Disappearance of vaccine-type invasive pneumococcal disease and emergence of serotype 19A in a minority population with a high prevalence of human immunodeficiency virus and low childhood immunization rates.

We analyzed the epidemiology of invasive pneumococcal disease (IPD) following introduction of pneumococcal conjugated vaccine in an urban population with a 2% human immunodeficiency virus (HIV) prevalence and history of low childhood immunization rates. We observed near-elimination of vaccine-type IPD. Substantial disease remains due to non-vaccine-type pneumococci, highlighting the need to increase pneumococcal immunization among HIV-infected adults.