Sex differences in invasive pneumococcal disease and the impact of pneumococcal conjugate vaccination in the Netherlands, 2004 to 2015

Gertjan H J Wagenvoort, Elisabeth A M Sanders, Bart J Vlaminckx, Hester E de Melker, Arie van der Ende, Mirjam J Knol

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Implementation of pneumococcal conjugate vaccines in the Netherlands (PCV7 in 2006 and PCV10 in 2011) for infants caused a shift in serotypes in invasive pneumococcal disease (IPD). We explored sex differences in serotype-specific IPD incidence before and after vaccine introduction. Incidences in the pre-PCV7 (June 2004-May 2006), post-PCV7 (June 2008-May 2011) and post-PCV10 period (June 2013-May 2015), stratified by age, were compared. Incidence was higher in men for all age groups (overall in men: 16.7, 15.5 and 14.4/100,000 and women: 15.4, 13.6 and 13.9/100,000 pre-PCV7, post-PCV7 and post-PCV10, respectively), except for 20-39 year-olds after PCV7 and 40-64 year-olds after PCV10 introduction. After PCV7 and PCV10 introduction, the overall IPD incidence decreased in men aged 20-39 years (from 5.3 pre-PCV7 to 4.7 and 2.6/100,000 post-PCV7 and post-PCV10, respectively), whereas it showed a temporary increase in women (from 3.9/100,000 pre-PCV7 to 5.0/100,000 post-PCV7 and back to 4.0/100,000 post-PCV10) due to replacement disease. PCV10 herd effects were observed throughout, but in women older than 40 years, a significant increase in non-PCV10 serotype offset a decrease in overall IPD incidence. Ongoing surveillance of IPD incidence by sex is important to evaluate the long-term effects of PCV implementation.

Original languageEnglish
JournalEurosurveillance
Volume22
Issue number10
DOIs
Publication statusPublished - 9 Mar 2017

Keywords

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Journal Article
  • Male
  • Middle Aged
  • Netherlands
  • Pneumococcal Infections
  • Pneumococcal Vaccines
  • Sentinel Surveillance
  • Serogroup
  • Serotyping
  • Sex Factors
  • Streptococcus pneumoniae
  • Vaccines, Conjugate
  • Young Adult

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