Yang, YangyupeiYangyupeiYangKnoll, Maria DeloriaMaria DeloriaKnollHerbert, CarlyCarlyHerbertBennett, Julia CJulia CBennettFeikin, Daniel RDaniel RFeikinQuesada, Maria GarciaMaria GarciaQuesadaHetrich, Marissa KMarissa KHetrichZeger, Scott LScott LZegerKagucia, Eunice WEunice WKaguciaXiao, MelodyMelodyXiaoCohen, Adam LAdam LCohenvan der Linden, MarkMarkvan der Lindendu Plessis, MignonMignondu PlessisYildirim, InciInciYildirimWinje, Brita ABrita AWinjeVaron, EmmanuelleEmmanuelleVaronValenzuela, Maria TeresaMaria TeresaValenzuelaValentiner-Branth, PallePalleValentiner-BranthSteens, AnnekeAnnekeSteensScott, J AnthonyJ AnthonyScottSavrasova, LarisaLarisaSavrasovaSanz, Juan CarlosJuan CarlosSanzKhan, Aalisha SahuAalisha SahuKhanOishi, KazunoriKazunoriOishiNzoyikorera, NéhémieNéhémieNzoyikoreraNuorti, J PekkaJ PekkaNuortiMereckiene, JolitaJolitaMereckieneMcMahon, KimberleyKimberleyMcMahonMcGeer, AllisonAllisonMcGeerMackenzie, Grant AGrant AMackenzieMacDonald, LauraLauraMacDonaldLadhani, Shamez NShamez NLadhaniKristinsson, Karl GKarl GKristinssonKleynhans, JackieJackieKleynhansKellner, James DJames DKellnerJayasinghe, SanjaySanjayJayasingheHo, Pak-LeungPak-LeungHoHilty, MarkusMarkusHilty0000-0002-2418-6474Hammitt, Laura LLaura LHammittGuevara, MarcelaMarcelaGuevaraGilkison, CharlotteCharlotteGilkisonGierke, RyanRyanGierkeDesmet, StefanieStefanieDesmetDe Wals, PhilippePhilippeDe WalsDagan, RonRonDaganColzani, EdoardoEdoardoColzaniCiruela, PilarPilarCiruelaChuluunbat, UrtnasanUrtnasanChuluunbatChan, GuanhaoGuanhaoChanCamilli, RominaRominaCamilliBruce, Michael GMichael GBruceBrandileone, Maria-Cristina CMaria-Cristina CBrandileoneAmpofo, KrowKrowAmpofoO'Brien, Katherine LKatherine LO'BrienHayford, KylaKylaHayford2025-02-112025-02-112025-03https://boris-portal.unibe.ch/handle/20.500.12422/204603Background Pneumococcal conjugate vaccines (PCVs) introduced in childhood national immunization programs lowered vaccine-type invasive pneumococcal disease (IPD), but replacement with non-vaccine-types persisted throughout the PCV10/13 follow-up period. We assessed PCV10/13 impact on pneumococcal meningitis incidence globally.Methods The number of cases with serotyped pneumococci detected in cerebrospinal fluid and population denominators were obtained from surveillance sites globally. Site-specific meningitis incidence rate ratios (IRRs) comparing pre-PCV incidence to each year post-PCV10/13 were estimated by age (<5, 5-17 and ≥18 years) using Bayesian multi-level mixed effects Poisson regression, accounting for pre-PCV trends. All-site weighted average IRRs were estimated using linear mixed-effects regression stratified by age, product (PCV10 or PCV13) and prior PCV7 impact (none, moderate, or substantial). Changes in pneumococcal meningitis incidence were estimated overall and for product-specific vaccine-types and non-PCV13-types.Results Analyses included 10,168 cases <5y from PCV13 sites and 2,849 from PCV10 sites, 3,711 and 1,549 for 5-17y and 29,187 and 5,653 for ≥18y from 42 surveillance sites (30 PCV13, 12 PCV10, 2 PCV10/13) in 30 countries, primarily high-income (84%). Six years after PCV10/PCV13 introduction, pneumococcal meningitis declined 4874% across products and PCV7 impact strata for children <5y, 3562% for 5-17y and 036% for ≥18y. Impact against PCV10-types at PCV10 sites, and PCV13-types at PCV13 sites was high for all age groups (<5y: 96100%; 5-17y: 7785%; ≥18y: 7385%). After switching from PCV7 to PCV10/13, increases in non-PCV13-types were generally low to none for all age groups.Conclusion Pneumococcal meningitis declined in all age groups following PCV10/PCV13 introduction. Plateaus in non-PCV13-type meningitis suggest less replacement than for all IPD. Data from meningitis belt and high-burden settings were limited.enIncidenceindirect protectionpneumococcal conjugate vaccinespneumococcal meningitisserotype replacementserotypesvaccine impact600 - Technology::610 - Medicine & healtharticle10.48620/853053986452610.1016/j.jinf.2025.106426