Table 4. Proportion of vaccine-type and nonvaccine type invasive pneumococcal disease cases before and after implementation of a PCV7 vaccination program, the Netherlands, June 2004–May 2010*.

Vaccination period, infecting serotype	No. (%) patients, by health status at time of infection
	Otherwise healthy	Immunocompromising condition†	p value	Any comorbidity‡	p value
Pre-implementation period
Total no. cases	399	216	NA	817	NA
PCV7 cases	189 (47)	88 (41)	NS	376 (46)	NS
Non–PCV7 cases	209 (52)	128 (59)	NS	441 (54)	NS
Post-implementation period
Total no. cases	356	255	NA	788	NA
PCV7 cases	78 (22)	73 (29)	NS	190 (24)	NS
Non–PCV7 cases	278 (78)	182 (71)	0.050	598 (76)	NS

*Cases are number of patients included in a study covering ≈25% of the Dutch population. Pre-implementations period, June 2004–May 2006; post-implementation period, June 2008–May 2010. Boldface, significant difference (p<0.05, calculated by χ2 test) compared with otherwise healthy patients. PCV7, 7-valent pneumococcal conjugate vaccine; NA, not applicable; NS, not significant (p>0.05). †Immunocompromising condition: primary immunodeficiency, HIV/AIDS, lymphoma, leukemia, myeloma, solid organ or stem cell transplant, current immunosuppressive therapy for malignancy or autoimmune disease, asplenia/splenectomy, sickle cell disease, and renal insufficiency (dialysis required and nephrotic syndrome). ‡Any comorbidity: malignancies (within previous 5 y) not considered to be immunocompromising; chronic pulmonary disease (chronic obstructive pulmonary disease and asthma); diabetes mellitus; cardiovascular disease (myocardial infarction, coronary artery condition, stroke/transient ischemic attack, cardiomyopathy, heart failure, heart valve disease, and presence of cerebral/abdominal/thoracic aneurysms); thyroid disease; liver disease; intravenous drug use; long-term alcohol abuse; cerebrospinal fluid leak; recent physical trauma/skull fracture; and, for children, premature birth (<37 weeks for children 0–1 y old and <32 weeks for children 0–4 y old).