Pneumococcal Carriage in Infants Post-PCV10 Introduction in Pakistan: Results from Serial Cross-Sectional Surveys

Shahira Shahid, Amala Khan, Muhammad Imran Nisar, Farah Khalid, Muhammad Farrukh Qazi, Sheraz Ahmed, Furqan Kabir, Aneeta Hotwani, Sahrish Muneer, Syed Asad Ali, Cynthia G. Whitney, Anita K.M. Zaidi, Fyezah Jehan

Research output: Contribution to journalArticlepeer-review


The 10-valent pneumococcal vaccine was introduced in Pakistan’s Expanded Program on Immunization (EPI) in 2013 as a 3 + 0 schedule without catchup. We conducted three annual cross-sectional surveys from 2014–2016 to measure vaccine-type (VT) carriage in infants from a rural part of Pakistan. Nasopharyngeal specimens were collected by random sampling of infants from two union councils of Matiari. Samples were then transported to the Infectious Disease Research Laboratory (IDRL) at the Aga Khan University within 6–8 h of collection. Serotypes were established using sequential multiplex PCR. Of the 665 children enrolled across three surveys, 547 were culturepositive for pneumococcus. VT carriage decreased from 21.8% in 2014 to 12.7% in 2016 (p-value for trend <0.001). Those who were not vaccinated or partially vaccinated were found to be at higher risk of carrying a VT serotype ((aOR 2.53, 95% CI 1.39, 4.63 for non-vaccinated) and (aOR 3.35, 95% CI 1.82, 6.16 for partially vaccinated)). On the other hand, being enrolled in the most recent survey was negatively associated with VT carriage (aOR 0.51, 95% CI 0.28, 0.93). We found that PCV10 was effective in decreasing the carriage of vaccine-type serotypes in Pakistani infants.

Original languageEnglish
Article number971
Issue number6
Publication statusPublished - Jun 2022


  • 10-valent pneumococcal conjugate vaccine
  • Pakistan
  • streptococcus pneumoniae


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