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Invasive pneumococcal disease and 7-valent pneumococcal conjugate vaccine, the Netherlands

Anna M M van Deursen, Suzan P van Mens, Elisabeth A M Sanders

    Emerging Infectious Diseases
    |October 25, 2012
    PubMed

    Insights

    The 7-valent pneumococcal conjugate vaccine (PCV7) significantly reduced invasive pneumococcal disease (IPD) in young children and older adults in the Netherlands. However, non-PCV7 serotype IPD cases increased, particularly in older adults.

    Area of Science:

    • * Public Health
    • * Infectious Diseases
    • * Vaccinology

    Background:

    • * The Netherlands implemented the 7-valent pneumococcal conjugate vaccine (PCV7) into its national immunization program for newborns in April 2006.
    • * Invasive pneumococcal disease (IPD) remains a significant public health concern globally, necessitating ongoing surveillance and vaccine impact assessment.

    Purpose of the Study:

    • * To evaluate the impact of PCV7 introduction on the incidence and characteristics of IPD in the Netherlands.
    • * To compare IPD trends before and after PCV7 implementation, focusing on different age groups and serotypes.

    Main Methods:

    • * A retrospective study design comparing IPD cases before (June 2004-June 2006) and after (June 2008-June 2010) PCV7 introduction.
    • * Culture-confirmed IPD cases were identified through a network of 9 sentinel laboratories representing approximately 25% of the Dutch population.
    • * Analysis included IPD incidence, patient demographics, disease characteristics, serotype distribution, and case fatality rates.

    Main Results:

    • * Significant reductions in overall IPD incidence were observed in children under 2 years (60% decrease) and individuals over 65 years (13% decrease).
    • * A notable trend of increasing non-PCV7 serotype IPD infections occurred across all age groups, with the most substantial rise in adults aged 50-64 (37%) and over 65 (25%).
    • * The proportion of immunocompromised individuals among adult IPD patients increased. Overall IPD-related mortality decreased from 16% to 12% due to a lower case-fatality rate for non-PCV7 serotype infections.

    Conclusions:

    • * PCV7 vaccination has been effective in reducing the burden of IPD, especially in the youngest and oldest populations in the Netherlands.
    • * The emergence and increase of non-PCV7 serotype IPD highlight the need for ongoing surveillance and potentially broader-spectrum pneumococcal vaccines.
    • * The findings underscore the dynamic nature of IPD epidemiology following vaccine introduction and the importance of monitoring serotype replacement.

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