Serotype 19A and 6C account for one third of pneumococcal carriage among Belgian day-care children four years after a shift to a lower-valent PCV.

The switch to a PCV-programme no longer covering serotypes 19A, 6A and 3 was associated with sustained increase of serotypes 19A and 6C in healthy children, similarly as in IPD. This resulted in a re-introduction of the 13-valent conjugate vaccine during the summer of 2019.