Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe
Germaine Hanquet, Pavla Křížová, Tina Dalby, Shamez Ladhani, J. Pekka Nuorti, Kostas Danis, Jolita Mereckiene, Mirjam J. Knol, Brita Askeland Winje, Pilar Ciruela, Sara de Miguel, María Eugenia Portillo, Laura MacDonald, Eva Morfeldt, Jana Kozáková, Palle Valentiner‐Branth, Norman K. Fry, Hanna Rinta‐Kokko, Emmanuelle Varon, Mary Corcoran, Arie van der Ende, Didrik F. Vestrheim, Carmen Muñoz‐Almagro, Juan Carlos Sanz, Jesús Castilla, A. Gordon Smith, Birgitta Henriques‐Normark, Edoardo Colzani, Lucia Pastore-Celentano, Camelia Savulescu, the SpIDnet group1
Abstract
We evaluated invasive pneumococcal disease (IPD) during 8 years of infant pneumococcal conjugate vaccine (PCV) programs using 10-valent (PCV10) and 13-valent (PCV13) vaccines in 10 countries in Europe. IPD incidence declined during 2011-2014 but increased during 2015-2018 in all age groups. From the 7-valent PCV period to 2018, IPD incidence declined by 42% in children <5 years of age, 32% in persons 5-64 years of age, and 7% in persons >65 years of age; non-PCV13 serotype incidence increased by 111%, 63%, and 84%, respectively, for these groups. Trends were similar in countries using PCV13 or PCV10, despite different serotype distribution. In 2018, serotypes in the 15-valent and 20-valent PCVs represented one third of cases in children <5 years of age and two thirds of cases in persons >65 years of age. Non-PCV13 serotype increases reduced the overall effect of childhood PCV10/PCV13 programs on IPD. New vaccines providing broader serotype protection are needed.