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
Multicenter Study
. 2019 May;74(5):473-482.
doi: 10.1136/thoraxjnl-2018-211767. Epub 2018 Oct 24.

Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination

Germaine Hanquet  1   2 , Pavla Krizova  3 , Palle Valentiner-Branth  4 , Shamez N Ladhani  5 , J Pekka Nuorti  6   7 , Agnes Lepoutre  8 , Jolita Mereckiene  9 , Mirjam Knol  10 , Brita A Winje  11 , Pilar Ciruela  12   13 , Maria Ordobas  14 , Marcela Guevara  13   15 , Eisin McDonald  16 , Eva Morfeldt  17 , Jana Kozakova  3 , Hans-Christian Slotved  4 , Norman K Fry  5 , Hanna Rinta-Kokko  6 , Emmanuelle Varon  18 , Mary Corcoran  19 , Arie van der Ende  20 , Didrik F Vestrheim  11 , Carmen Munoz-Almagro  13   21 , Pello Latasa  14 , Jesus Castilla  13   15 , Andrew Smith  22 , Birgitta Henriques-Normark  17   23   24 , Robert Whittaker  25 , Lucia Pastore Celentano  25 , Camelia Savulescu  1 ; SpIDnet/I-MOVE+ Pneumo Group
Collaborators, Affiliations
Multicenter Study

Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination

Germaine Hanquet et al. Thorax. 2019 May.

Abstract

Background: Pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies.

Methods: For each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100.

Results: After five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively.

Conclusion: Overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.

Keywords: bacterial infection; clinical epidemiology.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The following authors report funding for research projects, travels or consultancy outside the submitted work: H-CS (project sponsored by Pfizer); ZH (travel grant from Pfizer), SNL (research including GSK, Pfizer, Sanofi Pasteur on behalf of St George’s University of London and Public Health England (PHE)); NKF (employed by PHE Respiratory and Vaccine Preventable Bacteria Reference Unit and PHE Immunisation that provided serotype surveillance reports to Affinivax, Pfizer and GSK); HR-K and JJ (employed by the National Institute for Health and Welfare that received research funding from GSK for the conduct of a trial of PCV10); AvdE (Pfizer grant for an investigator initiated project, consultancy fees from GSK, participation in the Pfizer Scientific Advisory board); CM-A (fees from GSK and grants from Pfizer); EV (Pfizer grants and personal fees); MC (Pfizer grants and personal fees); HH (research funding from Pfizer and Astellas).

Figures

Figure 1
Figure 1
Overall incidence of invasive pneumococcal disease per site and years in persons aged ≥65 years over the period 2000–2015: SpIDnet/I-MOVE+ multicentre study.
Figure 2
Figure 2
Site incidence rate ratio by serotype category in 2015 compared with 2009: SpIDnet/I-MOVE+ multicentre study. (A) All. (B) PCV7. (C) Included in PCV10 and not in PCV7 (1, 5 and 7F). (D) Included in PCV13 and not in PCV10 (3, 6A and 19A). (E) Non-PCV13. (F) PPV23 non-PCV13. (G) Non-vaccine.
Figure 3
Figure 3
Pooled incidence rate ratio per serotype group over the PCV10/13 years (2011–2015) compared with 2009: SpIDnet/I-MOVE+ multicentre study.
Figure 4
Figure 4
Pooled incidence rate ratio per serotype group over the PCV10/13 years compared with 2009 by vaccine policy: SpIDnet/I-MOVE+ multicentre study.
Figure 5
Figure 5
Proportion of serotypes out of all invasive pneumococcal disease in 2015 by serotype group, site and vaccination policies: SpIDnet/I-MOVE+ multicentre study.
See this image and copyright information in PMC

Similar articles

  • Global impact of ten-valent and 13-valent pneumococcal conjugate vaccines on invasive pneumococcal disease in all ages (the PSERENADE project): a global surveillance analysis.
    Bennett JC, Deloria Knoll M, Kagucia EW, Garcia Quesada M, Zeger SL, Hetrich MK, Yang Y, Herbert C, Ogyu A, Cohen AL, Yildirim I, Winje BA, von Gottberg A, Viriot D, van der Linden M, Valentiner-Branth P, Suga S, Steens A, Skoczynska A, Sinkovec Zorko N, Scott JA, Savulescu C, Savrasova L, Sanz JC, Russell F, Ricketson LJ, Puentes R, Nuorti JP, Mereckiene J, McMahon K, McGeer A, Mad'arová L, Mackenzie GA, MacDonald L, Lepp T, Ladhani SN, Kristinsson KG, Kozakova J, Klein NP, Jayasinghe S, Ho PL, Hilty M, Heyderman RS, Hasanuzzaman M, Hammitt LL, Guevara M, Grgic-Vitek M, Gierke R, Georgakopoulou T, Galloway Y, Diawara I, Desmet S, De Wals P, Dagan R, Colzani E, Cohen C, Ciruela P, Chuluunbat U, Chan G, Camilli R, Bruce MG, Brandileone MC, Bigogo G, Ampofo K, O'Brien KL, Feikin DR, Hayford K; PSERENADE Team. Bennett JC, et al. Lancet Infect Dis. 2025 Apr;25(4):457-470. doi: 10.1016/S1473-3099(24)00665-0. Epub 2024 Dec 17. Lancet Infect Dis. 2025. PMID: 39706204 Free PMC article.
  • Serotype distribution of remaining invasive pneumococcal disease after extensive use of ten-valent and 13-valent pneumococcal conjugate vaccines (the PSERENADE project): a global surveillance analysis.
    Garcia Quesada M, Peterson ME, Bennett JC, Hayford K, Zeger SL, Yang Y, Hetrich MK, Feikin DR, Cohen AL, von Gottberg A, van der Linden M, van Sorge NM, de Oliveira LH, de Miguel S, Yildirim I, Vestrheim DF, Verani JR, Varon E, Valentiner-Branth P, Tzanakaki G, Sinkovec Zorko N, Setchanova LP, Serhan F, Scott KJ, Scott JA, Savulescu C, Savrasova L, Reyburn R, Oishi K, Nuorti JP, Napoli D, Mwenda JM, Muñoz-Almagro C, Morfeldt E, McMahon K, McGeer A, Mad'arová L, Mackenzie GA, Eugenia León M, Ladhani SN, Kristinsson KG, Kozakova J, Kleynhans J, Klein NP, Kellner JD, Jayasinghe S, Ho PL, Hilty M, Harker-Jones MA, Hammitt LL, Grgic-Vitek M, Gilkison C, Gierke R, French N, Diawara I, Desmet S, De Wals P, Dalby T, Dagan R, Corcoran M, Colzani E, Chanto Chacón G, Castilla J, Camilli R, Ang M, Ampofo K, Almeida SCG, Alarcon P, O'Brien KL, Deloria Knoll M; PSERENADE Team. Garcia Quesada M, et al. Lancet Infect Dis. 2025 Apr;25(4):445-456. doi: 10.1016/S1473-3099(24)00588-7. Epub 2024 Dec 17. Lancet Infect Dis. 2025. PMID: 39706205 Free PMC article.
  • Effect of high-valency pneumococcal conjugate vaccines on invasive pneumococcal disease in children in SpIDnet countries: an observational multicentre study.
    Savulescu C, Krizova P, Lepoutre A, Mereckiene J, Vestrheim DF, Ciruela P, Ordobas M, Guevara M, McDonald E, Morfeldt E, Kozakova J, Varon E, Cotter S, Winje BA, Munoz-Almagro C, Garcia L, Castilla J, Smith A, Henriques-Normark B, Celentano LP, Hanquet G; SpIDnet group. Savulescu C, et al. Lancet Respir Med. 2017 Aug;5(8):648-656. doi: 10.1016/S2213-2600(17)30110-8. Epub 2017 Mar 27. Lancet Respir Med. 2017. PMID: 28359798
  • Effects of PCV10 and PCV13 on pneumococcal serotype 6C disease, carriage, and antimicrobial resistance.
    Grant LR, Hanquet G, Sepúlveda-Pachón IT, Theilacker C, Baay M, Slack MPE, Jodar L, Gessner BD. Grant LR, et al. Vaccine. 2024 Apr 30;42(12):2983-2993. doi: 10.1016/j.vaccine.2024.03.065. Epub 2024 Mar 28. Vaccine. 2024. PMID: 38553292
  • Pneumococcal serotype evolution in Western Europe.
    Tin Tin Htar M, Christopoulou D, Schmitt HJ. Tin Tin Htar M, et al. BMC Infect Dis. 2015 Oct 14;15:419. doi: 10.1186/s12879-015-1147-x. BMC Infect Dis. 2015. PMID: 26468008 Free PMC article. Review.
See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ardanuy C, Marimón JM, Calatayud L, et al. . Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies. PLoS One 2012;7:e43619 10.1371/journal.pone.0043619 - DOI - PMC - PubMed
    1. Verhaegen J, Flamaing J, De Backer W, et al. . Epidemiology and outcome of invasive pneumococcal disease among adults in Belgium, 2009-2011. Euro Surveill 2014;19:14–22. 10.2807/1560-7917.ES2014.19.31.20869 - DOI - PubMed
    1. Reinert RR, Haupts S, van der Linden M, et al. . Invasive pneumococcal disease in adults in North-Rhine Westphalia, Germany, 2001-2003. Clin Microbiol Infect 2005;11:985–91. 10.1111/j.1469-0691.2005.01282.x - DOI - PubMed
    1. Drijkoningen JJ, Rohde GG. Pneumococcal infection in adults: burden of disease. Clin Microbiol Infect 2014;20(Suppl 5):45–51. 10.1111/1469-0691.12461 - DOI - PubMed
    1. Naucler P, Galanis I, Morfeldt E, et al. . Comparison of the impact of pneumococcal conjugate vaccine 10 or pneumococcal conjugate vaccine 13 on invasive pneumococcal disease in equivalent populations. Clin Infect Dis 2017;65:1780–9. 10.1093/cid/cix685 - DOI - PMC - PubMed

Publication types

Substances