Emerging Streptococcus pneumoniae Strains Colonizing the Nasopharynx in Children After 13-valent Pneumococcal Conjugate Vaccination in Comparison to the 7-valent Era, 2006–2015

Background:After introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States in 2000, emergence of replacement serotypes occurred, leading to the introduction of a 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 that contained all PCV7 serotypes plus 6 additional