Daniel R. FeikinEunice W. KaguciaJennifer D. LooRuth Link-GellesMilo A. PuhanThomas CherianOrin S. LevineCynthia G. WhitneyKatherine L. O'BrienMatthew R. MooreDaniel R. FeikinRuth Link-GellesThomas CherianRichard A. AdegbolaMary AgocsKrow AmpofoNick AndrewsTheresa BartonJavier BenitoClaire V. BroomeMichael G. BruceLisa R. BulkowCarrie L. ByingtonTeresa CamouHeather CookSuzanne CotterRon DaganPhilippe de WalsGeneviève DeceuninckBarbara DenhamGiles EdwardsJuhani EskolaMargaret FitzgeraldEmmanouil GalanakisGabriela Garcia-GabarrotJuan J. Garcia-GarciaAmadeu GeneBorja GomezHelen HeffernanThomas W. HennessySigrid HeubergerMarkus HiltyHelene IngelsSanjay JayasingheEunice W. KaguciaJames D. KellnerNicola P. KleinAndrea Kormann-KlementJana KozakovaVicki KrausePaula KrizLotte LambertsenAgnès LepoutreOrin S. LevineMarc LipsitchJennifer D. LooMariana Lopez-VegaMarguerite LovgrenSofia MarakiEdward O. MasonPeter B. McIntyreRobert MenziesAllison MessinaElizabeth MillerSantiago MintegiMatthew R. MooreJitka MotlovaLawrence H. MoultonKathrin MühlemannCarmen Muñoz-AlmagroKatherine L. O'BrienDavid R. MurdochDaniel E. ParkMilo A. PuhanArthur L. ReingoldRaquel Sa-LeaoAbanti SanyalPeter G. SmithLodewijk SpanjaardChonnamet TechasaensiriRichard E. ThompsonKoh C. ThoonGregory J. TyrrellPalle Valentiner-BranthArie van der EndeOtto G. VanderkooiMark P.G. van der LindenEmmanuelle VaronJan VerhaegenDidrik F. VestrheimImelda VickersAnne von GottbergRüdiger von KriesPauline WaightRobert WeatherholtzSusanne WeissCynthia G. WhitneyArnold YeeAnita K.M. ZaidiJohns Hopkins Bloomberg School of Public HealthCenters for Disease Control and PreventionOrganisation Mondiale de la SanteGlaxosmithkline Biologicals S.A.University of UtahHealth Protection AgencyUT Southwestern Medical SchoolCruces Universitary HospitalRollins School of Public HealthNational Center for Infectious DiseasesDepartamento de LaboratoriosCentre for Disease ControlHealth Protection Surveillance CentreBen-Gurion University of the NegevInstitut National de Santé PubliqueQuebec University Hospital Research CentreScottish Meningococcus and Pneumococcus Reference LaboratoryNational Institute for Health and WelfarePanepistimio KritisHospital Sant Joan de DeuESR - Kenepuru Science CentreAustrian Agency for Health and Food SafetyUniversity of BernStatens Serum InstitutThe University of SydneyUniversity of CalgaryKaiser PermanenteNational Institute of Public Health PragueFrench Institute for Public Health SurveillanceHarvard School of Public HealthProvincial Laboratory for Public Health, AlbertaHeraklion University HospitalBaylor College of MedicineChildren's Hospital At WestmeadAll Children's Hospital St. PetersburgUniversity of OtagoUniversity of California, BerkeleyUniversidade Nova de LisboaLondon School of Hygiene &amp; Tropical MedicineAcademic Medical Centre, University of AmsterdamMahidol UniversityNational University of SingaporeMedizinische Fakultat und Universitats Klinikum AachenHopital Europeen Georges-PompidouKU LeuvenNorwegian Institute of Public HealthChildren's University Hospital, DublinNational Institute for Communicable DiseasesLudwig-Maximilians-Universitat MunchenThe Aga Khan University2018-10-192018-10-192013-09-01PLoS Medicine. Vol.10, No.9 (2013)15491676154912772-s2.0-84884637235https://repository.li.mahidol.ac.th/handle/123456789/32199Background:Vaccine-serotype (VT) invasive pneumococcal disease (IPD) rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into national immunization programs. Increases in non-vaccine-serotype (NVT) IPD rates occurred in some sites, presumably representing serotype replacement. We used a standardized approach to describe serotype-specific IPD changes among multiple sites after PCV7 introduction.Methods and Findings:Of 32 IPD surveillance datasets received, we identified 21 eligible databases with rate data ≥2 years before and ≥1 year after PCV7 introduction. Expected annual rates of IPD absent PCV7 introduction were estimated by extrapolation using either Poisson regression modeling of pre-PCV7 rates or averaging pre-PCV7 rates. To estimate whether changes in rates had occurred following PCV7 introduction, we calculated site specific rate ratios by dividing observed by expected IPD rates for each post-PCV7 year. We calculated summary rate ratios (RRs) using random effects meta-analysis. For children <5 years old, overall IPD decreased by year 1 post-PCV7 (RR 0·55, 95% CI 0·46-0·65) and remained relatively stable through year 7 (RR 0·49, 95% CI 0·35-0·68). Point estimates for VT IPD decreased annually through year 7 (RR 0·03, 95% CI 0·01-0·10), while NVT IPD increased (year 7 RR 2·81, 95% CI 2·12-3·71). Among adults, decreases in overall IPD also occurred but were smaller and more variable by site than among children. At year 7 after introduction, significant reductions were observed (18-49 year-olds [RR 0·52, 95% CI 0·29-0·91], 50-64 year-olds [RR 0·84, 95% CI 0·77-0·93], and ≥65 year-olds [RR 0·74, 95% CI 0·58-0·95]).Conclusions:Consistent and significant decreases in both overall and VT IPD in children occurred quickly and were sustained for 7 years after PCV7 introduction, supporting use of PCVs. Increases in NVT IPD occurred in most sites, with variable magnitude. These findings may not represent the experience in low-income countries or the effects after introduction of higher valency PCVs. High-quality, population-based surveillance of serotype-specific IPD rates is needed to monitor vaccine impact as more countries, including low-income countries, introduce PCVs and as higher valency PCVs are used.Please see later in the article for the Editors' Summary.Mahidol UniversityMedicineArticleSCOPUS10.1371/journal.pmed.1001517