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Volume 18, Number 11—November 2012

CME ACTIVITY - Research

Invasive Pneumococcal Disease and 7-Valent Pneumococcal Conjugate Vaccine, the Netherlands

Anna M.M. van Deursen1, Suzan P. van Mens1, Elisabeth A.M. Sanders, Bart J.M. Vlaminckx, Hester E. de Melker, Leo M. Schouls, Sabine C. de Greeff2, Arie van der Ende2Comments to Author , and on behalf of the Invasive Pneumococcal Disease Sentinel Surveillance Laboratory Group
Author affiliations: University Medical Center, Utrecht, the Netherlands (A.M.M. van Deursen, S.P. van Mens, E.A.M. Sanders); Linnaeus Institute, Hoofddorp, the Netherlands (A.M.M. van Deursen); St Antonius Hospital, Nieuwegein, the Netherlands (S.P. van Mens, B.J.M. Vlaminckx); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (H.E. de Melker, L.M. Schouls, S.C. de Greeff); Academic Medical Center, Amsterdam, the Netherlands (A. van der Ende); Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam (A. van der Ende)

Main Article

Table 1

Incidence of invasive pneumococcal disease before and after implementation of a PCV7 vaccination program, the Netherlands, June 2004–May 2010*

Age group, 
y Vaccination period†
Late post- vs. pre-implementation period
Pre-implementation
Early post- implementation
Late 
post-implementation
No. cases Incidence No. cases Incidence No. cases Incidence IRR 95% CI p value
All serotypes

All ages

1,216 14.9 1,304 15.9 1,144 13.8 0.93 0.86–1.01 NS

<2

68 35.0 42 22.8 26 14.1 0.40 0.26–0.63 <0.001

2–4

25 8.2 26 8.9 12 4.3 0.52 0.26–1.04 NS

5–17

23 1.8 22 1.7 23 1.8 1.00 0.56–1.78 NS

18–49

181 4.9 209 5.8 197 5.5 1.11 0.91–1.36 NS

50–64

253 16.4 292 18.3 261 15.8 0.96 0.81–1.14 NS

>65


666
57.7

713
59.6

625
49.9

0.87
0.78–0.97
0.009
PCV7 serotypes

All ages

565 6.9 561 6.9 268 3.2 0.47 0.40–0.54 <0.001

<2

48 24.7 15 8.1 0 0.0 0 NA <0.001

2–4

17 5.6 17 5.8 3 1.1 0.19 0.06–0.66 0.003

5–17

11 0.9 4 0.3 4 0.3 0.36 0.12–1.14 NS

18–49

56 1.5 66 1.8 48 1.3 0.87 0.59–1.29 NS

50–64

114 7.4 129 8.1 56 3.4 0.46 0.33–0.63 <0.001

>65


319
27.6

330
27.6

157
12.5

0.45
0.37–0.55
<0.001
Non–PCV7 serotypes
All ages 650 8.0 741 9.1 876 10.6 1.33 1.20–1.47 <0.001

<2

20 10.3 27 14.7 26 14.1 1.37 0.77–2.46 NS

2–4

8 2.6 9 3.1 9 3.2 1.22 0.47–3.18 NS

5–17

12 0.9 18 1.4 19 1.5 1.58 0.77–3.26 NS

18–49

125 3.4 142 3.9 149 4.1 1.22 0.96–1.54 NS

50–64

139 9.0 163 10.2 205 12.4 1.37 1.11–1.70 0.004

>65

346 30.0 382 32.0 468 37.4 1.25 1.09–1.43 0.002

*Cases are number of patients included in a study covering ≈25% of the Dutch population; incidence is number of cases/100,000 persons. Three pneumococcal isolates (1 in the pre- and 2 in the early post-implementation period) were either not typeable or typed as a rough strain and, therefore, could not be classified as 7-valent pneumococcal conjugate vaccine (PCV7) or non–PCV7 serotypes. IRR, incidence rate ratio; NS, not significant (p>0.05); NA, not applicable; boldface, significant difference (p<0.05).
†Vaccination periods: pre-implementation period, June 2004–May 2006; early post-implementation, June 2006–May 2008; late post-implementation period, June 2008–May 2010.

Main Article

1These authors contributed equally to this article.

2These authors contributed equally to this article.

3Additional members of the Invasive Pneumococcal Disease Sentinel Surveillance Laboratory Group are listed at the end of this article.

Members of the Invasive Pneumococcal Disease Sentinel Surveillance Laboratory Group: Karola Waar, Izore, Centre for Infectious Diseases Friesland, Leeuwarden, the Netherlands; Bert Mulder, Laboratory of Medical Microbiology Twente Achterhoek, Enschede, the Netherlands; Caroline Swanink, Department of Medical Microbiology and Medical Immunology Hospital Rijnstate, Arnhem, the Netherlands; Bram Diederen, Regional Laboratory of Public Health, Haarlem, the Netherlands; Niek Arents, Laboratory for Pathology and Medical Microbiology, Veldhoven, the Netherlands; Ine Frénay, Regional Laboratory for Medical Microbiology and Infectious Diseases, Dordrecht–Gorinchem, the Netherlands; Hans Wagenvoort, Atrium Medical Center, Heerlen, the Netherlands; Bartelt de Jongh, St. Antonius Hospital, Nieuwegein, the Netherlands; Lodewijk Spanjaard, Academic Medical Center, Amsterdam, the Netherlands

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