Rapid increase in non-vaccine serotypes causing invasive pneumococcal disease in England and Wales, 2000–17: a prospective national observational cohort.

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Rapid increase in non-vaccine serotypes causing invasive pneumococcal disease in England and Wales, 2000–17: a prospective national observational cohort study  Shamez N Ladhani, MRCPCH, Sarah Collins, MPH, Abdelmajid Djennad, PhD, Carmen L Sheppard, PhD, Prof Ray Borrow, PhD, Norman K Fry, PhD, Prof Nicholas J Andrews, PhD, Prof Elizabeth Miller, FRCPath, Mary E Ramsay, FFPHM  The Lancet Infectious Diseases  Volume 18, Issue 4, Pages 441-451 (April 2018) DOI: 10.1016/S1473-3099(18)30052-5 Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 1 Corrected trends in IPD incidence in England and Wales for all ages and by age group The epidemiological year runs from July to June. The vertical lines labelled PCV7 and PCV13 denote introduction of the seven-valent and 13-valent pneumococcal conjugate vaccines (PCVs) into the national childhood immunisation programme. PCV7=invasive pneumococcal disease (IPD) due to the serotypes included in the seven-valent PCV. PCV13 only=IPD due to the additional six serotypes included in the 13-valent PCV. Non-PCV13=serotypes responsible for IPD that are not included in the 13-valent PCV. The Lancet Infectious Diseases 2018 18, 441-451DOI: (10.1016/S1473-3099(18)30052-5) Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 2 Corrected overall and age group-specific trends in invasive pneumococcal disease incidence due to the additional PCV13 serotypes and PCV13-related serotype 6C 7 years after the introduction of PCV13 in England and Wales The epidemiological year runs from July to June. The vertical lines labelled PCV7 and PCV13 denote the introduction of the seven-valent and 13-valent pneumococcal conjugate vaccines into the national childhood immunisation programme. The Lancet Infectious Diseases 2018 18, 441-451DOI: (10.1016/S1473-3099(18)30052-5) Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure 3 Corrected overall and age group-specific trends in invasive pneumococcal disease incidence due to the main replacing serotypes 7 years after the introduction of PCV13 in England and Wales The epidemiological year runs from July to June. The vertical lines labelled PCV7 and PCV13 denote the introduction of the seven-valent and 13-valent pneumococcal conjugate vaccines into the national childhood immunisation programme. The Lancet Infectious Diseases 2018 18, 441-451DOI: (10.1016/S1473-3099(18)30052-5) Copyright © 2018 Elsevier Ltd Terms and Conditions