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. 2022 Dec 7;99(Suppl 1):S46–S56. doi: 10.1016/j.jped.2022.11.003

Figure 1.

Fig 1

Host and environmental factors affecting encapsulated bacteria (including S. pneumoniae) shedding and disease forms. Conjugate vaccines interfere with colonization and disease progression by eliciting robust mucosal immunity (CD4+ Th1/Th17, IgG and IgA) and systemic immunity (CD4+ Th1 and IgG) (developed by the authors, adapted from Supplemental references #60–63). Abbreviations: AOM – acute otitis media; CSF – cerebrospinal fluid.