Three Cases of Invasive Pneumococcal Disease with Multiple Serotype Replacement in Vaccinated Children

Despite having undergone mandatory PCV7 vaccinations, three young children were hospitalized with invasive pneumococcal infections. Among them, two cases were diagnosed as having meningitis and one had bacteremia. Serotype ‘15A’ in one meningitis case was outside the range covered by PCV7 and PCV13 vaccinations, and that case was fatal. Voluntary PCV13 vaccination has been in place in Japan since autumn 2013; however, serotype replacement with uncovered serotypes is a possibility that physicians should consider.