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Volume 19, Number 1—January 2013

Research

Invasive Pneumococcal Disease after Routine Pneumococcal Conjugate Vaccination in Children, England and Wales

Shamez N. LadhaniComments to Author , Mary P.E. Slack, Nick J. Andrews, Pauline A. Waight, Ray Borrow, and Elizabeth Miller
Author affiliations: Author affiliations: Health Protection Services Colindale, London, UK (S.N. Ladhani, M.P.E. Slack, N.J Andrews, P.A Waight, E. Miller); Health Protection Agency, Manchester, UK (R. Borrow)

Main Article

Table 1

Characteristics of children with IPD in the cohort eligible for PCV7, England and Wales, September 4, 2006–March 31, 2010*

Characteristic Age group, mo, no. (%)
Total, n = 1,332
3–11, n = 507 12–23, n = 446 24–59, n = 379
Male sex 307 (60.6) 253 (56.7) 220 (58.0) 780 (58.6)
No comorbidity 441 (87.0) 392 (87.9) 301 (79.4) 1,134 (85.1)
Any comorbidity
66 (13.0)
54 (12.1)
78 (20.6)
198 (14.9)

Serotype group

PCV7

95 (18.7) 106 (23.8) 47 (12.4) 248 (18.6)

Extra 3 PCV10

86 (17.0) 78 (17.5) 135 (35.6) 299 (22.4)

Extra 3 PCV13

134 (26.4) 112 (25.1) 90 (23.7) 336 (25.2)

Extra 11 PPV23

82 (16.2) 62 (13.9) 42 (11.1) 186 (14.0)

Other

55 (10.8) 39 (8.7) 44 (11.6) 138 (10.4)

Not known


55 (10.8)
49 (11.0)
21 (5.5)
125 (9.4)
PCV7-IPD cases

Year 1

66/142 (46.5) 88/136 (64.7) 15/25 (60.0) 169/303 (55.8)

Year 2

17/104 (16.3) 13/90 (14.4) 13/69 (18.8) 43/263 (16.3)

Year 3

11/114 (9.6) 4/116 (3.4) 7/134 (5.2) 22/364 (6.0)

Year 4 (36–43 mo)


1/92 (1.1)
1/55 (1.8)
12/130 (9.2)
14/277 (5.1)
Comorbidity

Prematurity

58 (11.4) 44 (9.9) 28 (7.4) 130 (9.8)

Septicemia

272 (53.6) 291 (65.2) 209 (55.1) 772 (58.0)

Meningitis

195 (38.4) 70 (15.7) 35 (9.2) 300 (22.5)

LRTI

23 (4.5) 82 (18.4) 132 (34.8) 237 (17.8)

Other

17 (3.4) 3 (0.7) 3 (0.8) 23 (1.7)

>1 PCV7 vaccine dose

410 (80.9) 315 (70.6) 309 (81.5) 1,034 (77.6)

Hemolytic uremic syndrome†


8 (1.6)
11 (2.5)
5 (1.3)
24 (1.8)
Antimicrobial resistance

Penicillin‡

4/191 (2.1) 5/154 (3.2) 4/118 (3.4) 13/465 (2.8)

Erythromycin


9/153 (5.9)
16/129 (12.4)
4/92 (4.3)
29/374 (7.8)
Died and had 27/507 (5.3) 16/446 (3.6) 15/379 (4.0) 58/1,332 (4.4)

No comorbidity

17/437 (3.9) 13/389 (3.3) 10/295 (3.4) 40/1,121 (3.6)

Comorbidity

10/70 (14.3) 3/57 (5.3) 5/84 (6.0) 18/211 (8.5)

Septicemia

7/272 (2.6) 5/291 (1.7) 6/209 (2.9) 18/772 (2.3)

Meningitis

18/195 (9.2) 9/70 (12.9) 6/35 (17.1) 33/300 (11.0)

LRTI

1/23 (4.3) 2/82 (2.4) 3/132 (2.3) 6/237 (2.5)

Other

1/17 (5.9) 0/3 (0) 0/3 (0) 1/23 (4.3)

Serotype group

PCV7

3/95 (3.2) 6/106 (5.7) 2/47 (4.3) 11/248 (4.4)

PCV10

3/86 (3.5) 0/78 (0) 2/135 (1.5) 5/299 (1.7)

PCV13

8/134 (6.0) 3/112 (2.7) 5/90 5.6) 16/336 (4.8)

PPV23

2/82 (2.4) 5/62 (8.1) 2/42 (4.8) 9/186 (4.8)

Other

7/55 (12.7) 0/39 (0) 3/44 (6.8) 10/138 (7.2)

*IPD, invasive pneumococcal disease; PCV7, 7-valent pneumococcal conjugate vaccine, PCV10, 10-valent pneumococcal conjugate vaccine; PCV13, 13-valent pneumococcal conjugate vaccine; PPV23, 23-valent polysaccharide vaccine; PCV7-IPD cases, IPD caused by the serotypes in PCV7; LRTI, lower respiratory tract infection.
†The responsible serotypes were 19A (13 cases, 52%), 7F (4 cases, 16%), 3 (3 cases, 12%), 1 (2 cases, 8%), 11A (1 case, 4%), and 22A (1 case, 4%).
‡Two isolates from each age group were of intermediate penicillin resistance.

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