Distribution of piliated Streptococcus pneumoniae by serotype. The histograms show the frequency of type I piliated (black), type II piliated (gray), nonpiliated (white), and both type I and type II piliated (striped) isolates in our collection, stratified by serotypes. The PCV13 vaccine contains polysaccharides of the capsular antigens of Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F, individually conjugated to a nontoxic diphtheria CRM197 carrier protein. Serotypes included in the PCV13 are marked with a black dot (●), while those cross protected are indicated with a triangle (△). The PCV13 vaccine provides coverage for piliated invasive pneumococci in Malawi.