title: Long term population impact of seven-valent pneumococcal conjugate vaccine with a "3+0″ schedule-How do "2+1″ and "3+1″ schedules compare?
abstract: BACKGROUND
  Significant reductions in invasive pneumococcal disease (IPD) following 7-valent pneumococcal conjugate vaccine (7vPCV) are well documented, but population-level data comparing different schedules are sparse. We compared data from long-term stable surveillance in one Australian region (3 primary doses (3+0) schedule) with similar data from England and Wales (2+1 schedule) and the United States (3+1 schedule).
  
  
  METHODS
  Incidence rate ratios (IRRs) for all, vaccine type, and non-vaccine type IPD were calculated by age-group, using comparable case definitions and time periods post 7vPCV introduction.
  
  
  RESULTS
  At baseline, the % of IPD due to 7vPCV serotypes (VT) disease in children <5 years was 88% in Greater Sydney (GS), 83% in the United States (US), and 74% in England and Wales (E&W). IRR for VT IPD <5 years in GS was 0.05 (0.02-0.09), for ≥65 years was 0.15 (0.12-0.19) and for all ages 0.12 (0.10-0.13). In the US, IRR for VT IPD was lower in each age group, and for all ages the 95% CI of the IRR (0.06 (0.05-0.07)), did not overlap with GS or E&W (0.14 (0.11-0.18)). In contrast, the IRR for IPD due to any serotype did not differ between sites for any age group or overall.
  
  
  CONCLUSIONS
  Differences in direct and indirect reductions in VT IPD with a "3+0″ 7vPCV schedule versus "2+1″ or "3+1″ were small. All 3 countries moved to 13vPCV by 2011; data post 13vPCV will be important to assess IPD impact using more similar baseline incidence and comparison periods.
authors.affiliation: Public Health Officer Training Program, New South Wales Ministry of Health, Sydney, NSW, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia. Electronic address: clowb@doh.health.nsw.gov.au.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lowbridge
authors.affiliation: National Centre for Immunisation Research and Surveillance, Children's Hospital, Westmead, Sydney, NSW, Australia; Discipline of Paediatrics and Child Health and School of Public Health, University of Sydney, Children's Hospital, Westmead, Sydney, NSW, Australia. Electronic address: peter.mcintyre@health.nsw.gov.au.
authors.forename: Peter B
authors.initials: PB
authors.lastname: McIntyre
authors.affiliation: Health Protection New South Wales, Sydney, Australia. Electronic address: rgilm@doh.health.nsw.gov.au.
authors.forename: Robin
authors.initials: R
authors.lastname: Gilmour
authors.affiliation: National Centre for Immunisation Research and Surveillance, Children's Hospital, Westmead, Sydney, NSW, Australia. Electronic address: clayton.chiu@health.nsw.gov.au.
authors.forename: Clayton
authors.initials: C
authors.lastname: Chiu
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia. Electronic address: h.seale@unsw.edu.au.
authors.forename: Holly
authors.initials: H
authors.lastname: Seale
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia. Electronic address: mark.ferson@sesiahs.health.nsw.gov.au.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ferson
authors.affiliation: Centre for Infectious Diseases and Microbiology-Public Health, Sydney, NSW, Australia. Electronic address: lyn.gilbert@sydney.edu.au.
authors.forename: Gwendolyn L
authors.initials: GL
authors.lastname: Gilbert
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D062665:Epidemiological Monitoring; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage*; D006801:Humans; D007115:Immunization Schedule; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D065288:Serogroup; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine
keywords: Comparison; Conjugate; Pneumococcal; Schedule; Vaccination