Prediction of the potential benefit of different pneumococcal conjugate vaccines on invasive pneumococcal disease in German children.
BACKGROUND
In the US a pneumococcal conjugate vaccination program with a 7-valent conjugate vaccine was successfully implemented in 2000. How much invasive pneumococcal disease can potentially be prevented by the 7-valent (or 11-valent) vaccine in Europe?


METHODS
Prospective, active surveillance of invasive pneumococcal disease in German children age <16 years was performed between 1997 and 2000. Age- and disease-specific coverage and incidence rates were assessed in children old enough to benefit from complete vaccination to estimate the annual number of cases potentially preventable.


RESULTS
A total of 1,743 cases were reported; 667 isolates were serotyped. Coverage of 7-valent (11-valent) conjugate vaccines in children age 6 months and older was age- and diagnosis-dependent, ranging from 10.5% (15.8%) to 78.3% (82.6%) for meningitis and from 13.6% (68.2%) to 75.0% (89.3%) for nonmeningitis invasive pneumococcal disease cases. Of an estimated annual number of 176 children with pneumococcal meningitis age 6 months or older, 112 (122) cases had serotypes included in the 7-valent (11-valent) conjugate vaccine compared with 181 (254) of 324 nonmeningitis invasive pneumococcal disease cases, with 37 of the 73 cases covered by the 11-valent vaccine only in children older than 5 years. Regarding meningitis in this age group the potential benefit was equally poor for both the 7-valent (12 of 37 cases) and the 11-valent vaccine (15 of 37 cases).


CONCLUSIONS
Coverage of the 7- and 11-valent conjugate vaccines depends markedly on age and disease. The additional potential benefit of the 11-valent compared with the 7-valent vaccine for pneumococcal meningitis was marginal.
von Kries
Rüdiger
R
Institute for Social Pediatrics, Ludwig-Maximillans-Universität, Munich, Germany. ag.epi@lrz.uni-muenchen.de
Hermann
Monika
M
Hachmeister
Alexandra
A
Siedler
Anette
A
Schmitt
Heinz J
HJ
Al-Lahham
Adnan
A
Reinert
Ralf René
RR
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011159:Population Surveillance; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D018074:Vaccines, Conjugate / Q000276:immunology*
D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate