Hanquet, GermaineKrizova, PavlaValentiner-Branth, PalleLadhani, Shamez N.Nuorti, J. PekkaLepoutre, AgnesMereckiene, JolitaKnol, MirjamWinje, Brita A.Ciruela, PilarOrdobas, MariaGuevara, MarcelaMcDonald, EisinMorfeldt, EvaKozakova, JanaSlotved, Hans-ChristianFry, Norman K.Rinta-Kokko, HannaVaron, EmmanuelleCorcoran, MaryVan der Ende, ArieVestrheim, Didrik F.Muñoz-Almagro, CarmenLatasa, PelloCastilla, JesúsSmith, AndrewHenriques-Normark, BirgittaWhittaker, RobertPastore Celentano, LuciaSavulescu, CameliaSpIDnet/I-MOVE+ Pneumo Group2019-05-132019-05-132019-050040-6376https://hdl.handle.net/2445/133077Background: pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies. Methods: for each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100. Results: after five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively. Conclusion: overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.10 p.application/pdfeng(c) BMJ Publishing Group, 2019Malalties bacterianesEpidemiologiaVacuna antipneumocòccicaAdultsInfànciaEuropaBacterial diseasesEpidemiologyPneumococcal vaccineAdulthoodChildhoodEuropeinfo:eu-repo/semantics/article6855432019-05-13info:eu-repo/semantics/openAccess30355641