Bacterial Vaccines and Serotype Replacement: Lessons from Haemophilus influenzae and Prospects for Streptococcus pneumoniae
Figure 3. Two hypotheses explain the observation of higher rates of carriage of nonvaccine serotypes in vaccine recipients than in controls. Large circles represent plated samples from controls (top) andvaccine recipients (bottom). The left side shows true serotype replacement; here a control carries vaccine types (white colonies), while a vaccine recipient does not, and (possibly as a result of decreased competition) now carries only nonvaccine types (black colonies). The right side shows the unmasking phenomenon, which is an artifact of sampling. Here, both vaccinees and controls carry nonvaccine types, but because only one colony is sampled in each, the vaccinee does not appear to carry nonvaccine types.