{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T17:18:23Z","timestamp":1782235103824,"version":"3.54.5"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T00:00:00Z","timestamp":1611619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The PCV13 immunization demonstration program began in October 2017 in Indonesia. The aim of this study is to assess the dynamic changes of pneumococcal serotype before and after PCV13 administration, with two primary and one booster doses.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The prospective cohort study was conducted as a follow up study measuring the impact of PCV13 demonstration program by the Indonesian Ministry of Health in Lombok Island, West Nusa Tenggara, Indonesia, from March 2018 to June 2019. The subjects were two-month-old healthy infants who were brought to the primary care facility for routine vaccination and followed until 18 months of age. We use convenience sampling method. There were 115 infants in the control group and 118 infants in the vaccine group, and the PCV immunization was given on a 2+1 schedule. Nasopharyngeal (NP) swabs were collected four times during the vaccination periods by trained medical staff. Specimens were analyzed by culture methods to detect <jats:italic>S<\/jats:italic>. <jats:italic>pneumonia<\/jats:italic> colonization and multiplex polymerase chain reaction (mPCR) to determine serotype. The most frequently detected serotypes will be named as dominant serotypes. Descriptive analysis of demographic characteristics, the prevalence of overall and serotype colonization, and the distribution of serotypes were performed. The prevalence of both cohort groups were compared using chi-square test. Statistical significance was set at p &lt; 0.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Two hundred and thirty three infants age two months old were recruited, with 48.9% of the subjects were male and 51.1% of the subjects were female. Sociodemographic data in both cohort groups were relatively equal. Nasopharyngeal pneumococcal colonization before PCV13 administration occurred in 19.1% of the control and 22.9% of the vaccine group. The prevalence increased with increasing age in both groups. The prevalence of VT serotypes in control groups aged 2 months, 4 months, 12 months, and 18 months was 40.9%, 44.2%, 53.8%, and 54.3%, respectively, and in the vaccine group, 25.9%, 40.4%, 38.0%, and 22.6%, respectively. The most common VT serotypes in both groups were 6A\/6B, 19F, 23F, and 14. The prevalence of VT serotypes decreased significantly compared to non-vaccine type serotypes after three doses of the PCV13 vaccine (<jats:italic>p<\/jats:italic> &lt; 0.001). Another notable change was the decline in prevalence of serotype 6A\/6B after PCV13 administration using the 2+1 schedule.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study shows lower prevalence of VT and 6A\/6B serotypes in the nasopharynx among children who were PCV13 vaccinated compared with those who were unvaccinated. The result from this study will be the beginning of future vaccine evaluation in larger population and longer period of study.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0245789","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T18:24:15Z","timestamp":1611685455000},"page":"e0245789","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Pneumococcal nasopharyngeal carriage in Indonesia infants and toddlers post-PCV13 vaccination in a 2+1 schedule: A prospective cohort study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9107-239X","authenticated-orcid":true,"given":"Ari","family":"Prayitno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bambang","family":"Supriyatno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakiudin","family":"Munasir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anis","family":"Karuniawati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri Rezeki S.","family":"Hadinegoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joedo","family":"Prihartono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7639-7441","authenticated-orcid":true,"given":"Dodi","family":"Safari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julitasari","family":"Sundoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miftahuddin Majid","family":"Khoeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"pone.0245789.ref001","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1016\/S2214-109X(18)30408-X","article-title":"Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis","volume":"7","author":"DA McAllister","year":"2019","journal-title":"Lancet Glob Heal"},{"key":"pone.0245789.ref002","volume-title":"Pneumonia: the forgotten killer of children","author":"TM Wardlaw","year":"2006"},{"key":"pone.0245789.ref003","volume-title":"Profil Kesehatan Indonesia 2015","author":"Kementerian Kesehatan RI","year":"2016"},{"key":"pone.0245789.ref004","doi-asserted-by":"crossref","first-page":"4717","DOI":"10.1016\/j.vaccine.2012.04.093","article-title":"Pneumococcal vaccines WHO position paper\u2013 2012 \u2013Recommendations","volume":"30","author":"WHO Publication","year":"2012","journal-title":"Vaccine"},{"key":"pone.0245789.ref005","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1093\/cid\/ciu524","article-title":"Impact of 13-valent pneumococcal conjugate vaccination in invasive pneumococcal disease incidence and mortality","volume":"59","author":"ZB Harboe","year":"2014","journal-title":"Clin Infect Dis"},{"key":"pone.0245789.ref006","doi-asserted-by":"crossref","first-page":"4313","DOI":"10.1016\/j.vaccine.2016.06.075","article-title":"Modeling pneumococcal nasopharyngeal acquisition as a function of anticapsular serum antibody concentrations after pneumococcal conjugate vaccine administration","volume":"34","author":"R Dagan","year":"2016","journal-title":"Vaccine"},{"key":"pone.0245789.ref007","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1016\/S0140-6736(10)62225-8","article-title":"Serotype replacement in disease after pneumococcal vaccination","volume":"378","author":"DM Weinberger","year":"2011","journal-title":"Lancet"},{"key":"pone.0245789.ref008","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1086\/319605","article-title":"Streptococcus pneumoniae nasopharyngeal carriage prevalence, serotype distribution, and resistance patterns among children on Lombok Island, Indonesia","volume":"32","author":"S Soewignjo","year":"2001","journal-title":"Clin Infect Dis"},{"key":"pone.0245789.ref009","first-page":"485","article-title":"Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children under five years old in central lombok regency","volume":"47","author":"SR Hadinegoro","year":"2016","journal-title":"Indonesia. 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