Interim results of an ecological experiment - Conjugate vaccination against the pneumococcus and serotype replacement

Hum Vaccin Immunother. 2016;12(2):358-74. doi: 10.1080/21645515.2015.1118593.


Streptococcus pneumoniae has more than 95 serotypes, each of which presumably can cause sepsis, meningitis, pneumonia, and acute otitis media. Pneumococcal conjugate vaccines (PCV) targeted against a limited number of serotypes have nonetheless revealed an impressive impact on each manifestation of pneumococcal disease. At the same time, growing evidence of significant non-vaccine type (NVT) replacement disease following implementation of infant PCV programs has raised questions about the long-term viability of PCV immunization strategies and how to optimize PCV formulations. We discuss here theoretical and practical considerations regarding serotype replacement, and provide a snapshot of the most important NVT types seen to date after implementation of the 2 higher-valent PCVs.

Keywords: Acute Otitis Media; Invasive Pneumococcal Disease; Meningitis; Pneumococcal conjugate vaccines; Serotype replacement; Streptococcus pneumoniae.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Carrier State / microbiology
  • Heptavalent Pneumococcal Conjugate Vaccine / immunology*
  • Humans
  • Infant
  • Nasopharynx / microbiology
  • Pneumococcal Infections / prevention & control*
  • Pneumococcal Vaccines / immunology*
  • Serogroup*
  • Serotyping
  • Streptococcus pneumoniae / classification*
  • Streptococcus pneumoniae / immunology*
  • Vaccination
  • Vaccines, Conjugate / immunology*


  • 13-valent pneumococcal vaccine
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Pneumococcal Vaccines
  • Vaccines, Conjugate