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Volume 25, Number 9—September 2019
Research

Effect of Pneumococcal Conjugate Vaccines on Pneumococcal Meningitis, England and Wales, July 1, 2000–June 30, 2016

Godwin Oligbu, Sarah Collins, Abdelmajid Djennad, Carmen L. Sheppard, Norman K. Fry, Nick J. Andrews, Ray Borrow, Mary E. Ramsay, and Shamez N. LadhaniComments to Author 
Author affiliations: Public Health England, London, UK (G. Oligbu, S. Collins, A. Djennad, C.L. Sheppard, N.K. Fry, N.J. Andrews, M.E. Ramsay, S.N. Ladhani); St. George's, University of London, London (G. Oligbu, S.N. Ladhani); Public Health England Manchester Royal Infirmary, Manchester, UK (R. Borrow)

Main Article

Table 1

Cases, incidence, and age-adjusted IRRs for pneumococcal meningitis and nonmeningitis cases by age group, serotype group, and period, England and Wales, July 1, 2000–June 30, 2016*

Case type, age group, and serotype group
 July 1, 2015–June 30, 2016
Pre-PCV13 period, July 1, 2008–June 30, 2010
Pre-PCV7 period, July 1, 2000–June 30, 2006
No. corrected (raw) cases†
 Incidence, cases/ 100,000 person-years
 No. corrected (raw) cases†
 Incidence, cases/ 100,000 person-years
 IRR (95% CI)
vs. 2015–16
No. corrected (raw) cases†
 Incidence, cases/ 100,000 person-years
 IRR (95% CI)
vs. 2015–16
Meningitis
<5 y
All serotypes 41 (44) 1.22 105 (104) 3.10 0.39 (0.25–0.63) 138 (122) 4.08 0.30 (0.19–0.46)
PCV7 1 (1) 0.03 10 (10) 0.29 0.10 (0.01–1.84) 102 (76) 3.02 0.01 (0–0.16)
Additional PCV13 3 (3) 0.09 53 (51) 1.56 0.06 (0.01–0.29) 18 (14) 0.54 0.16 (0.03–0.85)
Non-PCV13
 37 (38)
 1.10
42 (41)
 1.25
 0.89 (0.51–1.56)
18 (13)
 0.52
 2.12 (1.22–3.75)
5–64 y
All serotypes 96 (98) 0.22 155 (155) 0.36 0.62 (0.44–0.86) 117 (110) 0.27 0.82 (0.60–1.11)
PCV7 2 (2) 0.00 28 (27) 0.07 0.07 (0.01–0.56) 54 (39) 0.13 0.04 (0.01–0.29)
Additional PCV13 14 (13) 0.03 51 (47) 0.12 0.27 (0.11–0.62) 22 (16) 0.05 0.62 (0.26–1.39)
Non-PCV13
 80 (77)
 0.19
76 (71)
 0.18
 1.06 (0.71–1.58)
41 (29)
 0.10
 1.95 (1.31–2.86)
>65 y
All serotypes 24 (28) 0.27 52 (52) 0.59 0.46 (0.25–0.85) 53 (49) 0.60 0.45 (0.26–0.80)
PCV7 0 (0) 0 8 (8) 0.09 0 (0–0.52) 23 (17) 0.26 0 (0–0.17)
Additional PCV13 2 (2) 0.02 11 (10) 0.12 0.19 (0.02–1.57) 10 (7) 0.11 0.20 (0.02–1.55)
Non-PCV13
 22 (22)
 0.25
33 (32)
 0.37
 0.67 (0.33–1.34)
20 (15)
 0.22
 1.11 (0.56–2.18)
All ages
All serotypes 162 (170) 0.29 311 (310) 0.56 0.51 (0.40–0.66) 301 (288) 0.55 0.52 (0.41–0.65)
PCV7 3 (3) 0.01 46 (44) 0.08 0.07 (0.01–0.35) 176 (133) 0.32 0.02 (0–0.09)
Additional PCV13 18 (18) 0.03 114 (108) 0.21 0.16 (0.08–0.32) 49 (38) 0.09 0.36 (0.18–0.72)
Non-PCV13
 141 (137)
 0.25
151 (143)
 0.27
 0.92 (0.69–1.25)
77 (58)
 0.14
 1.77 (1.33–2.36)
Nonmeningitis
<5 y
All serotypes 241 (257) 7.12 345 (341) 10.19 0.70 (0.57–0.86) 666 (592) 19.67 0.36 (0.30–0.44)
PCV7 5 (5) 0.15 25 (23) 0.74 0.21 (0.05–0.79) 479 (310) 14.17 0.01 (0–0.04)
Additional PCV13 30 (29) 0.89 217 (199) 6.40 0.14 (0.08–0.24) 112 (73) 3.30 0.27 (0.15–0.46)
Non-PCV13
 206 (198)
 6.08
103 (95)
 3.05
 2.00 (1.50–2.66)
75 (49)
 2.20
 2.76 (2.11–3.57)
5–64 y
All serotypes 2,333 (2,387) 5.44 2,385 (2,377) 5.56 0.98 (0.91–1.05) 2,141 (2,028) 4.99 1.09 (1.01–1.16)
PCV7 57 (55) 0.13 313 (274) 0.73 0.18 (0.12–0.28) 865 (465) 2.02 0.07 (0.04–0.10)
Additional PCV13 375 (359) 0.87 1,163 (1,022) 2.71 0.32 (0.27–0.38) 651 (366) 1.52 0.57 (0.46–0.64)
Non-PCV13
 1,901 (1,820)
 4.43
909 (799)
 2.12
 2.09 (1.90–2.30)
625 (355)
 1.46
 3.04 (2.74–3.30)
>65 y
All serotypes 2,442 (2,818) 27.29 2,417 (2,391) 27.01 1.01 (0.94–1.08) 2,820 (2,601) 31.51 0.87 (0.82–0.92)
PCV7 49 (53) 0.55 402 (351) 4.49 0.12 (0.08–0.18) 1,466 (775) 16.39 0.03 (0.02–0.05)
Additional PCV13 422 (455) 4.71 913 (803) 10.20 0.46 (0.40–0.53) 574 (318) 6.42 0.73 (0.61–0.82)
Non-PCV13
 1,971 (2,127)
 22.03
1,103 (970)
 12.32
 1.79 (1.63–1.95)
779 (411)
 8.70
 2.53 (2.34–2.77)
All ages
All serotypes 5,217 (5,467) 9.44 5,135 (5,116) 9.30 0.98 (0.93–1.02) 5,563 (5,321) 10.07 0.89 (0.85–0.93)
PCV7 115 (113) 0.21 735 (648) 1.33 0.15 (0.11–0.20) 2,813 (1,571) 5.09 0.04 (0.03–0.05)
Additional PCV13 862 (844) 1.56 2,290 (2,026) 4.15 0.36 (0.33–0.41) 1,311 (767) 2.37 0.60 (0.53–0.66)
Non-PCV13 4,239 (4,148) 7.67 2,109 (1,866) 3.82 1.92 (1.80–2.05) 1,439 (804) 2.61 2.75 (2.59–2.92)

*PCV7 refers to serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F, and additional PCV13 refers to serotypes 1, 3, 5, 6A, 7F, and 19A. Non-PCV13 refers to all other serotypes. IRR, incident rate ratio; PCV7, 7-valent pneumococcal conjugate vaccine; PCV13, 13-valent pneumococcal conjugate vaccine.
†Raw numbers of cases for each year were corrected for missing serotype and age with the assumption that cases with missing data for age, serotype, or both had the same age and serotype distributions as those cases in which this information was known—the number of extra cases were then added to the raw numbers in each category; cases were also corrected for annual changes in population denominators in each age group (13).

Main Article

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