This work was supported by grants from the Innovation Fund Denmark. M.G. and S.K. work at ChemoMetec, which produces the image cytometer used in the study, M.G. hold shares in the company. The other authors have no conflict of interest.

The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in 2010 to the childhood vaccination program in Greenland. This study aimed to estimate the effectiveness of the PCV13 on the incidence of invasive pneumococcal disease (IPD) in children and in adults in Greenland. IPD cases from the pre-PCV13 period (January 1995–September 2010) were compared with the post-PCV13 period (September 2010–October 2020). Register data were collected from laboratory records, IPD reports, the national registry on admissions, and medical files. A total of 295 IPD cases were identified in the study period. Overall IPD incidence rate (IR) declined from the pre-PCV13 period to the post-PCV13 period (IR 23.3 to 15.3 per 100,000 person years). Overall IPD incidence among children decreased significantly, whereas overall IPD incidence among the elderly increased significantly. During the post-PCV13 period, the incidence of vaccine serotype (VT) IPD decreased in all ages, while the incidence of non-vaccine serotype (NVT) IPD increased. This increase was most substantial among elderly ≥ 60 years. In conclusion, the PCV13 has reduced incidence rates of IPD in Greenland. However, the increase in NVT IPD among the elderly is noteworthy, and sup-ports continued surveillance of IPD in the population of Greenland.

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