Scientific Institute of Public Health, Brussels, Belgium.
Emerg Infect Dis. 2010 Sep;16(9):1428-39. doi: 10.3201/eid1609.100102.
After heptavalent pneumococcal conjugate vaccine (PCV7) was marketed in France, Spain, Belgium, and England and Wales (United Kingdom), invasive disease from non-PCV7 serotypes (NVT) increased. Adjusted serotype-specific incidences among children <15 years of age were compared between 1999-2002 (prevaccine) and 2005-2006 (postmarketing). Vaccine coverage increased to approximately 32%-48% in France, Spain, and Belgium but remained <1% in England and Wales. Serotype 1 incidence rose in all age groups and countries (incidence rate ratio [IRR] 1.3-4.2; p<0.004), independently of PCV7 use, but incidence of serotypes 7F and 19A increased most in France, Spain, and Belgium (IRR 1.9-16.9 in children <5 years; p<0.001), where PCV7 coverage was greater. Vaccine-induced replacement of PCV7 serotypes possibly contributed to NVT increases, as did secular trends. New vaccines targeting these serotypes are available, but serotype dynamics needs further exploration that accounts for underreporting and prevaccine trends.
在七价肺炎球菌结合疫苗（PCV7）在法国、西班牙、比利时和英格兰威尔士（英国）上市后，非 PCV7 血清型（NVT）引起的侵袭性疾病有所增加。对 1999-2002 年（疫苗前）和 2005-2006 年（上市后）15 岁以下儿童的血清型特异性发病率进行了调整。法国、西班牙和比利时的疫苗覆盖率增加到约 32%-48%，但在英格兰和威尔士仍低于 1%。所有年龄组和国家的血清型 1 的发病率均有所上升（发病率比 [IRR] 1.3-4.2；p<0.004），与 PCV7 的使用无关，但血清型 7F 和 19A 的发病率在法国、西班牙和比利时上升最多（5 岁以下儿童的 IRR 为 1.9-16.9；p<0.001），这些国家的 PCV7 覆盖率更高。疫苗诱导的 PCV7 血清型替代可能导致 NVT 增加，这与长期趋势有关。针对这些血清型的新疫苗已经可用，但血清型动态变化需要进一步探索，以考虑漏报和疫苗前趋势。
