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Trends

Following the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000, dramatic declines in invasive pneumococcal disease were reported among children less than 5 years of age. Before introduction of PCV7, rates of PCV7-type invasive pneumococcal disease among children in this age were around 80 cases per 100,000 population. After the introduction of PCV7, rates of disease due to these 7 serotypes dropped dramatically to less than 1 case per 100,000 by 2007 (see figure below).

The use of PCV7 also reduced the burden of invasive pneumococcal disease among older children and adults through reduced transmission of vaccine serotype pneumococci (herd protection). Declines in the incidence of PCV7-type invasive disease among adults were seen as early as 2001 and have continued since that time, reducing the incidence to 64-77% below the 1998-1999 baseline, depending on age. Increases in disease caused by serotypes not included in PCV7 (i.e., replacement disease) are evident in children and certain adult populations with underlying illnesses but are small in magnitude compared with the overall reduction in disease. With the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), it is anticipated that cases of invasive disease due to the 6 additional serotypes covered by the vaccine will decrease.

This graph shows the impact 7-valent pneumococcal conjugate vaccine (PCV7) had on invasive pneumococcal disease among children younger than 5 years old from 1998 to 2009. Rates of invasive pneumococcal disease dramatically declined after PCV7 was introduced in 2000. Larger declines were seen among serotypes included in PCV7 compared to those that were not part of the vaccine

*Active Bacterial Core surveillance data 1998-2009, unpublished


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Surveillance

Invasive pneumococcal disease is nationally notifiable and cases should be reported to the appropriate health department. Invasive pneumococcal disease cases are reported by states to CDC through the National Notifiable Diseases Surveillance System (NNDSS). Some regions in the United States also use Active Bacterial Core surveillance (ABCs), a core component of CDC’s Emerging Infections Programs (EIP) network, to report cases. Non-invasive pneumococcal disease, like ear and sinus infections, are not reported through either surveillance system.

National Notifiable Diseases Surveillance System

Invasive pneumococcal disease cases are reported by states to CDC through NNDSS. Both suspected and confirmed cases should be reported nationally.

Active Bacterial Core surveillance

Invasive pneumococcal disease cases are reported by some regions in the United States through ABCs. ABCs is an active, laboratory- and population-based surveillance system for invasive bacterial pathogens of public health importance. ABCs data have been used to track disease trends, including the decline in pneumococcal disease following the introduction of the pediatric pneumococcal conjugate vaccine.

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