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Volume 16, Number 5—May 2010

Research

Effects of Pneumococcal Conjugate Vaccine 2 Years after Its Introduction, the Netherlands

Gerwin D. Rodenburg1Comments to Author , Sabine C. de Greeff1, Angelique G.C.S. Jansen, Hester E. de Melker, Leo M. Schouls, Eelko Hak, Lodewijk Spanjaard, Elisabeth A.M. Sanders2, and Arie van der Ende2
Author affiliations: Wilhelmina Children’s Hospital/University Medical Center, Utrecht, the Netherlands (G.D. Rodenburg, A.G.C.S Jansen, E. Hak, E.A.M. Sanders); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (S.C. de Greeff, H.E. de Melker, L.M. Schouls); University Medical Center, Groningen, the Netherlands (E. Hak); Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam, the Netherlands (L. Spanjaard, A. van der Ende); 1, 2These pairs of authors contributed equally to this study.

Main Article

Table

Incidence rates of invasive pneumococcal diseases before and after implementation of 7-valent pneumococcal conjugate vaccine, the Netherlands*

Serotypes by patient age group, y Preimplementation period (June 2004–June 2006)
Postimplementation period (June 2006–June 2008)
Preimplementation vs. postimplementation
No. cases Rate No. cases Rate IRR (95% CI) p value†
Total
All ages 1,225 15.0 1,304 15.9 1.06 (0.98–1.15) 0.14
<2 68 34.5 42 22.5 0.65 (0.44–0.96) 0.006
2–4 25 8.1 26 8.7 1.07 (0.62–1.86)
5–49 206 4.1 231 4.7 1.13 (0.94–1.37)
50–64 254 16.7 292 18.5 1.11 (0.94–1.31)
>65
672
58.8

713
60.2

1.02 (0.92–1.14)

Vaccine serotypes‡
All ages 570 7.0 561 6.9 0.98 (0.87–1.10)
<2 48 24.3 15 8.0 0.33 (0.19–0.59) <0.0001
2–4 17 5.5 17 5.7 1.03 (0.53–2.02)
5–49 69 1.4 70 1.4 1.02 (0.73–1.43)
50–64 114 7.5 129 8.24 1.09 (0.85–1.40)
>65
322
28.2

330
27.9

0.99 (0.85–1.15)

Nonvaccine serotypes§
All ages 656 8.0 743 9.1 1.13 (1.02–1.26) 0.02
<2 20 10.1 27 14.5 1.43 (0.80–2.55)
2–4 8 2.6 9 3.0 1.16 (0.45–3.01)
5–49 137 2.8 161 3.3 1.19 (0.94–1.49)
50–64 140 9.2 163 10.3 1.12 (0.89–1.41)
>65 350 30.6 383 32.4 1.06 (0.91–1.22)

*Rate is cases/100,000 persons. IRR, incidence rate ratio; CI, confidence interval. Boldface indicates significant differences (p<0.05).
†p values shown <0.15; incidence rates pre vs. postimplementation period. Calculated by using Fisher exact test; all p values are 2 sided.
Streptococcus pneumoniae serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F.
§All other S. pneumoniae serotypes.

Main Article

1, 2These pairs of authors contributed equally to this study.

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