The fundamental link between pneumococcal carriage and disease

Birgit Simell, Kari Auranen, Helena Käyhty, David Goldblatt, Ron Dagan, Katherine L. O'Brien

Research output: Contribution to journalReview articlepeer-review

469 Scopus citations


Streptococcus pneumoniae (pneumococcus) is a major cause of worldwide mortality and morbidity, and to a large extent is vaccine-preventable. Nasopharyngeal carriage of pneumococcus precedes disease and is the source of pneumococcal spread between people. The use of vaccine effect on carriage as part of the vaccine licensure and post-vaccine introduction evaluation could facilitate and expand the licensure of new, life-saving pneumococcal vaccines and enable a comprehensive estimate of population effects after vaccine introduction. The authors provide a review of the evidence supporting pneumococcal carriage at the individual level as an immediate and necessary precursor to pneumococcal disease. Based on such a causal link between carriage and disease, the authors emphasize the role of information on pneumococcal carriage in vaccine trials and in public health decision-making.

Original languageEnglish
Pages (from-to)841-855
Number of pages15
JournalExpert Review of Vaccines
Issue number7
StatePublished - 1 Jul 2012


  • herd immunity
  • invasive pneumococcal disease
  • pneumococcal carriage
  • pneumococcal colonization
  • pneumococcal vaccine licensure
  • pneumococcal vaccines
  • pneumococcus
  • vaccine effect on colonization

ASJC Scopus subject areas

  • Immunology
  • Molecular Medicine
  • Pharmacology
  • Drug Discovery


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