title: Effects of pneumococcal conjugate vaccine 2 years after its introduction, the Netherlands.
abstract: 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.
authors.affiliation: Wilhelmina Children's Hospital/University Medical Center, Utrecht, the Netherlands. g.d.rodenburg@umcutrecht.nl
authors.forename: Gerwin D
authors.initials: GD
authors.lastname: Rodenburg
authors.forename: Sabine C
authors.initials: SC
authors.lastname: de Greeff
authors.forename: Angelique G C S
authors.initials: AG
authors.lastname: Jansen
authors.forename: Hester E
authors.initials: HE
authors.lastname: de Melker
authors.forename: Leo M
authors.initials: LM
authors.lastname: Schouls
authors.forename: Eelko
authors.initials: E
authors.lastname: Hak
authors.forename: Lodewijk
authors.initials: L
authors.lastname: Spanjaard
authors.forename: Elisabeth A M
authors.initials: EA
authors.lastname: Sanders
authors.forename: Arie
authors.initials: A
authors.lastname: van der Ende
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011159:Population Surveillance; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000276:immunology / Q000302:isolation & purification; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines
references.citation: Int J Infect Dis. 2010 Mar;14(3):e197-209
references.pmid: 19700359
references.citation: Commun Dis Intell Q Rep. 2008 Mar;32(1):18-30
references.pmid: 18522302
references.citation: Epidemiol Infect. 2008 Aug;136(8):1096-102
references.pmid: 17961282
references.citation: Euro Surveill. 2009 Mar 26;14(12):
references.pmid: 19341605
references.citation: J Med Microbiol. 2008 Apr;57(Pt 4):480-487
references.pmid: 18349369
references.citation: JAMA. 2005 Oct 26;294(16):2043-51
references.pmid: 16249418
references.citation: J Clin Microbiol. 2009 Apr;47(4):1012-20
references.pmid: 19225097
references.citation: J Infect Dis. 2005 Jul 15;192(2):192-9
references.pmid: 15962213
references.citation: JAMA. 2007 Oct 17;298(15):1772-8
references.pmid: 17940232
references.citation: Clin Infect Dis. 2000 Jan;30(1):122-40
references.pmid: 10619741
references.citation: N Engl J Med. 2009 Jan 15;360(3):244-56
references.pmid: 19144940
references.citation: MMWR Morb Mortal Wkly Rep. 2008 Feb 15;57(6):144-8
references.pmid: 18272956
references.citation: Ned Tijdschr Geneeskd. 2007 Jun 30;151(26):1454-7
references.pmid: 17633974
references.citation: Clin Infect Dis. 2008 Jan 15;46(2):174-82
references.pmid: 18171247
references.citation: Euro Surveill. 2008 Aug 28;13(35):
references.pmid: 18761883
references.citation: Vaccine. 2009 Jun 24;27(31):4136-41
references.pmid: 19406190
references.citation: Pediatr Infect Dis J. 2007 Jun;26(6):468-72
references.pmid: 17529860
references.citation: Vaccine. 2008 Jun 19;26(26):3277-81
references.pmid: 18456376
references.citation: JAMA. 2009 Jul 8;302(2):159-67
references.pmid: 19584345
references.citation: J Clin Microbiol. 2003 Nov;41(11):4966-70
references.pmid: 14605125
references.citation: Eur J Clin Microbiol Infect Dis. 2007 May;26(5):303-10
references.pmid: 17457623
references.citation: N Engl J Med. 2003 May 1;348(18):1737-46
references.pmid: 12724479
references.citation: Vaccine. 2009 Apr 14;27(17):2394-401
references.pmid: 19428856
references.citation: Euro Surveill. 2006 Jun 08;11(6):E060608.2
references.pmid: 16819118