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Slide 12 A study recently published in the New England Journal of Medicine reported that the routine use of 7-PCV in infants and toddlers in the United States has been associated with a significant reduction in IPD in vaccinated children, and may be reducing the rate of disease in unvaccinated adults. Population-based data from the Active Bacterial Core Surveillance programme of the Centers for Disease Control and Prevention was evaluated for the years 1998-2001. The surveillance areas contained a total population of 16 million in 2000, including 433 591 children under 2 years of age and 652 551 children of 2-4 years of age. References Whitney CG et al. N Engl J Med 2003; 348: 1737-1746 MMWR 2000 49 RR-9 1-38

Slide 13 The largest decline in incidence of invasive pneumococcal disease was in seen in children under 2 years of age. In this group the rate was 69% lower in 2001 than the baseline rate (p<0.0001). Reference Whitney CG et al. N Engl J Med 2003; 348: 1737-1746

Slide 14 Rates also fell in unvaccinated adults. A 32% drop in those aged 20-39 (p<0.001), an 8% drop for those aged 40-64 (p=0.03), and an 18% drop for those 65 years of age or older (p<0.001). Reference Whitney CG et al. N Engl J Med 2003; 348: 1737-1746

Slide 15 For children under two years of age, the rate of disease due to vaccine serotypes declined by 78% overall, and significant declines were seen for all serotypes included in the vaccine. There was also a 50% decline in the rate of disease due to vaccine-related serotypes. The rate of disease (in this age group) due to nonvaccine serotypes was 27% higher in 2001, but this change was not statistically significant. Reference Whitney CG et al. N Engl J Med 2003; 348: 1737-1746

Slide 16 Overall, the proportion of isolates that were not susceptible to penicillin decreased slightly between 1999 and 2001, but this change did not reach statistical significance (p=0.08). In those under two years of age, penicillin resistance levels dropped from 38% to 35%, but, again, this did not reach statistical significance (p=0.58). Reference Whitney CG et al. N Engl J Med 2003; 348: 1737-1746

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