Whole-cell pneumococcal vaccines: a future-proof approach to overcoming pneumococcal serotype replacement

Serotype replacement is an issue associated with currently licensed pneumococcal vaccines, all of which target the serotype-specific capsular polysaccharide. The use of pneumococcal polysaccharide vaccines and pneumococcal conjugate vaccines in particular, have profoundly reduced the burden of invasive pneumococcal disease. However, these advances are being offset by the steady rise in the incidence of disease caused by non-vaccine-covered serotypes, which may be observed soon after the introduction of capsule-based vaccines in a given region [1] [2] [3].

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