoniae - isolation & purification
surveillance
Time Factors
Treatment Outcome
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Summary:In the Netherlands, the 7-valent pneumococcal conjugate vaccine (PCV-7) was implemented in a 3+1-dose schedule in the national immunization program for infants born after April 1, 2006. To assess the vaccine's effectiveness, we compared disease incidence before and after vaccine implementation (June 2004-June 2006 and June 2006-June 2008, respectively). We serotyped 2,552 invasive pneumococcal isolates from throughout the Netherlands, covering 25% of the country's population. Clinical characteristics were extracted from hospital records. After June 2006, vaccine-serotype invasive pneumococcal disease (IPD) decreased 90% (95% confidence interval [CI] 68%-97%) in children age eligible for PCV-7; simultaneously, however, non-vaccine-serotype IPD increased by 71% (not significant), resulting in a 44% total net IPD reduction (95% CI 7%-66%). IPD rates did not change for other age groups. In the Netherlands, PCV-7 offered high protection against vaccine-serotype IPD in vaccinated children, but increases of non-vaccine-serotype IPD reduced net vaccine benefits.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid1605.091223