Program Schedule

Impact of 13-valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease in the United States

Session: Oral Abstract Session: Pediatric Vaccines
Friday, October 10, 2014: 10:30 AM
Room: The Pennsylvania Convention Center: 109-AB
Background: Incidence of invasive pneumococcal disease (IPD) dramatically declined among children and adults after 7-valent pneumococcal conjugate vaccine (PCV7) introduction for children in 2000. In February 2010, 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7. We evaluated PCV13 impact on IPD rates among children and adults.

Methods: IPD cases (isolation of pneumococcus from sterile sites) were identified through 10 Active Bacterial Core surveillance (ABCs) sites during July 2006–June 2013. Isolates were serotyped at reference laboratories. To distinguish the incremental effect of PCV13, we focused on the 5 serotypes (PCV5 types) not affected by PCV7. We used pre-PCV13 observed cases in time-series models to forecast post-PCV13 incidence in the absence of PCV13. PCV13 impact was the difference between forecasted and observed incidence.

Results: ABCs identified 3,355 and 21,747 IPD cases among children and adults, respectively; 90% of isolates had serotyping results. Incidence of PCV5-type IPD declined in all age groups after PCV13 introduction with the largest decline among children <5 years (Table). Reductions in PCV5-type IPD were driven by serotypes 19A and 7F.  No significant increase was seen in non-PCV13 serotypes, except among 50–64 year olds in 2012–2013 (percent change, 26; 95% interval estimate (IE): 13–44).

Table. Changes in incidence of PCV5-type IPD, by age


Percent Change Compared to

Incidence Expected in Absence of PCV13 (95% IE)

Age group (years)





-66 (-70, -61)

-88 (-89, -86)

-93 (-94, -91)


-35 (-45, -21)

-59 (-66, -48)

-75 (-80, -67)


-33 (-38, -26)

-64 (-68, -60)

-72 (-75, -69)


-23 (-28, -18)

-54 (-57, -50)

-62 (-65, -59)


-23 (-31, -13)

-46 (-52, -39)

-58 (-64, -52)

Conclusion: Dramatic reductions in PCV5-type IPD were evident among children and adults after 3 years of PCV13 use. Continued surveillance is needed to monitor for serotype replacement.

Lindsay Kim, MD, MPH1, Thomas H. Taylor Jr., PE, MS1, Tracy Pondo, MSPH1, Monica M. Farley, MD2,3, William Schaffner, MD4, Arthur Reingold, MD5, Ann Thomas, MD, MPH6, Lee Harrison, MD MPH7, Ruth Lynfield, MD8, Nancy M. Bennett, MD9, Susan Petit, MPH10, Lisa Miller, MD, MSPH11, Megin Nichols, DVM, MPH, DACVPM12, Lesley Mcgee, PhD1 and Bernard Beall, PhD1, (1)Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, (2)Emory University School of Medicine, Atlanta, GA, (3)Atlanta VA Medical Center, Decatur, GA, (4)Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, (5)University of California - Berkeley, Berkeley, CA, (6)Oregon Public Health Division, Portland, OR, (7)Johns Hopkins University, Baltimore, MD, (8)Minnesota Department of Health, St. Paul, MN, (9)University of Rochester Medical Center, Rochester, NY, (10)Connecticut Department of Public Health, Hartford, CT, (11)Colorado Department of Public Health and Environment, Denver, CO, (12)New Mexico Department of Public Health, Santa Fe, NM


L. Kim, None

T. H. Taylor Jr., None

T. Pondo, None

M. M. Farley, None

W. Schaffner, Pfizer, GlaxoSmithKline, Dynavax: Limited consulting fee, Consulting fee
Merck & Sanofi-Pasteur: Data safety monitoring board, Board membership benefits

A. Reingold, None

A. Thomas, None

L. Harrison, None

R. Lynfield, None

N. M. Bennett, None

S. Petit, None

L. Miller, None

M. Nichols, None

L. Mcgee, None

B. Beall, None

See more of: Pediatric Vaccines
See more of: Oral Abstract Session
Previous Abstract | Next Abstract >>

Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

Sponsoring Societies:

© 2014, All Rights Reserved.

Follow IDWeek