{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:45:05Z","timestamp":1790639105687,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>After 7-valent pneumococcal conjugate vaccine introduction in the United States in 2000, invasive pneumococcal disease (IPD) due to serotype 4 greatly decreased in children and adults. Starting in 2013, serotype 4 IPD incidence increased among adults within 3 of 10 Active Bacterial Core surveillance sites. Of 325 serotype 4 cases among adults in 2010\u20132018, 36% were persons experiencing homelessness (PEH); incidence of serotype 4 IPD among PEH was 100\u2013300 times higher than in the general population within these 3 areas. Genome sequencing for isolates recovered 2015\u20132018 (n\u2005=\u2005246), revealed that increases in serotype 4 IPD were driven by lineages ST10172, ST244, and ST695. Within each lineage, clusters of near-identical isolates indicated close temporal relatedness. Increases in serotype 4 IPD were limited to Colorado, California, and New Mexico, with highest increases among PEH, who were at increased risk for exposure to and infections caused by these strains.<\/jats:p>","DOI":"10.1093\/infdis\/jiaa501","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T15:13:27Z","timestamp":1596554007000},"page":"1241-1249","source":"Crossref","is-referenced-by-count":51,"title":["Upsurge of Conjugate Vaccine Serotype 4 Invasive Pneumococcal Disease Clusters Among Adults Experiencing Homelessness in California, Colorado, and New Mexico"],"prefix":"10.1093","volume":"223","author":[{"given":"Bernard","family":"Beall","sequence":"first","affiliation":[{"name":"Respiratory Disease Branch, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hollis","family":"Walker","sequence":"additional","affiliation":[{"name":"IHRC Inc., Contractor to Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Tran","sequence":"additional","affiliation":[{"name":"ASRT Inc., Contractor to Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongya","family":"Li","sequence":"additional","affiliation":[{"name":"ASRT Inc., Contractor to Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Varghese","sequence":"additional","affiliation":[{"name":"ASRT Inc., Contractor to Respiratory Diseases Branch, Centers for Disease Control 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Gierke","sequence":"additional","affiliation":[{"name":"Respiratory Disease Branch, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Mosites","sequence":"additional","affiliation":[{"name":"Respiratory Disease Branch, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8222-7353","authenticated-orcid":false,"given":"Sopio","family":"Chochua","sequence":"additional","affiliation":[{"name":"Respiratory Disease Branch, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, 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