The impact of introduction of the 10-valent pneumococcal conjugate vaccine on pneumococcal carriage in Nigeria

Nat Commun. 2023 May 9;14(1):2666. doi: 10.1038/s41467-023-38277-z.


Pneumococcal conjugate vaccines (PCVs) protect against invasive pneumococcal disease (IPD) among vaccinees. However, at population level, this protection is driven by indirect effects. PCVs prevent nasopharyngeal acquisition of vaccine-serotype (VT) pneumococci, reducing onward transmission. Each disease episode is preceded by infection from a carrier, so vaccine impacts on carriage provide a minimum estimate of disease reduction in settings lacking expensive IPD surveillance. We documented carriage prevalence and vaccine coverage in two settings in Nigeria annually (2016-2020) following PCV10 introduction in 2016. Among 4,684 rural participants, VT carriage prevalence fell from 21 to 12% as childhood (<5 years) vaccine coverage rose from 7 to 84%. Among 2,135 urban participants, VT carriage prevalence fell from 16 to 9% as uptake rose from 15 to 94%. Within these ranges, carriage prevalence declined with uptake. Increasing PCV10 coverage reduced pneumococcal infection at all ages, implying at least a comparable reduction in IPD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Humans
  • Nigeria / epidemiology
  • Pneumococcal Infections* / epidemiology
  • Pneumococcal Infections* / prevention & control
  • Pneumococcal Vaccines*
  • Streptococcus pneumoniae
  • Vaccines, Conjugate


  • 10-valent pneumococcal conjugate vaccine
  • Pneumococcal Vaccines
  • Vaccines, Conjugate