ArticleThe Lancet. Infectious diseases2025
Serotype distribution of remaining invasive pneumococcal disease after extensive use of ten-valent and 13-valent pneumococcal conjugate vaccines (the PSERENADE project): a global surveillance analysis.
Article in The Lancet. Infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 49 papers, 3 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Recommendation for use of 15- and 20-valent pneumococcal conjugate vaccines in Korean infants and children.Clinical and experimental pediatrics · 2026Guideline
- 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
- 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
- Lot-to-lot consistency, immunogenicity, and safety of a 23-valent pneumococcal polysaccharide vaccine (PPV23) in healthy adults aged 40-65 years: A randomized, double-blind, controlled, phase IV clinical trial.Human vaccines & immunotherapeutics · 2025Trial
- Overview of adult immunization in Finland: Successes, lessons learned and the way forward.Human vaccines & immunotherapeutics · 2026Review
- Serotype distribution ofHuman 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
- From 10-Valent to 21-Valent Pneumococcal Conjugate Vaccines: Divergent Global Pathways and Future Directions for India.Indian pediatrics · 2026Review
- ZPY-CpG-Ch, a broad coverage vaccine againstScience advances · 2026Article
- Severe invasive pneumococcal disease beyond current vaccination recommendations: implications for higher-valency vaccines.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Antibiotic non-susceptibility associated serotypes of invasive pneumococcal disease - a nationwide population study from Switzerland, 2012-2022.Pneumonia (Nathan Qld.) · 2026Article
- Incidence of Recurrent Invasive Pneumococcal Disease in Canada.JAMA network open · 2026Article
- The Convergence of Antimicrobial Resistance and Virulence inMicroorganisms · 2026Review
- Metabolic rewiring at the pyruvate node contributes to severe pneumonia and attenuation of T cell responses in serotype 3 Streptococcus pneumoniae infection.Respiratory research · 2026Article
- Human antibodies as emerging drugs for antimicrobial resistance.Trends in immunology · 2026Review
- Article
- Identification of transporter-dependent capsular loci associated with the invasive potential of Escherichia coli.Nature microbiology · 2026Article
- Predicting optimal impact interventions in the post-HPV vaccination world.International journal of cancer · 2026Review
- Genomic epidemiology ofMicrobial genomics · 2026Article
- Fourteen-year genomic surveillance of pediatric invasive Streptococcus pneumoniae: genomic and pan-genomic characterization.BMC microbiology · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
71 authors.
Funding
Abstract
backgroundWidespread use of pneumococcal conjugate vaccines (PCVs) has reduced vaccine-type invasive pneumococcal disease (IPD). We describe the serotype distribution of IPD after extensive use of ten-valent PCV (PCV10; Synflorix, GSK) and 13-valent PCV (PCV13; Prevenar 13, Pfizer) globally.
methodsIPD data were obtained from surveillance sites participating in the WHO-commissioned Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project that exclusively used PCV10 or PCV13 (hereafter PCV10 and PCV13 sites, respectively) in their national immunisation programmes and had primary series uptake of at least 70%. Serotype distribution was estimated for IPD cases occurring 5 years or more after PCV10 or PCV13 introduction (ie, the mature period when the serotype distribution had stabilised) using multinomial Dirichlet regression, stratified by PCV product and age group (<5 years, 5-17 years, 18-49 years, and ≥50 years).
findingsThe analysis included cases occurring primarily between 2015 and 2018 from 42 PCV13 sites (63 362 cases) and 12 PCV10 sites (6806 cases) in 41 countries. Sites were mostly high income (36 [67%] of 54) and used three-dose or four-dose booster schedules (44 [81%]). At PCV10 sites, PCV10 serotypes caused 10·0% (95% CI 6·3-12·9) of IPD cases in children younger than 5 years and 15·5% (13·4-19·3) of cases in adults aged 50 years or older, while PCV13 serotypes caused 52·1% (49·2-65·4) and 45·6% (40·0-50·0), respectively. At PCV13 sites, PCV13 serotypes caused 26·4% (21·3-30·0) of IPD cases in children younger than 5 years and 29·5% (27·5-33·0) of cases in adults aged 50 years or older. The leading serotype at PCV10 sites was 19A in children younger than 5 years (30·6% [95% CI 18·2-43·1]) and adults aged 50 years or older (14·8% [11·9-17·8]). Serotype 3 was a top-ranked serotype, causing about 9% of cases in children younger than 5 years and 14% in adults aged 50 years or older at both PCV10 and PCV13 sites. Across all age and PCV10 or PCV13 strata, the proportion of IPD targeted by higher-valency PCVs beyond PCV13 was 4·1-9·7% for PCV15, 13·5-36·0% for PCV20, 29·9-53·8% for PCV21, 15·6-42·0% for PCV24, and 31·5-50·1% for PCV25. All top-ten ranked non-PCV13 serotypes are included in at least one higher-valency PCV.
interpretationThe proportion of IPD due to serotypes included in PCVs in use was low in mature PCV10 and PCV13 settings. Serotype distribution differed between PCV10 and PCV13 sites and age groups. Higher-valency PCVs target most remaining IPD and are expected to extend impact.
fundingBill & Melinda Gates Foundation as part of the WHO Pneumococcal Vaccines Technical Coordination Project.
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