Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct 15;232(4):e609-e620.
doi: 10.1093/infdis/jiaf376.

Pneumococcal Serotype Distribution and Coverage of Existing and Pipeline Pneumococcal Vaccines

Laura M King  1 , Kristin L Andrejko  2 , Miwako Kobayashi  2 , Wei Xing  2 , Adam L Cohen  2 , Wesley H Self  3 , J Jackson Resser  4 , Cynthia G Whitney  5 , Adrienne Baughman  3 , Mai Kio  6 , Carlos G Grijalva  7 , Jessica Traenkner  6 , Nadine Rouphael  6 , Joseph A Lewnard  1
Affiliations

Pneumococcal Serotype Distribution and Coverage of Existing and Pipeline Pneumococcal Vaccines

Laura M King et al. J Infect Dis. .

Abstract

Background: Next-generation pneumococcal conjugate vaccines (PCVs) target an expanding array of serotype antigens. We assessed the proportions of invasive pneumococcal disease (IPD) and pneumococcal acute respiratory infections (ARIs) caused by serotypes targeted by existing and pipeline PCVs, and the annual United States pneumococcal disease burdens potentially preventable by these products.

Methods: We estimated serotype distribution and proportions of pneumococcal ARIs (acute otitis media [AOM; children only], sinusitis, nonbacteremic pneumonia) and IPD attributable to serotypes targeted by each PCV using Markov chain Monte Carlo approaches incorporating data from epidemiological studies and Active Bacterial Core surveillance. We then estimated annual numbers of outpatient-managed ARIs, nonbacteremic pneumonia hospitalizations, and IPD cases potentially preventable by PCVs by multiplying disease incidence rates by PCV-targeted disease proportions and vaccine effectiveness estimates.

Results: In children, PCV15, PCV20, PCV24, PCV25, and PCV31 serotypes account for 16% (95% confidence interval, 15%-17%), 31% (30%-32%), 34% (32%-35%), 43% (42%-44%), and 68% (67%-69%) of pneumococcal AOM, respectively. In adults, PCV15, PCV20, PCV21, PCV24, PCV25, and PCV31 serotypes account for 43% (38%-47%), 52% (47%-57%), 69% (64%-73%), 65% (61%-70%), 62% (57%-67%), and 87% (83%-90%) of pneumococcal nonbacteremic pneumonia. For IPD, 42%-85% of pediatric and 42%-94% of adult cases were due to PCV-targeted serotypes. PCV-preventable burdens encompassed 270 000-3 300 000 outpatient-managed ARIs, 2000-17 000 pneumonia hospitalizations, and 3000-14 000 IPD cases annually.

Conclusions: Across pneumococcal conditions, coverage and preventable burdens were lowest for PCV15 and highest for PCV31, with PCV21 also targeting sizeable burdens of adult disease. Comparative estimates of preventable disease burden may inform future policy.

Keywords: Streptococcus pneumoniae; acute otitis media; invasive pneumococcal disease; pneumococcal conjugate vaccines; pneumonia.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. L. M. K. reports consulting fees from Merck Sharpe & Dohme for unrelated work and Vaxcyte for related and unrelated work, and support for attending a meeting from UC Berkeley Center for Effective Global Action. L. M. K. is now an employee of GSK. C. G. G. reports consulting fees from Merck & Co, Inc and research funding from NIH, CDC, Agency for Healthcare Research and Quality (AHRQ), and Campbell Alliance/Syneos Health for unrelated work. N. R. reports research funding from Merck, Sanofi, Pfizer, Vaccine Company, Immorna, Quidel, and Lilly for unrelated work; consulting fees from Krog; honoraria from Virology Education and Medscape; support for attending a meeting from Sanofi and Moderna; participation in advisory boards for Moderna, Sanofi, Seqirus, Pfizer, EMMES, ICON, and Micron; and leadership roles with the Antibacterial Resistance Leadership Group, TMRC, CDC-Pertussis challenge, and Clinical Infectious Diseases. J. A. L. reports research grants from Pfizer, Merck Sharpe & Dohme, and Gilead for unrelated work; consulting fees from Pfizer, Merck, Sharpe & Dohme, Vaxcyte, Seqirus, and Valneva SE for unrelated work and Vaxcyte for related work; and support for attending a meeting from Vaxcyte. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Pneumococcal serotypes targeted by pneumococcal conjugate vaccine (PCV) products. The 24-valent Pn-MAPS24v uses a Multiple Antigen Presenting System platform rather than the traditional conjugate protein platform. PCV24 and Pn-MAPS24v target the same serotypes and so are considered together.
Figure 2.
Figure 2.
Serotype-specific proportions of pneumococcal infections by condition and age group. Serotypes accounting for <0.05% of pneumococcal isolates within a condition and age group not displayed. All serotype distribution estimates are detailed in Supplementary Table 7. Abbreviations: AOM, acute otitis media; IPD, invasive pneumococcal disease.
See this image and copyright information in PMC

Update of

References

    1. Blacklock CB, Weinberger DM, Perniciaro S, Wyllie AL. Streptococcus pneumoniae serotypes. 2024. Available at: https://pneumococcalcapsules.github.io/serotypes/. Accessed 1 May 2025.
    1. Varghese J, Chochua S, Tran T, et al. Multistate population and whole genome sequence-based strain surveillance of invasive pneumococci recovered in the USA during 2017. Clin Microbiol Infect 2020; 26:512.e1–e10. - PMC - PubMed
    1. Centers for Disease Control and Prevention . Bact facts: Streptococcus pneumoniae. Available at: https://app.powerbigov.us/view?r=eyJrIjoiNjc5OGRjODctNWQ5ZC00ZWEwLWI5Zjg.... Accessed 8 March 2022.
    1. Hersh AL, King LM, Shapiro DJ, Hicks LA, Fleming-Dutra KE. Unnecessary antibiotic prescribing in US ambulatory care settings, 2010–2015. Clin Infect Dis 2021; 72:133–7. - PMC - PubMed
    1. King LM, Tsay SV, Hicks LA, Bizune D, Hersh AL, Fleming-Dutra K. Changes in outpatient antibiotic prescribing for acute respiratory illnesses, 2011 to 2018. Antimicrob Steward Healthc Epidemiol 2021; 1:1–8. - PMC - PubMed

MeSH terms