About 75% of cases of invasive pneumococcal disease and 83% of cases of pneumococcal meningitis occur in children < 2 years of age. It is difficult to determine the proportion of pneumonia due to S. pneumoniae. Cross-sectional point prevalence of nasopharyngeal carriage ranges from 27% to 85%, with higher carriage rates in LMICs and in some indigenous populations in HICs. At least 34% of radiologically confirmed pneumonia could be caused by S. pneumoniae in children < 5 years of age.
Available microbiological, epidemiological and modelled data indicate that there is also a substantial burden of disease attributable to S. pneumoniae in adults ≥50 years of age. Go to footnote 1 Go to footnote 2, Go to footnote 3 The risk of sequelae is 3 times higher in Africa and Asia than in Europe. Go to footnote 4
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World Health Organization (2019). Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper – February 2019. Wkly Epidemiol Rec. 94(8):85–104 (https://iris.who.int/bitstream/handle/10665/310968/WER9408.pdf?sequence=1, accessed 4 August 2025).
- Go back to footnote reference 2
Wahl B, O’Brien KL, Greenbaum A, Majumder A, Liu L et al. (2018). Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000–15. Lancet Glob Health. 6(7):e744–e757. doi: 10.1016/S2214-109X(18)30247-X.
- Go back to footnote reference 3
World Health Organization (2021). Considerations for pneumococcal vaccination in older adults: concept note. Wkly Epidemiol Rec. 23:217–228.
- Go back to footnote reference 4
Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK et al. (2010). Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis. 10(5):317–328. doi: 10.1016/S1473-3099(10)70048-7
