Pneumococcal serotypes in children in 4 European countries

Germaine Hanquet*, Esther Kissling, Asuncion Fenoll, Robert George, Agnes Lepoutre, Tinne Lernout, David Tarragó, Emmanuelle Varon, Jan Verhaegen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

77 Citations (Scopus)


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 ≈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.

Original languageEnglish
Pages (from-to)1428-1439
Number of pages12
JournalEmerging Infectious Diseases
Issue number9
Publication statusPublished - 2010


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