title: Pneumococcal serotypes in children in 4 European countries.
abstract: After heptavalent pneumococcal conjugate vaccine (PCV7) was marketed in France, Spain, Belgium, and England and Wales (United Kingdom), invasive disease from non-PCV7 serotypes (NVT) increased. Adjusted serotype-specific incidences among children <15 years of age were compared between 1999-2002 (prevaccine) and 2005-2006 (postmarketing). Vaccine coverage increased to approximately 32%-48% in France, Spain, and Belgium but remained <1% in England and Wales. Serotype 1 incidence rose in all age groups and countries (incidence rate ratio [IRR] 1.3-4.2; p<0.004), independently of PCV7 use, but incidence of serotypes 7F and 19A increased most in France, Spain, and Belgium (IRR 1.9-16.9 in children <5 years; p<0.001), where PCV7 coverage was greater. Vaccine-induced replacement of PCV7 serotypes possibly contributed to NVT increases, as did secular trends. New vaccines targeting these serotypes are available, but serotype dynamics needs further exploration that accounts for underreporting and prevaccine trends.
authors.affiliation: Scientific Institute of Public Health, Brussels, Belgium. germaine@skynet.be
authors.forename: Germaine
authors.initials: G
authors.lastname: Hanquet
authors.forename: Esther
authors.initials: E
authors.lastname: Kissling
authors.forename: Asuncion
authors.initials: A
authors.lastname: Fenoll
authors.forename: Robert
authors.initials: R
authors.lastname: George
authors.forename: Agnes
authors.initials: A
authors.lastname: Lepoutre
authors.forename: Tinne
authors.initials: T
authors.lastname: Lernout
authors.forename: David
authors.initials: D
authors.lastname: Tarragó
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Varon
authors.forename: Jan
authors.initials: J
authors.lastname: Verhaegen
mesh_terms: D000293:Adolescent; D001530:Belgium / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000382:microbiology; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000494:pharmacology; D011446:Prospective Studies; D012703:Serotyping; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000145:classification*; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines