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

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 effect of childhood PCV10/PCV13 programs on IPD. New vaccines providing broader serotype protection are needed.

Automated summary

We evaluated the incidence of invasive pneumococcal disease (IPD) in Europe during the 8 years of infant pneumococcal conjugate vaccine (PCV) programs using PCV10 and PCV13 vaccines. IPD incidence declined between 2011 and 2014, but increased between 2015 and 2018. The incidence of non-PCV13 serotypes increased while PCV13 serotypes decreased. Similar trends were observed in countries using PCV13 or PCV10 vaccines. The study highlights the need for new vaccines providing broader serotype protection.