Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe

Germaine Hanquet*, Pavla Krizova, Tina Dalby, Shamez N. Ladhani, J. Pekka Nuorti, Kostas Danis, Jolita Mereckiene, Mirjam J. Knol, Brita A. Winje, Pilar Ciruela, Sara de Miguel, Maria Eugenia Portillo, Laura MacDonald, Eva Morfeldt, Jana Kozakova, Palle Valentiner-Branth, Norman K. Fry, Hanna Rinta-Kokko, Emmanuelle Varon, Mary CorcoranArie van der Ende, Didrik F. Vestrheim, Carmen Munoz-Almagro, Juan Carlos Sanz, Jesus Castilla, Andrew Smith, Birgitta Henriques-Normark, Edoardo Colzani, Lucia Pastore-Celentano, Camelia Savulescu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


We evaluated invasive pneumococcal disease (IPD) during 8 years of infant pneumococcal conjugate vaccine (PCV) programs using 10-valent (PCV10) and 13-valent (PCV13) vaccines in 10 countries in Europe. IPD incidence declined during 2011-2014 but increased during 2015-2018 in all age groups. From the 7-valent PCV period to 2018, IPD incidence declined by 42% in children <5 years of age, 32% in persons 5-64 years of age, and 7% in persons >65 years of age; non-PCV13 serotype incidence increased by 111%, 63%, and 84%, respectively, for these groups. Trends were similar in countries using PCV13 or PCV10, despite different serotype distribution.Serotypes included in the 15- valent PCV represented one third of cases and those in the 20-valent PCVs two thirds of cases in children <5 years of age and in persons >65 years of age in 2018. Non-PCV13 serotype increases reduced the overall eff ect of childhood PCV10/PCV13 programs on IPD. New vaccines providing broader serotype protection are needed.

Original languageEnglish
Pages (from-to)127-138
Number of pages12
JournalEmerging Infectious Diseases
Issue number1
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
This study received funding from the European Centre for Disease Prevention and Control, the European Commission Horizon 2020, and the participating sites.

Publisher Copyright:
© 2022 Centers for Disease Control and Prevention (CDC). All rights reserved.


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