title: Impact of the pneumococcal conjugate vaccines on invasive pneumococcal disease in France, 2001-2012.
abstract: OBJECTIVE
  Vaccination with the 7-valent pneumococcal conjugate vaccine (PCV7) was recommended in France in 2003 for children <2 years. The 13-valent conjugate vaccine (PCV13) replaced PCV7 in 2010. We assessed the impact of PCVs vaccination on the incidence of invasive pneumococcal diseases (IPD) in French children (0-15 years) and adults (>15 years).
  
  
  METHODS
  IPD rates were calculated using cases reported from 2001 to 2012 to Epibac, a laboratory network. The distribution of serotypes was assessed from invasive isolates serotyped at the National reference Centre for Pneumococci. IPD incidence rates were compared between the pre-PCV7 (2001-2002), late PCV7 (2008-2009) and post PCV13 (2012) periods.
  
  
  RESULTS
  The PCVs coverage increased from 56% in the 2004 birth-cohort to 94% in the 2008 and following birth-cohorts. Following PCV7 introduction, IPD incidence decreased by 19% between 2001-2002 and 2008-2009 in children <2 years, but increased in children aged 2-15 years and adults, despite a sharp decline in PCV7-IPD in all age-groups. After PCV13 introduction, IPD incidence decreased by 34% in children <5 years, by 50% in those aged 5-15 years and 15% in adults from 2008-2009 to 2012. The incidence of PCV13-Non PCV7-IPD decreased by 74% in children <5 years and by 60% in those aged 5-15 years.
  
  
  CONCLUSIONS
  Vaccination with PCV13 was rapidly followed by a decrease in the incidence of all-type IPD in children, in relation with a sharp decrease in the incidence of PCV13-Non PCV7-IPD. Moreover, all-type IPD decreased after PCV13 introduction in older non-vaccinated age-groups, with a shift in the distribution of serotypes. Considering the whole 2001-2012 period, the vaccination with PCV7 and PCV13 resulted in a decline in the incidence of IPD in children up to the age of 5 but not in older children and adults.
authors.affiliation: Département des maladies infectieuses, Institut de Veille Sanitaire, Saint Maurice, France. Electronic address: a.lepoutre@invs.sante.fr.
authors.forename: A
authors.initials: A
authors.lastname: Lepoutre
authors.affiliation: Centre National de Référence des Pneumocoques, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Varon
authors.affiliation: Département des maladies infectieuses, Institut de Veille Sanitaire, Saint Maurice, France.
authors.forename: S
authors.initials: S
authors.lastname: Georges
authors.affiliation: Département des maladies infectieuses, Institut de Veille Sanitaire, Saint Maurice, France.
authors.forename: F
authors.initials: F
authors.lastname: Dorléans
authors.affiliation: Centre National de Référence des Pneumocoques, AP-HP, Hôpital Européen Georges Pompidou, Paris, France; Université Paris Sud, EA 4043 Châtenay-Malabry, France.
authors.forename: C
authors.initials: C
authors.lastname: Janoir
authors.affiliation: Centre National de Référence des Pneumocoques, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Gutmann
authors.affiliation: Département des maladies infectieuses, Institut de Veille Sanitaire, Saint Maurice, France.
authors.forename: D
authors.initials: D
authors.lastname: Lévy-Bruhl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011159:Population Surveillance; D065288:Serogroup; D012703:Serotyping; D013997:Time Factors; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: France; Invasive pneumococcal disease; Pneumococcal conjugate vaccines; Population surveillance; Serotype replacement; Vaccine impact