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Post-pandemic increase in pediatric invasive pneumococcal disease driven by serotype 3
Jorge Benito Arribas1, Celina García Pérez1, Emilia Cercenado2
1Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.
Journal of Infection and Public Health
|November 27, 2025
Summary
Pediatric invasive pneumococcal disease (IPD) declined during COVID-19 but resurged, driven by serotype 3. This serotype caused severe illness and fatalities despite high vaccination rates, highlighting the need for updated vaccines.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Vaccinology
Background:
- Invasive pneumococcal disease (IPD) remains a significant pediatric health concern.
- The COVID-19 pandemic altered respiratory pathogen circulation and pediatric infectious disease patterns.
Purpose of the Study:
- To analyze trends in pediatric IPD before and after the COVID-19 pandemic.
- To identify pathogens, severity, and outcomes associated with pediatric IPD.
Main Methods:
- Retrospective study of children under 18 with confirmed IPD.
- Data collected from January 2018 to April 2023 in Madrid, Spain.
- Analysis of clinical, microbiological, and vaccination data, comparing pre- and post-pandemic periods.
Main Results:
- A decline in IPD cases was observed during the early COVID-19 pandemic, with a subsequent rise in incidence and severity post-pandemic.
- Serotype 3 was the most common cause of IPD, strongly associated with severe disease, PICU admissions, and one fatality.
- Severe cases and PICU admissions were significantly more frequent in the post-pandemic period, even in fully vaccinated children.
Conclusions:
- A resurgence of pediatric IPD, particularly due to serotype 3, was observed after the COVID-19 pandemic.
- Serotype 3 IPD is linked to increased severity and poor outcomes, irrespective of vaccination status.
- Improved vaccine formulations and adaptive immunization strategies are crucial for managing pediatric IPD.
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