The heptavalent pneumococcal conjugate vaccine: lights and shades?

The heptavalent pneumococcal conjugate vaccine has proved a high efficacy, not only to reduce the incidence of invasive pneumococcal disease in children, but also in the decrease of resistance to antibiotics and nasopharyngeal colonization, which affects older age groups. The publication of papers that show an increase of isolates of non-vaccine serotypes, mainly 19A, but with an impact on the disease still unimportant, casts shadows in the above picture of success vaccine. We propose a review of recent literature with the aim of providing an overview of both the current vaccine, as well as the potential disputes.