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A Streptococcus pneumoniae serotype 4 outbreak in a North Carolina correctional facility resulted in 14 cases (8 suspected, 1 probable, and 5 confirmed). After implementation of movement restrictions and vaccination with 23-valent pneumococcal polysaccharide vaccine, new cases ceased. Serotype 4 presence in this setting raises challenges for an effective vaccination strategy.
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Gowler et al. (2026) studied this question.
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