Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe

Emerg Infect Dis. 2022 Jan;28(1):137-138. doi: 10.3201/eid2801.210734.


We evaluated invasive pneumococcal disease (IPD) during 8 years of infant pneumococcal conjugate vaccine (PCV) programs using 10-valent (PCV10) and 13-valent (PCV13) vaccines in 10 countries in Europe. IPD incidence declined during 2011-2014 but increased during 2015-2018 in all age groups. From the 7-valent PCV period to 2018, IPD incidence declined by 42% in children <5 years of age, 32% in persons 5-64 years of age, and 7% in persons >65 years of age; non-PCV13 serotype incidence increased by 111%, 63%, and 84%, respectively, for these groups. Trends were similar in countries using PCV13 or PCV10, despite different serotype distribution. In 2018, serotypes in the 15-valent and 20-valent PCVs represented one third of cases in children <5 years of age and two thirds of cases in persons >65 years of age. Non-PCV13 serotype increases reduced the overall effect of childhood PCV10/PCV13 programs on IPD. New vaccines providing broader serotype protection are needed.

Keywords: 10-valent pneumococcal vaccine; 13-valent pneumococcal vaccine; 15-valent pneumococcal vaccine; 20-valent pneumococcal vaccine; SpIDnet Multicenter Study; Streptococcus pneumoniae; bacteria; invasive pneumococcal disease; pneumococcal infections; respiratory infections; serotype.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Europe / epidemiology
  • Humans
  • Infant
  • Middle Aged
  • Pneumococcal Infections* / epidemiology
  • Pneumococcal Infections* / prevention & control
  • Pneumococcal Vaccines
  • Serogroup
  • Streptococcus pneumoniae*
  • Vaccines, Conjugate
  • Young Adult


  • Pneumococcal Vaccines
  • Vaccines, Conjugate