title: Reduced incidence of invasive pneumococcal disease after introduction of the 13-valent conjugate vaccine in Navarre, Spain, 2001-2013.
abstract: Pneumococcal conjugate vaccines (PCVs) were licensed for use in children and became available for private purchase in Spain in 2001 (PCV7), 2009 (PCV10) and 2010 (PCV13). This study evaluates changes in the incidence of invasive pneumococcal disease (IPD) and the pattern of serotypes isolated in Navarre, Spain, between the period of use of PCV7 (2004-2009) and that of PCV13 (2010-2013). The percentage of children <2 years who received at least one dose of PCV in these periods ranged from 25 to 61% and 61 to 78%, respectively. Between the periods 2004-2009 and 2010-2013 IPD incidence declined by 37%, from 14.9 to 9.4 cases/100,000 inhabitants (p<0.001). In children <5 years it fell by 69% (p<0.001), in persons aged 5-64 years, by 34% (p<0.001), and in those ≥ 65, by 23% (p=0.024). The incidence of cases due to PCV13 serotypes declined by 81% (p<0.001) in children <5 years and by 52% (p<0.001) in the whole population. No significant changes were seen in the distribution of clinical presentations or in disease severity. The incidence of IPD has declined and the pattern of serotypes causing IPD has changed notably in children and moderately in adults following the replacement of PCV7 by PCV13.
authors.affiliation: Instituto de Salud Pública de Navarra, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain. Electronic address: mguevare@navarra.es.
authors.forename: Marcela
authors.initials: M
authors.lastname: Guevara
authors.affiliation: Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Ezpeleta
authors.affiliation: Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Gil-Setas
authors.affiliation: Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Torroba
authors.affiliation: Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: Xabier
authors.initials: X
authors.lastname: Beristain
authors.affiliation: Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Aitziber
authors.initials: A
authors.lastname: Aguinaga
authors.affiliation: Hospital Reina Sofía, Tudela, Spain.
authors.forename: José Javier
authors.initials: JJ
authors.lastname: García-Irure
authors.affiliation: Hospital García Orcoyen, Estella, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Navascués
authors.affiliation: Instituto de Salud Pública de Navarra, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: García-Cenoz
authors.affiliation: Instituto de Salud Pública de Navarra, Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Castilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D018571:Sentinel Surveillance; D013030:Spain / Q000453:epidemiology; D018074:Vaccines, Conjugate / Q000008:administration & dosage; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Impact; Invasive pneumococcal disease; Pneumococcal conjugate vaccine; Public health surveillance; Streptococcus pneumoniae