We conducted statistical analysis using SPSS Statistics 25.0 software for Windows (https://www.ibm.com/analytics/spss-statistics-software); p<0.05 was considered statistically significant. We analyzed data from active surveillance during 2009–2017 by epidemiologic years, July through June. We calculated prevalence rate ratios (RRs) with 95% CIs, comparing VT13, VT20–13, and NVT20 proportions in late PCV13 (2015–2017) versus early PCV (2009–2011) periods. Prevalence RRs were adjusted for age and ethnicity (Table 1; Figure 2).

*Values are percentage of total pneumococcal isolates except as indicated. Epi, epidemiological; IPD, invasive pneumococcal disease; LRTI, lower respiratory tract infection; ND, no data; NVT20, serotypes not included in PCV20; PRR, prevalence rate ratio; VT13, serotypes included in 13-valent conjugate pneumococcal vaccine (PCV13); VT20-13, additional 20-valent PCV (PCV20) serotypes, not included in PCV13.
†2015–2017 vs. 2009–11.
‡Data from 2009–2011 not available.

Prevalence rate ratios of pneumococcal VT13, VT20–13, and NVT20 of all pneumococcal isolates in carriage, conjunctivitis, OM, and IPD in children <24 months of age, Israel, comparing the late PCV13 period (2015–2017) to the early PCV period (2009–2011). The comparison could not be done for carriage in healthy children due to the nonavailability of data for the early PCV period. p<0.05 for all comparisons. Error bars indicate 95% CIs. IPD, invasive pneumococcal disease; LRTI, lower respiratory tract infection; NVT, nonvaccine serotype; OM, otitis media; PCV, pneumococcal conjugate vaccine; PCV13, 13-valent PCV; VT, vaccine serotype.

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