Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar 9;22(10):30481.
doi: 10.2807/1560-7917.ES.2017.22.10.30481.

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

Gertjan H J Wagenvoort  1 , Elisabeth A M Sanders  2   3 , Bart J Vlaminckx  1 , Hester E de Melker  2 , Arie van der Ende  4 , Mirjam J Knol  2
Affiliations

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

Gertjan H J Wagenvoort et al. Euro Surveill. .

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.

Keywords: Streptococcus pneumoniae; epidemiology; invasive pneumococcal disease; pneumococcal conjugate vaccine; sentinel surveillance; sex.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: Gertjan Wagenvoort received a lecturing fee from Pfizer.

Clinical data collection was supported by an unrestricted research grant from GlaxoSmithKline Pharmaceuticals and Pfizer Pharmaceuticals. The sponsors played no role in the study design, data analyses and preparation, review, or approval of the manuscript.

Figures

Figure 1
Figure 1
Age-specific incidence of invasive pneumococcal disease in men and women in the pre- and post-PCV periods, the Netherlands, 2004–15 (n = 4,303)
Figure 2
Figure 2
Age-specific female/male incidence ratio of invasive pneumococcal disease in the pre- and post-PCV periods, the Netherlands, 2004–15 (n = 4,303)
Figure 3
Figure 3
Incidences of invasive pneumococcal disease per serotype group in 20–39 year-old men and women pre-PCV7, post-PCV7 and post-PCV10, the Netherlands, 2004–15 (n = 324)
Figure 4
Figure 4
Serotype-specific female/male ratio for causing invasive pneumococcal disease in patients 5 years and older, the Netherlands, 2004–15 (n = 6,628)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Fish EN. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol. 2008;8(9):737-44. 10.1038/nri2394 - DOI - PMC - PubMed
    1. Roberts CW, Walker W, Alexander J. Sex-associated hormones and immunity to protozoan parasites. Clin Microbiol Rev. 2001;14(3):476-88. 10.1128/CMR.14.3.476-488.2001 - DOI - PMC - PubMed
    1. Kadioglu A, Cuppone AM, Trappetti C, List T, Spreafico A, Pozzi G, et al. Sex-based differences in susceptibility to respiratory and systemic pneumococcal disease in mice. J Infect Dis. 2011;204(12):1971-9. 10.1093/infdis/jir657 - DOI - PubMed
    1. van Lunzen J, Altfeld M. Sex differences in infectious diseases-common but neglected. J Infect Dis. 2014;209(Suppl 3):S79-80. 10.1093/infdis/jiu159 - DOI - PubMed
    1. Falagas ME, Mourtzoukou EG, Vardakas KZ. Sex differences in the incidence and severity of respiratory tract infections. Respir Med. 2007;101(9):1845-63. 10.1016/j.rmed.2007.04.011 - DOI - PubMed

MeSH terms

Substances