Regional Differences in the Epidemiology of Invasive Pneumococcal Disease in Toddlers in Germany

In a population-based study, regional differences in incidence, serotype distribution and resistance rates in invasive pneumococcal disease in 1-2-year-old children were related to different day care attendance rates. Day-care attendance appears to be a relevant risk factor in some German states and should be considered for inclusion in the recommendations for pneumococcal vaccination of children at risk.