Invasive pneumococcal disease caused by nonvaccine serotypes among alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage.

  • Singleton R
  • Hennessy T
  • Bulkow L
 et al. 
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CONTEXT: With routine childhood vaccination using heptavalent pneumococcal conjugate vaccine, one concern has been the potential for emergence and expansion of replacement disease caused by serotypes not contained in the heptavalent conjugate vaccine.

OBJECTIVE: To determine whether replacement disease is associated with the overall decline in invasive pneumococcal disease among Alaska Native children.

DESIGN, SETTING, AND PATIENTS: Alaska statewide longitudinal population-based laboratory surveillance of invasive Streptococcus pneumoniae infections from January 1, 1995, through December 31, 2006.

MAIN OUTCOME MEASURES: Incidence and types of pneumococcal disease in children younger than 2 years.

RESULTS: In the first 3 years after introduction of routine vaccination with heptavalent pneumococcal conjugate vaccine, overall invasive pneumococcal disease decreased 67% in Alaska Native children younger than 2 years (from 403.2 per 100,000 in 1995-2000 to 134.3 per 100,000 per year in 2001-2003, P
CONCLUSIONS: Alaska Native children are experiencing replacement invasive pneumococcal disease with serotypes not covered by heptavalent pneumococcal conjugate vaccine. The demonstration of replacement invasive pneumococcal disease emphasizes the importance of ongoing surveillance and development of expanded valency vaccines.

Author-supplied keywords

  • Adult
  • Alaska
  • Alaska: epidemiology
  • Child
  • Conjugate
  • Conjugate: administration & dosage
  • Conjugate: immunology
  • Humans
  • Indians
  • Infant
  • Inuits
  • Meningococcal Vaccines
  • Meningococcal Vaccines: administration & dosage
  • Meningococcal Vaccines: immunology
  • Middle Aged
  • North American
  • Pneumococcal Infections
  • Pneumococcal Infections: epidemiology
  • Pneumococcal Infections: microbiology
  • Pneumococcal Infections: prevention & control
  • Pneumococcal Vaccines
  • Pneumococcal Vaccines: administration & dosage
  • Pneumococcal Vaccines: immunology
  • Preschool
  • Serotyping
  • Streptococcus pneumoniae
  • Streptococcus pneumoniae: classification
  • Streptococcus pneumoniae: isolation & purification
  • Vaccination
  • Vaccination: statistics & numerical data
  • Vaccines

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  • Rosalyn J J Singleton

  • Thomas W W Hennessy

  • Lisa R R Bulkow

  • Laura L L Hammitt

  • Tammy Zulz

  • Debby A A Hurlburt

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