{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:15:39Z","timestamp":1747196139859,"version":"3.40.5"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"GlaxoSmithKline Biologicals SA"},{"name":"Finnish Institute for Health and Welfare"}],"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>In the nation-wide double-blind cluster-randomised Finnish Invasive Pneumococcal disease trial (FinIP, ClinicalTrials.gov NCT00861380, NCT00839254), we assessed the indirect impact of the 10-valent pneumococcal <jats:italic>Haemophilus influenzae<\/jats:italic> protein D conjugate vaccine (PHiD-CV10) against five pneumococcal disease syndromes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Children 6 weeks to 18 months received PHiD-CV10 in 48 clusters or hepatitis B\/A-vaccine as control in 24 clusters according to infant 3+1\/2+1 or catch-up schedules in years 2009\u20152011. Outcome data were collected from national health registers and included laboratory-confirmed and clinically suspected invasive pneumococcal disease (IPD), hospital-diagnosed pneumonia, tympanostomy tube placements (TTP) and outpatient antimicrobial prescriptions. Incidence rates in the unvaccinated population in years 2010\u20152015 were compared between PHiD-CV10 and control clusters in age groups &lt;5 and \u22655 years (5\u20157 years for TTP and outpatient antimicrobial prescriptions), and in infants &lt;3 months. PHiD-CV10 was introduced into the Finnish National Vaccination Programme (PCV-NVP) for 3-month-old infants without catch-up in 9\/2010.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>From 2\/2009 to 10\/2010, 45398 children were enrolled. Vaccination coverage varied from 29 to 61% in PHiD-CV10 clusters. We detected no clear differences in the incidence rates between the unvaccinated cohorts of the treatment arms, except in single years. For example, the rates of vaccine-type IPD, non-laboratory-confirmed IPD and empyema were lower in PHiD-CV10 clusters compared to control clusters in 2012, 2015 and 2011, respectively, in the age-group \u22655 years.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This is the first report from a clinical trial evaluating the indirect impact of a PCV against clinical outcomes in an unvaccinated population. We did not observe consistent indirect effects in the PHiD-CV10 clusters compared to the control clusters. We consider that the sub-optimal trial vaccination coverage did not allow the development of detectable indirect effects and that the supervening PCV-NVP significantly diminished the differences in PHiD-CV10 vaccination coverage between the treatment arms.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0261750","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T18:32:40Z","timestamp":1641407560000},"page":"e0261750","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the indirect impact of the 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine in a cluster-randomised trial"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-4923","authenticated-orcid":true,"given":"Hanna","family":"Rinta-Kokko","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arto A.","family":"Palmu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esa","family":"Ruokokoski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3353-7579","authenticated-orcid":true,"given":"Heta","family":"Nieminen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Moreira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lode","family":"Schuerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"Borys","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukka","family":"Jokinen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"issue":"4","key":"pone.0261750.ref001","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1093\/oxfordjournals.aje.a115884","article-title":"Struchiner CJ. Direct and indirect effects in vaccine efficacy and effectiveness","volume":"133","author":"ME Halloran","year":"1991","journal-title":"Am J Epidemiol"},{"issue":"7","key":"pone.0261750.ref002","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1586\/erv.12.53","article-title":"The fundamental link between pneumococcal carriage and disease.","volume":"11","author":"B Simell","year":"2012","journal-title":"Expert Rev Vaccines"},{"issue":"3","key":"pone.0261750.ref003","doi-asserted-by":"crossref","first-page":"e00937","DOI":"10.1128\/mBio.00937-20","article-title":"A new pneumococcal capsule type, 10D, is the 100th serotype and has a large cps fragment from an oral Streptococcus","volume":"11","author":"F Ganaie","year":"2020","journal-title":"mBio"},{"issue":"8","key":"pone.0261750.ref004","first-page":"85","article-title":"Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper\u2013February 2019","volume":"94","author":"World Health Organization","year":"2019","journal-title":"Wkly Epidemiol Rec"},{"key":"pone.0261750.ref005","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":"D Weinberger","year":"2011","journal-title":"Lancet"},{"issue":"5","key":"pone.0261750.ref006","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1586\/14760584.5.5.651","article-title":"Nasopharyngeal colonization: a target for pneumococcal vaccination","volume":"5","author":"H K\u00e4yhty","year":"2006","journal-title":"Expert Rev Vaccines"},{"article-title":"Pneumococcal conjugate vaccine (PCV) product assessment.","year":"2017","author":"O Cohen","key":"pone.0261750.ref007"},{"issue":"18","key":"pone.0261750.ref008","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa022823","article-title":"Decline in invasive pneumococcal disease after the introduction of protein\u2013polysaccharide conjugate vaccine","volume":"348","author":"C Whitney","year":"2003","journal-title":"N Engl J Med"},{"issue":"35","key":"pone.0261750.ref009","doi-asserted-by":"crossref","first-page":"18962","DOI":"10.2807\/ese.13.35.18962-en","article-title":"Impact of infant pneumococcal vaccination on invasive pneumococcal diseases in France, 2001\u20132006","volume":"13","author":"A Lepoutre","year":"2008","journal-title":"Euro Surveill"},{"issue":"1","key":"pone.0261750.ref010","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1086\/594125","article-title":"Epidemiology of invasive pneumococcal disease among adult patients in Barcelona before and after pediatric 7-valent pneumococcal conjugate vaccine introduction, 1997\u20132007","volume":"48","author":"C Ardanuy","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"8","key":"pone.0261750.ref011","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":"Z Harboe","year":"2014","journal-title":"Clin Infect Dis"},{"issue":"3","key":"pone.0261750.ref012","doi-asserted-by":"crossref","first-page":"e0120290","DOI":"10.1371\/journal.pone.0120290","article-title":"Impact of ten-valent pneumococcal conjugate vaccination on invasive pneumococcal disease in Finnish children\u2014a population-based study","volume":"10","author":"J Jokinen","year":"2015","journal-title":"PLoS One."},{"issue":"3","key":"pone.0261750.ref013","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S1473-3099(14)71081-3","article-title":"Effect of use of 13-valent pneumococcal conjugate vaccine in children on invasive pneumococcal disease in children and adults in the USA: analysis of multisite, population-based surveillance","volume":"15","author":"MR Moore","year":"2015","journal-title":"Lancet Infect Dis"},{"issue":"11","key":"pone.0261750.ref014","doi-asserted-by":"crossref","first-page":"2040","DOI":"10.3201\/eid2111.140780","article-title":"Invasive pneumococcal disease 3 years after introduction of 10-valent pneumococcal conjugate vaccine, the Netherlands","volume":"21","author":"MJ Knol","year":"2015","journal-title":"Emerg Infect Dis"},{"issue":"6","key":"pone.0261750.ref015","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1183\/09031936.00183614","article-title":"Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia","volume":"45","author":"C Rodrigo","year":"2015","journal-title":"Eur Respir J"},{"issue":"14","key":"pone.0261750.ref016","doi-asserted-by":"crossref","first-page":"30186","DOI":"10.2807\/1560-7917.ES.2016.21.14.30186","article-title":"Direct, indirect and total effects of 13-valent pneumococcal conjugate vaccination on invasive pneumococcal disease in children in Navarra, Spain, 2001 to 2014: cohort and case\u2013control study","volume":"21","author":"M Guevara","year":"2016","journal-title":"Euro Surveill"},{"issue":"9","key":"pone.0261750.ref017","doi-asserted-by":"crossref","first-page":"e0184204","DOI":"10.1371\/journal.pone.0184204","article-title":"Direct and indirect impact of 10-valent pneumococcal conjugate vaccine introduction on pneumonia hospitalizations and economic burden in all age-groups in Brazil: A time-series analysis","volume":"12","author":"AL Andrade","year":"2017","journal-title":"PLoS One"},{"issue":"5","key":"pone.0261750.ref018","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1136\/thoraxjnl-2018-211767","article-title":"Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination","volume":"74","author":"G Hanquet","year":"2019","journal-title":"Thorax"},{"issue":"8","key":"pone.0261750.ref019","doi-asserted-by":"crossref","first-page":"e1002632","DOI":"10.1371\/journal.pmed.1002632","article-title":"Choices in vaccine trial design in epidemics of emerging infections","volume":"15","author":"R Kahn","year":"2018","journal-title":"Plos Med"},{"key":"pone.0261750.ref020","unstructured":"WHO Expert Committee on Biological Standardization. Guidelines on clinical evaluation of vaccines: regulatory expectations. Replacement of Annex 1 of WHO Technical Report Series, No. 924; [Accessed 2021 May 29]. Available at: https:\/\/www.who.int\/biologicals\/vaccines\/clinical_evaluation\/en\/."},{"issue":"9862","key":"pone.0261750.ref021","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/S0140-6736(12)61854-6","article-title":"Effectiveness of the ten-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against invasive pneumococcal disease: a cluster randomised trial","volume":"381","author":"AA Palmu","year":"2013","journal-title":"Lancet"},{"issue":"3","key":"pone.0261750.ref022","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/jpids\/piw010","article-title":"Effectiveness of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D\u2013conjugated vaccine (PHiD-CV) against carriage and acute otitis media\u2014a double-blind randomized clinical trial in Finland","volume":"5","author":"T Vesikari","year":"2016","journal-title":"J Pediatric Infect Dis Soc."},{"issue":"39","key":"pone.0261750.ref023","doi-asserted-by":"crossref","first-page":"5891","DOI":"10.1016\/j.vaccine.2018.08.020","article-title":"Effectiveness of pneumococcal Haemophilus influenzae protein D conjugate vaccine against pneumonia in children: a cluster-randomised trial","volume":"36","author":"TM Kilpi","year":"2018","journal-title":"Vaccine"},{"key":"pone.0261750.ref024","unstructured":"Finnish Institute for Health and Welfare (THL), Finland. Health 2011 survey. Helsinki: THL; [Accessed 27 Jan 2020]. Available at: https:\/\/thl.fi\/en\/web\/thlfi-en\/research-and-expertwork\/projects-and-programmes\/health-2000-2011"},{"key":"pone.0261750.ref025","unstructured":"Finnish Institute for Health and Welfare (THL), Finland. The vaccination register. Helsinki: THL; [Accessed 27 Jan 2020]. Available from: https:\/\/thl.fi\/en\/web\/vaccination\/vaccination-coverage\/national-vaccination-register"},{"issue":"3","key":"pone.0261750.ref026","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S1473-3099(13)70338-4","article-title":"Effect of pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) on outpatient antimicrobial purchases: a double-blind, cluster randomised phase 3\u20134 trial","volume":"14","author":"AA Palmu","year":"2014","journal-title":"Lancet Infect Dis"},{"issue":"9","key":"pone.0261750.ref027","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S2213-2600(14)70139-0","article-title":"Vaccine effectiveness of the pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against clinically suspected invasive pneumococcal disease: a cluster-randomised trial.","volume":"2","author":"AA Palmu","year":"2014","journal-title":"Lancet Respir Med"},{"issue":"11","key":"pone.0261750.ref028","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1097\/INF.0000000000000857","article-title":"Effectiveness of the ten-valent pneumococcal conjugate vaccine against tympanostomy tube placements in a cluster-randomized trial","volume":"34","author":"AA Palmu","year":"2015","journal-title":"Pediatr Infect Dis J"},{"author":"R: A Language and Environment for Statistical Computing","key":"pone.0261750.ref029"},{"issue":"16","key":"pone.0261750.ref030","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1001\/jama.294.16.2043","article-title":"Changing epidemiology of invasive pneumococcal disease among older adults in the era of pediatric pneumococcal conjugate vaccine","volume":"294","author":"The Statistical Analysis System (SAS)","year":"2005","journal-title":"JAMA"},{"issue":"10","key":"pone.0261750.ref031","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1016\/j.vaccine.2009.12.054","article-title":"Indirect effect of conjugate pneumococcal vaccination in a 2+1 dose schedule","volume":"28","author":"DF Vestrheim","year":"2010","journal-title":"Vaccine"},{"issue":"9","key":"pone.0261750.ref032","doi-asserted-by":"crossref","first-page":"e1001517","DOI":"10.1371\/journal.pmed.1001517","article-title":"Serotype-specific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites","volume":"10","author":"DR Feikin","year":"2013","journal-title":"PLoS Med"},{"issue":"7","key":"pone.0261750.ref033","doi-asserted-by":"crossref","first-page":"e0131494","DOI":"10.1371\/journal.pone.0131494","article-title":"Effects of infant pneumococcal conjugate vaccination on serotype distribution in invasive pneumococcal disease among children and adults in Germany.","volume":"10","author":"M van der Linden","year":"2015","journal-title":"PLoS One"},{"issue":"4","key":"pone.0261750.ref034","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/S1473-3099(18)30052-5","article-title":"Rapid increase in non-vaccine serotypes causing invasive pneumococcal disease in England and Wales, 2000\u201317: a prospective national observational cohort study","volume":"18","author":"SN Ladhani","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"11","key":"pone.0261750.ref035","doi-asserted-by":"crossref","first-page":"2390","DOI":"10.1017\/S0950268817001194","article-title":"The epidemiology of invasive pneumococcal disease in older adults in the post-PCV era. Has there been a herd effect?","volume":"145","author":"M Corcoran","year":"2017","journal-title":"Epidemiol. Infect"},{"issue":"11","key":"pone.0261750.ref036","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1093\/cid\/cix685","article-title":"Comparison of the impact of pneumococcal conjugate vaccine 10 or pneumococcal conjugate vaccine 13 on invasive pneumococcal disease in equivalent populations","volume":"65","author":"P Naucler","year":"2017","journal-title":"Clin Infect Dis"},{"issue":"3","key":"pone.0261750.ref037","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.vaccine.2017.11.054","article-title":"Incidence of invasive pneumococcal disease before and during an era of use of three different pneumococcal conjugate vaccines in Quebec","volume":"36","author":"P De Wals","year":"2018","journal-title":"Vaccine"},{"issue":"1","key":"pone.0261750.ref038","doi-asserted-by":"crossref","first-page":"e0210081","DOI":"10.1371\/journal.pone.0210081","article-title":"Invasive pneumococcal diseases in children and adults before and after introduction of the 10-valent pneumococcal conjugate vaccine into the Austrian national immunization program","volume":"14","author":"L Richter","year":"2019","journal-title":"PLoS One"},{"issue":"6","key":"pone.0261750.ref039","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1093\/cid\/civ429","article-title":"Pneumonia in elderly Australians: reduction in presumptive pneumococcal hospitalizations but no change in all-cause pneumonia hospitalizations following 7-valent pneumococcal conjugate vaccination","volume":"61","author":"RI Menzies","year":"2015","journal-title":"Clin Infect Dis"},{"key":"pone.0261750.ref040","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1186\/s12879-016-1693-x","article-title":"Pneumonia hospitalisations in Scotland following the introduction of pneumococcal conjugate vaccination in young children","volume":"16","author":"H Nair","year":"2016","journal-title":"BMC Infect Dis"},{"issue":"3","key":"pone.0261750.ref041","doi-asserted-by":"crossref","first-page":"e0172690","DOI":"10.1371\/journal.pone.0172690","article-title":"Impact of ten-valent pneumococcal conjugate vaccine on pneumonia in Finnish children in a nation-wide population-based study","volume":"12","author":"AA Palmu","year":"2017","journal-title":"PLoS One"},{"issue":"1","key":"pone.0261750.ref042","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12916-018-1004-z","article-title":"Elucidating the impact of the pneumococcal conjugate vaccine programme on pneumonia, sepsis and otitis media hospital admissions in England using a composite control","volume":"16","author":"D Thorrington","year":"2018","journal-title":"BMC Medicine"},{"issue":"3","key":"pone.0261750.ref043","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1136\/thoraxjnl-2017-210440","article-title":"Population-level impact of infant 10-valent pneumococcal conjugate vaccination on adult pneumonia hospitalisations in Finland.","volume":"73","author":"O Okasha","year":"2018","journal-title":"Thorax"},{"issue":"1","key":"pone.0261750.ref044","doi-asserted-by":"crossref","first-page":"e0209428","DOI":"10.1371\/journal.pone.0209428","article-title":"Indirect effect of 7-valent and 13-valent pneumococcal conjugated vaccines on pneumococcal pneumonia hospitalizations in elderly","volume":"14","author":"I Kislaya","year":"2019","journal-title":"PLoS One"},{"issue":"6","key":"pone.0261750.ref045","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1097\/01.inf.0000069760.65826.f2","article-title":"Vaccination of day-care center attendees reduces carriage of Streptococcus pneumoniae among their younger siblings","volume":"22","author":"N Givon-Lavi","year":"2003","journal-title":"Pediatr Infect Dis J"},{"issue":"11","key":"pone.0261750.ref046","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1086\/503805","article-title":"Indirect effect of conjugate vaccine on adult carriage of Streptococcus pneumoniae: an explanation of trends in invasive pneumococcal disease","volume":"193","author":"LL Hammitt","year":"2006","journal-title":"J Infect Dis"},{"issue":"4","key":"pone.0261750.ref047","doi-asserted-by":"crossref","first-page":"e1001017","DOI":"10.1371\/journal.pmed.1001017","article-title":"Effect of pneumococcal conjugate vaccination on serotype-specific carriage and invasive disease in England: a cross-sectional study","volume":"8","author":"S Flasche","year":"2011","journal-title":"PLoS Med"},{"issue":"34","key":"pone.0261750.ref048","doi-asserted-by":"crossref","first-page":"4349","DOI":"10.1016\/j.vaccine.2014.03.017","article-title":"Pneumococcal carriage in children and adults two years after introduction of the thirteen valent pneumococcal conjugate vaccine in England","volume":"32","author":"AJ van Hoek","year":"2014","journal-title":"Vaccine"},{"issue":"39","key":"pone.0261750.ref049","doi-asserted-by":"crossref","first-page":"5242","DOI":"10.1016\/j.vaccine.2017.08.020","article-title":"Pneumococcal vaccination: direct and herd effect on carriage of vaccine types and antibiotic resistance in Icelandic children","volume":"35","author":"S Sigurdsson","year":"2017","journal-title":"Vaccine"},{"issue":"12","key":"pone.0261750.ref050","doi-asserted-by":"crossref","first-page":"e1375","DOI":"10.1016\/S2214-109X(18)30383-8","article-title":"Effect of ten-valent pneumococcal conjugate vaccine introduction on pneumococcal carriage in Fiji: results from four annual cross-sectional carriage surveys","volume":"6","author":"EM Dunne","year":"2018","journal-title":"Lancet Glob Health"},{"issue":"9","key":"pone.0261750.ref051","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1093\/cid\/ciy726","article-title":"Persistence of nasopharyngeal pneumococcal vaccine serotypes and increase of nonvaccine serotypes among vaccinated infants and their mothers 5 years after introduction of pneumococcal conjugate vaccine 13 in the Gambia","volume":"68","author":"E Usuf","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"6","key":"pone.0261750.ref052","doi-asserted-by":"crossref","first-page":"E213","DOI":"10.1016\/S1473-3099(18)30660-1","article-title":"Making sense of differences in pneumococcal serotype replacement","volume":"19","author":"J Lewnard","year":"2019","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"pone.0261750.ref053","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1097\/INF.0000000000001705","article-title":"Direct and indirect effectiveness of the 10-valent pneumococcal conjugate vaccine against carriage in a cluster randomized trial","volume":"36","author":"AA Palmu","year":"2017","journal-title":"Pediatr Infect Dis J"},{"issue":"7","key":"pone.0261750.ref054","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1016\/S2214-109X(14)70224-4","article-title":"Population effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae and non-typeable Haemophilus influenzae in Kilifi, Kenya: findings from cross-sectional carriage studies","volume":"2","author":"LL Hammitt","year":"2014","journal-title":"Lancet Glob Health"},{"issue":"9","key":"pone.0261750.ref055","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1111\/apa.14335","article-title":"A pneumococcal conjugate vaccination programme reduced clinically suspected invasive disease in unvaccinated children","volume":"107","author":"AA Palmu","year":"2018","journal-title":"Acta P\u00e6diatr"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261750","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T18:33:33Z","timestamp":1641407613000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0261750"}},"subtitle":[],"editor":[{"given":"Ray","family":"Borrow","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,5]]},"references-count":55,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0261750","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2022,1,5]]}}}