Serogroup 1 replaced 14 as the most common Talazoparib cost in 2005/06. The proportion of serogroup 1 IPD increased steadily over the pre-PCV7 study period, with evidence of an increasing trend (p < 0.001) ( Table 1, Part

A). Serogroup 14 was borderline significant after adjustment for multiple testing, with a decreasing trend from 1999/00–2005/06. From 2003/04–2005/06, 42 serotypes were identified in IPD. PCV7 serotypes accounted for 47% of cases in this period; 68% of cases in those <5 years, 40% and 48% in those 5–64 years and ≥65 years, respectively. The most common serotypes, 14 (15%), 1 (13%), 4 (7%), 9V (7%), 8 (6%), 3 (6%), 23F (5%), 6B (4%), 7F (4%) and 19F (4%), were responsible for 71% of IPD. Evidence

of an increasing trend in Libraries serotype 1 IPD was found (p = 0.029). No other serotypes were found to have significant trends. The most common STs in IPD from 2003/04–2005/06 were 9 (9%), 306 (9%), 162 (6%), 53 (5%), 180 (4%), 191 (4%), MAPK inhibitor 124 (4%), 218 (3%), 199 (3%) and 227 (3%). ST9 was commonly associated with serotype 14; ∼60% of serotype 14 IPD during this period was ST9. ST306 was commonly associated with serotype 1. There were 158 STs in IPD in 2003/04, 140 in 2004/05 and 115 in 2005/06, showing a reduction in diversity over time. There was evidence of an increasing trend in ST306 IPD from 2003/04–2005/06, compared to the 0.05 significance level (Table 1, Part A). No other STs showed strong evidence of a trend. From 2006–2010, 2380 cases of IPD were reported. 140 cases occurred in those aged <5 years, 1239 in those 5–64 years, 1001 in those ≥65 years. Following PCV7 use, PCV7 serotype IPD incidence declined by 97.4% in children under 5 (Table 2). Among those aged 5–64

years and ≥65 years, a 3-mercaptopyruvate sulfurtransferase significant reduction of VT IPD of 86.3% and 80.4%, respectively, was observed. For those <5 years and 5–64 years, there was no significant increase in NVT notifications in 2008/09 compared to the predicted incidence (Fig. 1). Among those aged ≥65 years, a significant increase in NVT disease of 46.5% was observed. The reduction in VT incidence and increase in NVT incidence resulted in no change in all-type incidence in this group. Almost all NVT serotypes exhibited an increase in disease incidence from the last two pre-vaccination years to 2008/09 (7F: 153.6%, 3: 26.2%, 8: 42.5%, 19A: 78.7%, 22F: 151.6%, 6A: 31.8%, 12F: 2.3%, 11A: 73.9%, 9N: 33.3%). The exception is serotype 1 which showed a decrease despite the previously reported increase pre-PCV7. Only increases in 7F (128.5%; 95% CI (30%, 308.8%)) and 22F (126.7%; 95% CI (15%, 356.6%)) were found to be significant when allowing for pre-vaccination trends. The decrease in serotype 1 IPD was mainly driven by those aged <5 years and 5–65 years.