Persistent vaccine-type invasive pneumococcal disease in children despite high PCV13 coverage: the role of serotype 3
Vaccine·
- DOI
- 10.1016/j.vaccine.2026.128940
- PMID
- 42486053
- PMCID
- —
- OpenAlex
- W7170036043
- Study type
- Journal article
- Publisher
- Elsevier BV
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings identify serotype 3 and PCR-based diagnosis as prominent features of the reported paediatric PCV13-type invasive pneumococcal disease cases. The abstract also reports that the authors considered molecular diagnostics, ongoing surveillance, and improved serotype 3 protection relevant to this issue.
Structured evidence summary
Research question
Among children with invasive pneumococcal disease despite PCV13 vaccination in a setting with sustained high coverage, how frequently did cases meet definitions of vaccine failure or breakthrough infection, and what clinical, epidemiological, microbiological, and molecular characteristics were associated with these outcomes?
Study design
Retrospective observational study comparing identified vaccine-failure and breakthrough-infection cases with cases from the pre-universal-PCV13 period. Clinical, vaccination, epidemiological, microbiological, and molecular variables were analyzed using univariable and multivariable logistic regression.
Population and setting
The study included children with invasive pneumococcal disease who had received PCV13 in a setting with sustained high vaccine coverage. The supplied classifier metadata identifies Spain as the country context, and the analyzed cases involved PCV13 serotypes.
Main findings
Among 206 PCV13-vaccinated children with invasive pneumococcal disease, 85 of 177 fully vaccinated children met the study definition of vaccine failure, while 2 of 29 incompletely vaccinated children met the definition of breakthrough infection. Serotype 3 accounted for most vaccine-failure cases and all breakthrough infections, was associated with complicated pneumonia, and was predominantly linked to sequence type ST180. Removing serotype 3 reduced the vaccine-failure proportion from 48.0% to 12.4%.
Public-health relevance
The findings identify serotype 3 and PCR-based diagnosis as prominent features of the reported paediatric PCV13-type invasive pneumococcal disease cases. The abstract also reports that the authors considered molecular diagnostics, ongoing surveillance, and improved serotype 3 protection relevant to this issue.
Important limitations
The retrospective observational design can describe associations but does not establish causality. The supplied abstract contains an incomplete age-range statement and does not provide the full methods, case ascertainment details, or analysis needed for decision-grade interpretation; this summary is therefore limited to the supplied single-article abstract and metadata.
GIDS interpretation
This article is discoverable as evidence concerning invasive pneumococcal disease, vaccination, and surveillance, with a focus on persistent PCV13-serotype disease and serotype 3. The article provides single-study context only and does not confirm or characterize any live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 10 auditable classifier relationships to diseases, places, topics, and study design.