Evidence map›Paper›PMID 42246152›Full record

ArticleThe Journal of infectious diseases2026

Post-COVID Rebound in Invasive Pneumococcal Disease Driven by Resurgence of Serotype 4 Among American Indian Individuals in the Southwest United States.

Catherine G Sutcliffe, Victoria M Sergent, Del Yazzie, George Brasinikas, Loretta Christensen, Matthew Clark, Wanda Cowboy, Sheri L Dixon, Lindsay R Grant, Marcella Harker-Jones and 17 more

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Article in The Journal of infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Catherine G SutcliffeCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID 0000-0001-8512-8326
Victoria M SergentCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID 0009-0001-6651-523X
Del YazzieNavajo Epidemiology Center, Navajo Department of Health, Window Rock, Arizona, USA.ORCID 0009-0001-5682-4012
George BrasinikasGallup Indian Medical Center, Indian Health Service, Gallup, New Mexico, USA.
Loretta ChristensenIndian Health Service, Rockville, Maryland, USA.
Matthew ClarkIndian Health Service, Rockville, Maryland, USA.
Wanda CowboyCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Sheri L DixonTséhootsooí Medical Center, Fort Defiance, Arizona, USA.
Lindsay R GrantCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Marcella Harker-JonesArctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA.
Chloe HurleyCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Jonathan V IraluGallup Indian Medical Center, Indian Health Service, Gallup, New Mexico, USA.ORCID 0000-0003-3295-8769
James B McAuleyWhiteriver Indian Hospital, Indian Health Service, Whiteriver, Arizona, USA.
Karen MiernykArctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA.
Pierrette MontanezNorthern Navajo Medical Center, Indian Health Service, Shiprock, New Mexico, USA.
Amy RiceCrownpoint Health Care Facility, Indian Health Service, Crownpoint, New Mexico, USA.
Eugene RomancitoWhiteriver Indian Hospital, Indian Health Service, Whiteriver, Arizona, USA.
Charis SalabyeTuba City Regional Health Care Corporation, Tuba City, Arizona, USA.
Brenna Simons-PetrusaArctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska, USA.
Joyselynn PitaluaCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Valerie L TenequerKayenta Health Center, Indian Health Service, Kayenta, Arizona, USA.
Polly ThompsonChinle Comprehensive Health Care Facility, Indian Health Service, Chinle, Arizona, USA.
Minnie TsingineWinslow Indian Health Care Center, Winslow, Arizona, USA.
Dan VanDeRietCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Robert C WeatherholtzCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Mathuram SantoshamCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Laura L HammittCenter for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID 0000-0001-6051-1484

Funding

Indian Health ServiceJG CDC HHSMerck Sharp & Dohme, LLC
6 · The paper itself

Abstract

backgroundIncidence of invasive pneumococcal disease (IPD) in American Indian (AI) communities in the Southwest United States declined during the COVID-19 pandemic. We estimated the burden and serotype distribution of IPD in the same communities in 2022-2024.

methodsWe conducted active, laboratory-based surveillance for IPD in the Navajo Nation and White Mountain Apache Tribal (WMAT) lands. Isolates were collected and serotyped. Annual incidence rates were calculated and serotype distribution was estimated. The proportion of serotypes covered by available pneumococcal conjugate vaccines (PCV20 and PCV21) were estimated and compared by age group using McNemar χ2 or exact McNemar tests, as appropriate.

resultsIPD rates increased from 2022 to 2024 to pre-pandemic levels: from 45.9 to 62.1 per 100 000 in the Navajo Nation and 52.9 to 84.4 in the WMAT lands. Among adults in the Navajo Nation, serotype 4 accounted for 28.5% of cases and occurred primarily among younger unvaccinated males. The proportion of cases covered by PCV21 was lower than PCV20 for adults aged 18-49 years (53.2% vs 77.3%; P < .001) but higher for adults aged ≥65 years (82.5% vs 65.1%; P = .03). In the WMAT lands, no cases of serotype 4 were identified; the proportion of cases covered by PCV21 was the same or higher than for PCV20 across age groups.

conclusionsIn 2 AI communities in the Southwest, IPD rates returned to pre-pandemic levels. In the Navajo Nation, the increase was driven by serotype 4 IPD among younger male unvaccinated adults. These findings can inform vaccine recommendations and highlight the value of surveillance.

Indexed as

COVID-19Indians, North AmericanPneumococcal InfectionsStreptococcus pneumoniaeAdolescentAdultAgedChildChild, PreschoolFemaleHumansIncidenceInfantMaleMiddle AgedPneumococcal VaccinesPneumococcal Vaccinesadult vaccinationcomorbiditiesIndigenous healthinvasive pneumococcal diseaseserotype 4

Identifiers

PMID42246152
PMCPMC13668367

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