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Failures of 13-Valent Conjugated Pneumococcal Vaccine in Age-Appropriately Vaccinated Children 2–59 Months of Age, Spain

Emerging Infectious Diseases. 2020;26(6):1147-1155 DOI 10.3201/eid2606.190951


Journal Homepage

Journal Title: Emerging Infectious Diseases

ISSN: 1080-6040 (Print); 1080-6059 (Online)

Publisher: Centers for Disease Control and Prevention

LCC Subject Category: Medicine: Internal medicine: Infectious and parasitic diseases

Country of publisher: United States

Language of fulltext: English

Full-text formats available: PDF, HTML, XML



Sergi Hernández

Fernando Moraga-Llop

Alvaro Díaz

Mariona F. de Sevilla

Pilar Ciruela

Carmen Muñoz-Almagro

Gemma Codina

Magda Campins

Juan José García-García

Cristina Esteva

Conchita Izquierdo

Sebastià González-Peris

Johanna Martínez-Osorio

Sonia Uriona

Luis Salleras

Ángela Domínguez


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Time From Submission to Publication: 8 weeks


Abstract | Full Text

Vaccination with the 13-valent conjugated pneumococcal disease (PCV13) has reduced invasive pneumococcal disease (IPD), but there have been reports of vaccine failures. We performed a prospective study in children aged 2–59 months who received diagnoses of IPD during January 2012–June 2016 in 3 pediatric hospitals in Catalonia, Spain, a region with a PCV13 vaccination coverage of 63%. We analyzed patients who had been age-appropriately vaccinated but who developed IPD caused by PCV13 serotypes. We detected 24 vaccine failure cases. The serotypes involved were 3 (16 cases); 19A (5 cases); and 1, 6B, and 14 (1 case each). Cases were associated with children without underlying conditions, with complicated pneumonia (OR 6.65, 95% CI 1.91–23.21), and with diagnosis by PCR (OR 5.18, 95% CI 1.84–14.59). Vaccination coverage should be increased to reduce the circulation of vaccine serotypes. Continuous surveillance of cases of IPD using both culture and PCR to characterize vaccine failures is necessary.