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Volume 28, Number 1—January 2022
Research

Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe

Germaine HanquetComments to Author , Pavla Krizova, Tina Dalby, Shamez N. Ladhani, J. Pekka Nuorti, Kostas Danis, Jolita Mereckiene, Mirjam J. Knol, Brita A. Winje, Pilar Ciruela, Sara de Miguel, Maria Eugenia Portillo, Laura MacDonald, Eva Morfeldt, Jana Kozakova, Palle Valentiner-Branth, Norman K. Fry, Hanna Rinta-Kokko, Emmanuelle Varon, Mary Corcoran, Arie van der Ende, Didrik F. Vestrheim, Carmen Munoz-Almagro, Juan-Carlos Sanz, Jesus Castilla, Andrew Smith, Birgitta Henriques-Normark, Edoardo Colzani, Lucia Pastore-Celentano, Camelia Savulescu, and the SpIDnet group1
Author affiliations: Epiconcept, Paris, France (G. Hanquet, C. Savulescu); Antwerp University, Antwerp, Belgium (G. Hanquet); National Institute of Public Health, Prague, Czech Republic (P. Krizova, J. Kozakova); Statens Serum Institut, Copenhagen, Denmark (T. Dalby, P. Valentiner-Branth); Public Health England, London, UK (S.N. Ladhani, N.K. Fry); Tampere University, Tampere, Finland (J.P. Nuorti); Finnish Institute for Health and Welfare, Helsinki, Finland (J.P. Nuorti, H. Rinta-Kokko); Santé Publique France, the National Public Health Agency, Saint-Maurice, France (K. Danis); Health Protection Surveillance Centre, Dublin, Ireland, UK (J. Mereckiene); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (M.J. Knol); Norwegian Institute of Public Health, Oslo, Norway (B.A. Winje, D.F. Vestrheim); Public Health Agency of Catalonia, Barcelona, Spain (P. Ciruela); CIBER Epidemiología y Salud Pública, Madrid, Spain (P. Ciruela, C. Munoz-Almagro, J. Castilla); General Directorate of Public Health–Madrid Region, Madrid (S. de Miguel, J.-C. Sanz); Navarra Hospital Complex–IdiSNA, Pamplona, Spain (M.E. Portillo); Public Health Scotland, Glasgow, Scotland, UK (L. MacDonald); Public Health Agency of Sweden, Stockholm, Sweden (E. Morfeldt); Centre de Recherche Clinique et Biologique, Creteil, France (E. Varon); Children’s Health Ireland (CHI) at Temple Street, Dublin (M. Corcoran); Academic Medical Center, Amsterdam, the Netherlands (A. van der Ende); Hospital Sant Joan de Déu, Barcelona (C. Munoz-Almagro); Universitat Internacional of Catalunya, Barcelona (C. Munoz-Almagro); Public Health Institute of Navarra–IdiSNA, Pamplona (J. Castilla); University of Glasgow, Glasgow, Scotland, UK (A. Smith); Karolinska Institutet, Stockholm (B. Henriques-Normark); K; arolinska University Hospital, Solna, Sweden (B. Henriques-Normark); European Centre for Disease Prevention and Control, Stockholm (E. Colzani, L. Pastore-Celentano)

Main Article

Table 4

IPD incidence per PCV10/PCV13 year during 2011–2018 compared with the PCV7 period by age group in the 13 sites of SpIDnet multicenter study, Europe*

Serotype group Incidence rate ratio (95% CI)
2011 2012 2013 2014 2015 2016 2017 2018
In children <5 y
All types 0.70
(0.6–0.79)		 0.52
(0.43–0.63)		 0.53
(0.45–0.62)		 0.51
(0.43–0.60)		 0.54
(0.44–0.66)		 0.54
(0.45–0.64)		 0.54
(0.44–0.65)		 0.58
(0.49–0.70)
PCV7 0.22
(0.12–0.40)		 0.18
(0.11–0.29)		 0.13
(0.07–0.23)		 0.11
(0.05–0.23)		 0.11
(0.06–0.23)		 0.09
(0.04–0.20)		 0.10
(0.05–0.20)		 0.12
(0.07–0.22)
PCV10–non-7† 0.59
(0.48–0.74)		 0.36
(0.26–0.48)		 0.22
(0.13–0.36)		 0.13
(0.07–0.24)		 0.07
(0.04–0.11)		 0.05
(0.03–0.11)		 0.03
(0.02–0.06)		 0.05
(0.02–0.12)
Non-PCV10 1.09
(0.89–1.34)		 0.91
(0.74–1.11)		 1.06
(0.85–1.33)		 1.08
(0.87–1.34)		 1.18
(0.98–1.43)		 1.21
(0.98–1.49)		 1.21
(0.98–1.48)		 1.34
(1.07–1.68)
PCV13–non-10‡ 0.77
(0.61–0.98)		 0.40
(0.27–0.61)		 0.45
(0.31–0.67)		 0.37
(0.23–0.58)		 0.35
(0.21–0.60)		 0.50
(0.32–0.78)		 0.47
(0.30–0.73)		 0.54
(0.32–0.93)
Serotype 3 0.97
(0.71–1.33)		 0.58
(0.34–0.99)		 0.80
(0.57–1.11)		 0.60
(0.40–0.89)		 0.64
(0.44–0.92)		 1.02
(0.74–1.40)		 1.01
(0.73–1.39)		 1.03
(0.67–1.58)
Non-PCV13
 1.39
(1.05–1.85)
 1.47
(1.15–1.88)
 1.63
(1.28–2.09)
 1.76
(1.40–2.21)
 2.03
(1.65–2.50)
 1.93
(1.52–2.44)
 1.93
(1.54–2.43)
 2.11
(1.68–2.65)
In persons 5–64 y
All types 0.87
(0.79–0.96)		 0.78
(0.71–0.85)		 0.76
(0.69–0.84)		 0.66
(0.61–0.71)		 0.75
(0.67–0.84)		 0.72
(0.63–0.83)		 0.76
(0.69–0.85)		 0.78
(0.71–0.87)
PCV7 0.45
(0.32–0.62)		 0.28
(0.20–0.42)		 0.25
(0.17–0.37)		 0.16
(0.10–0.24)		 0.17
(0.11–0.24)		 0.14
(0.11–0.20)		 0.15
(0.10–0.23)		 0.17
(0.12–0.24)
PCV10–non-7† 0.83
(0.70–1.00)		 0.61
(0.49–0.76)		 0.54
(0.42–0.69)		 0.34
(0.27–0.44)		 0.22
(0.15–0.32)		 0.12
(0.08–0.18)		 0.09
(0.06–0.13)		 0.07
(0.04–0.11)
PCV13–non-10‡ 1.10
(1.01–1.19)		 0.92
(0.79–1.07)		 0.95
(0.77–1.19)		 0.77
(0.59–0.99)		 0.90
(0.67–1.19)		 0.89
(0.65–1.22)		 0.99
(0.72–1.36)		 1.06
(0.80–1.41)
Serotype 3§ 1.03
(0.90–1.17)		 1.03
(0.86–1.22)		 1.10
(0.86–1.42)		 0.90
(0.73–1.10)		 1.03
(0.86–1.22)		 1.06
(0.80–1.40)		 1.19
(0.92–1.54)		 1.28–1.01–1.63)
Non-PCV13
 1.04
(0.91–1.19)
 1.14
(1.02–1.28)
 1.17
(1.05–1.31)
 1.21
(1.08–1.35)
 1.48
(1.28–1.71)
 1.59
(1.37–1.85)
 1.61
(1.41–1.84)
 1.63
(1.42–1.88)
In persons >65 y
All types 0.86
(0.81–0.92)		 0.87
(0.82–0.92)		 0.84
(0.78–0.90)		 0.78
(0.71–0.85)		 0.89
(0.79–1.00)		 0.90
(0.80–1.00)		 0.94
(0.83–1.07)		 0.93
(0.82–1.05)
PCV7 0.37
(0.29–0.47)		 0.29
(0.20–0.41)		 0.24
(0.16–0.34)		 0.19
(0.13–0.27)		 0.17
(0.11–0.26)		 0.15
(0.10–0.22)		 0.17
(0.11–0.24)		 0.14
(0.09–0.20)
PCV10–non-7† 0.90
(0.77–1.06)		 0.81
(0.67–0.98)		 0.56
(0.46–0.68)		 0.44
(0.34–0.58)		 0.27
(0.19–0.39)		 0.16
(0.11–0.23)		 0.08
(0.05–0.12)		 0.09
(0.06–0.14)
PCV13–non-10‡ 1.02
(0.93–1.12)		 0.89
(0.79–1.00)		 0.87
(0.71–1.07)		 0.73
(0.58–0.92)		 0.87
(0.68–1.11)		 0.88
(0.71–1.10)		 0.95
(0.75–1.20)		 0.97
(0.73–1.29)
Serotype 3 0.99
(0.87–1.12)		 0.93
(0.82–1.05)		 0.99
(0.82–1.21)		 0.93
(0.72–1.19)		 1.11
(0.89–1.37)		 1.22
(1.05–1.42)		 1.28
(1.08–1.50)		 1.32
(1.05–1.66)
Non-PCV13 1.20
(1.09–1.34)		 1.40
(1.30–1.51)		 1.44
(1.33–1.54)		 1.44
(1.34–1.55)		 1.74
(1.58–1.90)		 1.81
(1.61–2.03)		 1.88
(1.68–2.11)		 1.84
(1.69–2.00)
PPV23–
non-PCV13¶ 1.14
(0.97–1.35)		 1.25
(1.12–1.41)		 1.30
(1.17–1.44)		 1.30
(1.20–1.41)		 1.63
(1.50–1.76)		 1.75
(1.54–1.99)		 1.83
(1.65–2.03)		 1.76
(1.61–1.92)
Nonvaccine# 1.31
(1.11–1.54)		 1.65
(1.40–1.95)		 1.71
(1.43–2.05)		 1.67
(1.39–2.01)		 1.97
(1.65–2.36)		 1.97
(1.66–2.35)		 2.03
(1.63–2.54)		 2.13
(1.81–2.50)

*See Table 1 for PCV7 period. IPD, invasive pneumococcal disease; PCV, pneumococcal conjugate vaccine; PCV7, 7-valent pneumococcal conjugate vaccine; PCV10, 10-valent pneumococcal conjugate vaccine; PCV13: 13-valent pneumococcal conjugate vaccine; PPV23, 23-valent pneumococcal polysaccharide vaccine; SpIDnet, Streptococcus pneumoniae Invasive Disease network. †Serotypes 1, 5, and 7F. ‡Serotypes 3, 6A, and 19A. §12 sites (all sites except Sweden). ¶Serotypes 2, 8, 9N, 10A, 11A, 12F, 15B, 17F, 20, 22F, and 33F. #Serotypes not in PPV23 and not in PCV13.

Main Article

1Members of the SpIDnet group who contributed are listed at the end of this article.

Page created: November 15, 2021
Page updated: December 20, 2021
Page reviewed: December 20, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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