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Pneumococcal serotype epidemiology and resistance after PCV13 replacement with PCV10, Sweden
Linda Yamba Yamba1, Fabian Uddén2, Silvana Dalence3
1Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Inga Marie Nilssons gata 53, Wallenberglaboratoriet, SE21428 Malmö, Sweden; Clinical Microbiology, Infection Control and Prevention, Laboratory Medicine Skåne, Sölvegatan 23B, SE22185 Lund, Sweden.
The Journal of Infection
|March 14, 2026
Summary
Sweden
Area of Science:
- Microbiology
- Immunology
- Public Health
Background:
- Sweden transitioned from PCV13 to PCV10 in its childhood immunization program in 2018.
- This switch aimed to reassess the impact on Streptococcus pneumoniae serotype distribution.
Purpose of the Study:
- To evaluate the effect of the PCV13 to PCV10 vaccine switch on pneumococcal serotype distribution in Sweden.
- To monitor changes in serotype prevalence and antimicrobial resistance patterns post-vaccine policy change.
Main Methods:
- Analysis of 1,615 respiratory tract (RT) Streptococcus pneumoniae isolates (2020-2023) for serotyping and antimicrobial susceptibility.
- Comparison with 397 invasive pneumococcal disease (IPD) isolates and historical data from the PCV13 era (2016-2018).
Main Results:
- Serotypes 3 and 19A re-emerged as predominant in RT isolates after PCV10 reintroduction (p<0.001).
- Serotype 19A also significantly increased in IPD cases (p<0.001).
- Reduced benzylpenicillin susceptibility was noted in 11% of RT isolates, with multidrug resistance primarily in serotypes 15A and 19A.
Conclusions:
- The reintroduction of PCV10 led to the resurgence of serotypes 3 and 19A.
- Continuous surveillance is crucial, highlighting the risk of rapid serotype replacement with lower-valency vaccines.
Keywords:
Antimicrobial resistancePneumococcal infectionPneumococcal vaccineRespiratory tract infectionSerotype, Streptococcus pneumoniaeMore Related Videos
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