Observational studyNature communications2020
High residual carriage of vaccine-serotype Streptococcus pneumoniae after introduction of pneumococcal conjugate vaccine in Malawi.
Observational study in Nature communications, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Natural Carriage of Streptococcus pneumoniae Is Associated With Increased Experimental Pneumococcal Carriage but Reduced Conjugate Vaccine Efficacy in a Human Challenge Model.The Journal of infectious diseases · 2025Trial
- Effect of 13-valent pneumococcal conjugate vaccine on experimental carriage of Streptococcus pneumoniae serotype 6B in Blantyre, Malawi: a randomised controlled trial and controlled human infection study.The Lancet. Microbe · 2023Trial
- Trial
- High-throughput antigen discovery using Functional Genomic Vaccinology (FGV) identifies protective Streptococcus pneumoniae vaccine candidates.Nature communications · 2026Article
- Prevalence, antimicrobial resistance, and risk factors of pneumococcal disease among preschool children in Bushenyi District, Uganda.BMC infectious diseases · 2026Article
- Epidemiological, immunological and virulence characteristics of persistent Streptococcus pneumoniae vaccine serotypes following vaccine introduction.Nature communications · 2026Article
- Genomic and statistical models to characterizeMicrobial genomics · 2026Article
- What is driving the resurgence and persistence of vaccine-targeted pneumococcal serotypes?-Serotype 19F as the paradigm.PLoS pathogens · 2026Review
- Pooled analysis of PCV13 efficacy from controlled human infection trials in Malawi and the UK.NPJ vaccines · 2026Article
- Article
- Acceptability of advanced Controlled Human Infection Models: The case of a pneumococcal challenge in people living with HIV and mycobacterial challenge with Bacillus Calmette Guerin in Malawi.PLOS global public health · 2026Article
- Investigation of the essential role of capsular polysaccharide in serotype 1Frontiers in cellular and infection microbiology · 2026Article
- Urine bioassay optimisation to assess the association between antimicrobial exposure, pneumococcal carriage and antimicrobial resistance among hospitalised children in Malawi.BMC infectious diseases · 2025Article
- Within-host genetic diversity of pneumococcal serotype 3 during one-year prolonged carriage in a healthy adult.Nature communications · 2025Article
- Assessing the effect of social contact structure on the impact of pneumococcal conjugate vaccines.Scientific reports · 2025Article
- Identification of age-group reservoirs for persistent vaccine-type pneumococcal carriage in rural Gambia.Pneumonia (Nathan Qld.) · 2025Article
- High Propensity for Multidrug-Resistant Pneumococcal Shedding Among Adults Living With HIV on Stable Antiretroviral Therapy in Malawi.Open forum infectious diseases · 2025Article
- Article
- Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
There are concerns that pneumococcal conjugate vaccines (PCVs) in sub-Saharan Africa sub-optimally interrupt Streptococcus pneumoniae vaccine-serotype (VT) carriage and transmission. Here we assess PCV carriage using rolling, prospective nasopharyngeal carriage surveys between 2015 and 2018, 3.6-7.1 years after Malawi's 2011 PCV13 introduction. Carriage decay rate is analysed using non-linear regression. Despite evidence of reduction in VT carriage over the study period, there is high persistent residual carriage. This includes among PCV-vaccinated children 3-5-year-old (16.1% relative reduction from 19.9% to 16.7%); PCV-unvaccinated children 6-8-year-old (40.5% reduction from 26.4% to 15.7%); HIV-infected adults 18-40-years-old on antiretroviral therapy (41.4% reduction from 15.2% to 8.9%). VT carriage prevalence half-life is similar among PCV-vaccinated and PCV-unvaccinated children (3.26 and 3.34 years, respectively). Compared with high-income settings, there is high residual VT carriage 3.6-7.1 years after PCV introduction. Rigorous evaluation of strategies to augment vaccine-induced control of carriage, including alternative schedules and catch-up campaigns, is required.
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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.