ReviewLancet (London, England)2011
Serotype replacement in disease after pneumococcal vaccination.
Review in Lancet (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01735084 (Pneumococcal Conjugate Vaccine), which is not on this map. Cited by 537 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pneumococcal Conjugate Vaccine (PCV) Schedules for the Northern Territory (NT): Randomised Controlled Trial of Booster Vaccines to Broaden and Strengthen Protection From Invasive and Mucosal Infections.
Who cites it
537 citing papers in PubMed, 7 syntheses or guidelines pooled it, 1,019 citations in OpenAlex.
- European stroke organisation guideline on stroke-associated pneumonia.European stroke journal · 2026Guideline
- Prevalence of Streptococcus pneumoniae and Staphylococcus aureus co-colonization in healthy children under five years: a systematic review.BMC pediatrics · 2026Pooled it
- Determinants of pneumococcal carriage by age in Africa (2000-2021): a systematic analysis.Frontiers in medicine · 2025Pooled it
- Serotype distribution of invasive and non-invasive pneumococcal disease in adults ≥65 years of age following the introduction of 10- and 13-valent pneumococcal conjugate vaccines in infant national immunization programs: a systematic literature review.Frontiers in public health · 2025Pooled it
- Serotype distribution of invasive and non-invasive pneumococcal disease in children ≤5 years of age following the introduction of 10- and 13-valent pneumococcal conjugate vaccines in infant national immunization programs: a systematic literature review.Frontiers in public health · 2025Pooled it
- Nasopharyngeal carriage of Streptococcus pneumoniae in Latin America and the Caribbean: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Analysing pneumococcal invasiveness using Bayesian models of pathogen progression rates.PLoS computational biology · 2022Pooled it
- Precancerous cervical lesions caused by non-vaccine-preventable HPV types after vaccination with the bivalent AS04-adjuvanted HPV vaccine: an analysis of the long-term follow-up study from the randomised Costa Rica HPV Vaccine Trial.The Lancet. Oncology · 2022Trial
- Trial
- Real-world effectiveness of EV-A71 vaccine against encephalitis in children.Human vaccines & immunotherapeutics · 2026Article
- Effectiveness of the 10-valent pneumococcal non-typeableHuman vaccines & immunotherapeutics · 2026Article
- Indirect Effect of Pneumococcal Conjugate Vaccines on Pneumococcal Colonization: Persistence and Dynamics of Vaccine Serotypes in Sicily (Italy) 11 Years Postintroduction, 2009-2020.The Journal of infectious diseases · 2026Article
- Transcriptomic analysis of naturally occurring bovine respiratory disease in Australian feedlot cattle identifies bovine viral diarrhoea virus-induced immunosuppression and Mollicutes as the dominant drivers of lung inflammation.Veterinary research · 2026Article
- ZPY-CpG-Ch, a broad coverage vaccine againstScience advances · 2026Article
- Pneumococcal meningitis among hospitalised children after introduction of pneumococcal conjugate vaccine in India: a sentinel hospital surveillance (2019-2022).The Lancet regional health. Southeast Asia · 2026Article
- Genomic surveillance of post-immunization pneumococcal carriage in Ghana.Microbial genomics · 2026Article
- Article
- Article
- Epidemiological, immunological and virulence characteristics of persistent Streptococcus pneumoniae vaccine serotypes following vaccine introduction.Nature communications · 2026Article
- Post-Vaccination Surveillance of Invasive Pneumococcal Disease in Ghana.Diseases (Basel, Switzerland) · 2026Article
477 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
Vaccination with heptavalent pneumococcal conjugate vaccine (PCV7) has significantly reduced the burden of pneumococcal disease and has had an important public health benefit. Because this vaccine targets only seven of the more than 92 pneumococcal serotypes, concerns have been raised that non-vaccine serotypes (NVTs) could increase in prevalence and reduce the benefits of vaccination. Indeed, among asymptomatic carriers, the prevalence of NVTs has increased substantially, and consequently, there has been little or no net change in the bacterial carriage prevalence. In many populations, pneumococcal disease caused by NVT has increased, but in most cases this increase has been less than the increase in NVT carriage. We review the evidence for serotype replacement in carriage and disease, and address the surveillance biases that might affect these findings. We then discuss possible reasons for the discrepancy between near-complete replacement in carriage and partial replacement for disease, including differences in invasiveness between vaccine serotypes. We contend that the magnitude of serotype replacement in disease can be attributed, in part, to a combination of lower invasiveness of the replacing serotypes, biases in the pre-vaccine carriage data (unmasking), and biases in the disease surveillance systems that could underestimate the true amount of replacement. We conclude by discussing the future potential for serotype replacement in disease and the need for continuing surveillance.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.