Invasive Pneumococcal Disease in Scotland, 1999-2001: Use of Record Linkage to Explore Associations between Patients and Disease in Relation to Future Vaccination Policy

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Abstract
A record linkage study was done to provide comprehensive data on the epidemiologic characteristics of invasive pneumococcal disease (IPD) in Scotland. The overall incidence of IPD was 11 cases/105 persons and 21 cases/105 persons 5 persons 1 year of age, 45 cases/105 elderly persons (age ⩾65 years), 176–483 cases/105 persons with chronic medical conditions, and 562–2031 cases/105 persons with severe immunosuppression. The case-fatality rate was 11% among elderly persons and ranged from 3% to 13% among persons with underlying medical conditions. The most common pneumococcal serogroups associated with IPD were 14, 9, 6, 19, 23, 8, and 4. Serogroups included in the 23-valent polysaccharide vaccine caused the majority of cases of IPD. The proportion of IPD due to the 7-, 9-, and 11-valent conjugate vaccine serogroups was lower among older people and persons with underlying medical conditions.