Lepoutre A, Varon E, Georges S, Gutmann L, Lévy-Bruhl Daniel
Department of infectious diseases, Institut de Veille Sanitaire, Saint Maurice, France.
Euro Surveill. 2008 Aug 28;13(35):18962. doi: 10.2807/ese.13.35.18962-en.
Vaccination with the 7-valent pneumococcal conjugate vaccine (PCV) has been recommended in France since 2003 for children under the age of two years who are at risk due to medical or living conditions. From 2006, the recommendation has been extended to all children under two years. The impact of PCV introduction on the incidence of pneumococcal meningitis and bacteraemia and on the serotype distribution in French children and other age-groups was assessed using laboratory surveillance data. The coverage with three doses of PCV was 44% in children aged 6-12 months in 2006. From 2001/2002 to 2006, the incidence of pneumococcal meningitis decreased from 8.0 to 6.0 cases per 100,000, and the incidence of pneumococcal bacteraemia decreased from 21.8 to 17.5 cases per 100,000 in children under the age of two years. For the vaccine strains, the incidence of pneumococcal meningitis and bacteraemia decreased from 20,4 to 6.0 cases per 100,000, while the incidence of pneumococcal meningitis and bacteraemia due to non-vaccine strains increased from 9.4 to 17.5 cases per 100,000 in this time period. The incidence in older children and adults did not decrease. Further expansion of PCV coverage is expected to increase the impact of the vaccination in both children and adults. However, the fact that cases caused by vaccine serotypes have been partially substituted by cases of non-vaccine serotypes is likely to reduce the overall benefit of PCV in France, should this early observation be confirmed in the future.
自2003年起，法国就建议对因医疗或生活条件而处于风险中的两岁以下儿童接种7价肺炎球菌结合疫苗（PCV）。从2006年起，该建议扩大到所有两岁以下儿童。利用实验室监测数据评估了引入PCV对法国儿童及其他年龄组肺炎球菌性脑膜炎和菌血症发病率以及血清型分布的影响。2006年，6至12个月大儿童的三剂PCV接种覆盖率为44%。从2001/2002年到2006年，两岁以下儿童的肺炎球菌性脑膜炎发病率从每10万人8.0例降至6.0例，肺炎球菌菌血症发病率从每10万人21.8例降至17.5例。对于疫苗菌株，肺炎球菌性脑膜炎和菌血症的发病率从每10万人20.4例降至6.0例，而在此期间，非疫苗菌株引起的肺炎球菌性脑膜炎和菌血症的发病率从每10万人9.4例增至17.5例。大龄儿童和成人的发病率没有下降。预计进一步扩大PCV覆盖率将增加疫苗接种对儿童和成人的影响。然而，如果这一早期观察结果在未来得到证实，疫苗血清型引起的病例被非疫苗血清型病例部分替代这一事实可能会降低PCV在法国的总体益处。
