{"id":14978,"date":"2024-07-01T10:40:00","date_gmt":"2024-07-01T02:40:00","guid":{"rendered":"https:\/\/vaxlab.dukekunshan.edu.cn\/?post_type=evidence-db-expert&p=14978"},"modified":"2025-07-25T14:38:44","modified_gmt":"2025-07-25T06:38:44","slug":"streptococcus-pneumoniae","status":"publish","type":"evidence-db-expert","link":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/evidence-db-expert\/pcv-vaccine-evidence-pool\/streptococcus-pneumoniae\/","title":{"rendered":"Streptococcus Pneumoniae"},"content":{"rendered":"\n

Streptococcus pneumoniae<\/strong> (Spn<\/em>) is a lancet-shaped, Gram-positive, facultative anaerobic bacterium first identified in 18811<\/sup>. It is a major opportunistic pathogen that commonly colonizes the human nasopharynx, with colonization rates ranging from 27% to 65% in children and less than 10% in adults 1,2<\/sup>. Generally, it does not cause disease, depending on host characteristics and changes in the colonization environment1<\/sup>.<\/p>\n\n\n\n

Spn is widely distributed in nature, with humans as its only host. It spreads from person to person, typically through respiratory droplets or by colonizing the upper respiratory tract, with infections more common in winter and early spring1<\/sup>. Although the infectious period of pneumococcal diseases is not well-defined, it is presumed that transmission can occur as long as the pathogen is present in respiratory secretions3<\/sup>.<\/p>\n\n\n\n

Pneumococcal disease (PD)<\/strong> refers to a group of infections caused by Spn, categorized into invasive pneumococcal disease (IPD) and non-invasive pneumococcal disease (NIPD) based on the site of infection4<\/sup>. NIPD is more common but often undiagnosed due to the lack of pathogen testing, whereas IPD, though less frequent, presents more severe symptoms and higher mortality risk5<\/sup>.<\/p>\n\n\n\n

The migration of Spn<\/em> to sterile tissues and organs is the main cause of all pneumococcal diseases6<\/sup>. Spn colonizing the nasopharynx can cause invasive infections if not cleared by the immune system7<\/sup>, leading to conditions like pneumonia, bacteremia, and meningitis.<\/p>\n\n\n\n

Risk factors for IPD include immunosuppression due to disease or medication, functional or anatomical asplenia, chronic heart diseases, lung diseases (including asthma), liver or kidney diseases, smoking, alcoholism, cerebrospinal fluid leaks, cochlear implants, and attending day-care or other preschool childcare settings8<\/sup>.<\/p>\n\n\n\n

Nearly 100 serotypes of Spn are known, most capable of causing disease. Approximately 62% of global IPD cases are attributed to the 10 most common serotypes6<\/sup>. The prevalent serotypes among carriers are also the primary causes of infections. While colonization does not always lead to disease, it is a critical prerequisite for PD9<\/sup>. Different serotypes may preferentially cause various diseases or conditions, such as asymptomatic colonization, meningitis, or pneumonia.<\/p>\n\n\n

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Figure 1 Number of Deaths Among Children Aged 1\u201359 Months Caused by Streptococcus pneumoniae*<\/strong>
Pneumococcal deaths only include the HIV-negative deaths number. WHO\/UNICEF adjusted the vaccine coverage estimates to present the proportion of children aged 1-59 months who have been vaccinated PCV. The Vertical lines indicate uncertainty intervals.
(Source: Wahl, B., O\u2019Brien, K. L., Greenbaum, A., Majumder, A., Liu, L., Chu, Y., \u2026 & Cohen, A. L. (2018). Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000\u201315. The Lancet Global Health, 6(7), e744\u2013e757.\uff09

<\/span><\/i><\/p><\/figcaption><\/figure>\n<\/div>\n\n\n

The distribution of pathogenic Spn serotypes varies by geography, age, and clinical presentation. Globally, the seven most common serotypes in children under five are 1, 5, 6A, 6B, 14, 19F, and 23F, accounting for over half of IPD cases10<\/sup>. A systematic review published in 2010 described the serotype distribution among children under five with IPD worldwide from 1980 to 2007 (Figure 2) 10<\/sup>. In Southeast Asia, the most common serogroups and serotypes among reported IPD cases are serogroup 19 (16.2%), serogroup 6 (14.6%), serogroup 23 (12.5%), serotype 14 (9.2%), serotype 1 (5.7%), and serotype 3 (4.0%)11<\/sup>. In China, a literature review from 1980 to 2008 indicated that serotypes 14, 19A, and 19F were most prevalent among pneumonia and meningitis cases in children under five12<\/sup>. Additionally, studies have found that the common serotypes causing IPD in children in mainland China include 19A, 19F, 14, 23F, and 6B13<\/sup>.<\/p>\n\n\n

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Figure 2 Distribution of Serotypes Covered by PCV Vaccines Before Introduction, by WHO Region and Age Group<\/strong>
(Source: Fletcher, M. A., Daigle, D., Siapka, M., Baay, M., Hanquet, G., & Morales, G. D. C. (2024). Serotype distribution of invasive pneumococcal disease from countries of the WHO Africa, Americas, Eastern Mediterranean, South-East Asia, and Western Pacific regions: A systematic literature review from 2010 to 2021.\u00a0Frontiers in Public Health, 12.\uff09<\/figcaption><\/figure>\n<\/div>\n\n\n
\n

Table 1 Distribution of PCV serotypes after inclusion of different doses of PCV vaccine in the immunization schedule<\/strong><\/p>\n\n\n\n

WHO Region













    AMRO<\/td>		Country\/ Region<\/td>Age Group<\/td>Time Period<\/td>Enrollment Time<\/td>Study ID<\/td>Study Period<\/td>PCV13 Serotypes<\/td>PCV20 Serotypes (excluding PCV13)<\/td>Non-PCV20 Serotypes<\/td>Other Serotypes<\/td>Total Number<\/td><\/tr>
%<\/td>%<\/td>%<\/td>%<\/td>N<\/td><\/tr>
Argentina<\/td>Children<\/td>PCV<\/td>PCV13(2012)<\/td>3860<\/td>2012-2013<\/td>62.7<\/td>11.9<\/td>7.5<\/td>13.4<\/td>67<\/td><\/tr>
 <\/td>2012-2013<\/td>79.4<\/td> <\/td> <\/td>20.6<\/td>563<\/td><\/tr>
1270<\/td>2015-2017<\/td>34.3<\/td>21.0<\/td>32.7<\/td>12.0<\/td>434<\/td><\/tr>
Adults<\/td>PCV-hv<\/td>PCV13(2012)<\/td>1245<\/td>2013-2017<\/td>43.1<\/td>27.6<\/td>4.6<\/td>24.8<\/td>791<\/td><\/tr>
Brazil<\/td>Children<\/td>PCV-hv<\/td>PCV10(2010)<\/td>1828<\/td>2010-2012<\/td>72.0<\/td>9.8<\/td>17.8<\/td>0.3<\/td>325<\/td><\/tr>
450<\/td>2011-2015<\/td>51.6<\/td> <\/td> <\/td>48.4<\/td>62<\/td><\/tr>
1270<\/td>2015-2017<\/td>46.7<\/td>18.1<\/td>29.7<\/td>5.4<\/td>441<\/td><\/tr>
Adults<\/td>PCV-hv<\/td>PCV10(2010)<\/td>197<\/td>2013-2015<\/td>51.0<\/td>23.5<\/td>7.6<\/td> <\/td>02<\/td><\/tr>
All Ages<\/td>PCV-hv<\/td>PCV10(2010)<\/td>748<\/td>2010-2012<\/td>61.6<\/td>14.5<\/td>19.5<\/td>4.4<\/td>159<\/td><\/tr>
121<\/td>2014-2015<\/td>47.5<\/td>19.9<\/td>25.0<\/td>7.4<\/td>1630<\/td><\/tr>
120<\/td>2017-2019<\/td>44.6<\/td>7.2<\/td>36.8<\/td>1.5<\/td>2402<\/td><\/tr>
Chile<\/td>Children<\/td>PCV-hv<\/td>PCV10(2011)<\/td>1127<\/td>2012-2012<\/td>60.4<\/td> <\/td>1.1<\/td>38.5<\/td>91<\/td><\/tr>
1270<\/td>2015-2017<\/td>52.7<\/td>4.6<\/td>28.2<\/td>4.5<\/td>404<\/td><\/tr>
Colombia<\/td>Children<\/td>PCV-hv<\/td>PCV10(2011)<\/td>1270<\/td>2015-2017<\/td>66.8<\/td>4.8<\/td>26.1<\/td>3.1<\/td>352<\/td><\/tr>
Adults Adults<\/td>PCV-hv<\/td>PCV10(2011)<\/td>4034<\/td>2012-2019<\/td>48.1<\/td>4.2<\/td>37.7<\/td> <\/td>310<\/td><\/tr>
All Ages<\/td>PCV-hv<\/td>PCV10(2011)<\/td>3267<\/td>2012-2017<\/td>56.9<\/td>11.4<\/td>31.6<\/td>0.1<\/td>842<\/td><\/tr>
Dominican Republic<\/td>Children<\/td>PCV-hv<\/td>PCV13(2013)<\/td>1270<\/td>2015-2017<\/td>67.2<\/td>3.4<\/td>19.0<\/td>10.3<\/td>58<\/td><\/tr>
All Ages<\/td>PCV-hv<\/td>PCV13(2013)<\/td>3480<\/td>2013-2016<\/td>897<\/td> <\/td> <\/td>10.3<\/td>39<\/td><\/tr>
Mexico<\/td>Children<\/td>PCV-hv<\/td>PCV13(2011)<\/td>270<\/td>2015-2017<\/td>41.2<\/td>18.3<\/td>32.0<\/td>8.5<\/td>153<\/td><\/tr>
Paraguay<\/td>Children<\/td>PCV-hv<\/td>PCV10(2011)<\/td>1270<\/td>2015-2017<\/td>679<\/td>10.1<\/td>13.8<\/td>8.3<\/td>109<\/td><\/tr>
Peru<\/td>Children<\/td>Transitional Period<\/td>PCV7(2009<\/td> <\/td>2009-2011<\/td>84.5<\/td> <\/td>10.3<\/td> <\/td>58<\/td><\/tr>
All Ages<\/td>Transitional Period<\/td>PCV7(2009)<\/td>2136<\/td>2010-2011<\/td>64.6<\/td>15.2<\/td>15.2<\/td>2.5<\/td>79<\/td><\/tr>
Uruguay<\/td>Children<\/td>PCV-hv<\/td>PCV13(2010)<\/td>1270<\/td>2015-2017<\/td>43.7<\/td>9.5<\/td>29.9<\/td>6.9<\/td>87<\/td><\/tr>
All Ages<\/td>PCV-hv<\/td>PCV13(2010)<\/td>348<\/td>2011-2012<\/td>46.1<\/td> <\/td> <\/td>53.9<\/td>356<\/td><\/tr>
Venezuela<\/td>Children<\/td>Hybrid Period<\/td>pre-PCV, PCV13(2014)<\/td>1270<\/td>2006-2017<\/td>90.6<\/td> <\/td> <\/td>9.4<\/td>309<\/td><\/tr>
AFRO<\/td>Burkina Faso<\/td>Children<\/td>PCV-hv<\/td>PCV13(2013)<\/td>
3356<\/td>		2014a<\/sup><\/td>88.0<\/td> <\/td> <\/td>12.0<\/td>25<\/td><\/tr>
2017b<\/sup><\/td>50.0<\/td> <\/td>7.1<\/td>42.9<\/td>14<\/td><\/tr>
All Ages<\/td>PCV-hv<\/td>PCV13(2013)<\/td>2320<\/td>2014-2015<\/td>72.7<\/td>8.1<\/td>3.3<\/td>15.8<\/td>377<\/td><\/tr>
3355<\/td>2016-2017<\/td>56.0<\/td>0.5<\/td>2.0<\/td>41.4<\/td>739<\/td><\/tr>
Cameroon<\/td> <\/td>Hybrid Period<\/td>pre-PCV, PCV13(2011)<\/td>1493<\/td>2010-2016<\/td>55.2<\/td>27.6<\/td>17.2<\/td> <\/td>29<\/td><\/tr>
PCV-hv<\/td>PCV13(2011)<\/td>2536<\/td>2015-2018<\/td>35.8<\/td>17.0<\/td>30.2<\/td>17.0<\/td>53<\/td><\/tr>
Ethiopia<\/td>All Ages<\/td>PCV-hv<\/td>PCV10(2011)<\/td> <\/td>2018-2019<\/td>37.1<\/td>5.7<\/td>28.6<\/td>28.6<\/td>35<\/td><\/tr>
Gambia<\/td>Children<\/td>Hybrid Period<\/td>Pre-PCV, PCV7(2009),
PCV13(2011)<\/td>		2575<\/td>1995-2016<\/td>63.1<\/td>17.7<\/td>19.2<\/td> <\/td>203<\/td><\/tr>
Ghana<\/td>All Ages<\/td>PCV-hv<\/td>PCV13(2012)<\/td>2445<\/td>2015-201<\/td>69.5<\/td>0.2<\/td>3.4<\/td>16.9<\/td>59<\/td><\/tr>
1497<\/td>2015-2017<\/td>71.5<\/td> <\/td> <\/td>28.5<\/td>137<\/td><\/tr>
Kenya<\/td>Children<\/td>PCV-hv<\/td>PCV10(2011)<\/td>400<\/td>2012-2016<\/td>26.8<\/td> <\/td> <\/td>73.2<\/td>82<\/td><\/tr>
Madagascar<\/td>Children<\/td>PCV-hv<\/td>PCV10(2012)<\/td>4041<\/td>2013-2018<\/td>19.5<\/td>1.1<\/td>37.9<\/td>41.4<\/td>87<\/td><\/tr>
Malawi<\/td>Children<\/td>Hybrid Period<\/td>Pre-PCV, PCV13(2011)<\/td>2575<\/td>1995-2016<\/td>73.0<\/td>6.6<\/td>20.4<\/td> <\/td>226<\/td><\/tr>
All Ages<\/td>\u591a\u65f6\u671f<\/td>Pre-PCV, PCV13(2011)<\/td>1407<\/td>2006-2018<\/td>54.5<\/td> <\/td> <\/td>45.5<\/td>1594<\/td><\/tr>
Mozambique<\/td>Children<\/td>PCV-hv<\/td>PCV10(2013)<\/td>785<\/td>2013-2014<\/td>62.0<\/td>2.0<\/td> <\/td>36.0<\/td>50<\/td><\/tr>
2870<\/td>2013-2015<\/td>71.0<\/td> <\/td> <\/td>29.0<\/td>69<\/td><\/tr>
695<\/td>2014-2015<\/td>70.0<\/td>3.3<\/td>20.0<\/td>6.7<\/td>30<\/td><\/tr>
Niger<\/td>All Ages<\/td>PCV-hv<\/td>PCV13(2014)<\/td>2958<\/td>2016-2018<\/td>42.4<\/td>5.3<\/td>4.1<\/td>38.2<\/td>70<\/td><\/tr>
Nigeria<\/td>Children<\/td>Hybrid Period<\/td>Pre-PCV, PCV10(2014)<\/td>1073<\/td>2010-2016<\/td>50.0<\/td> <\/td>3.6<\/td>46.4<\/td>28<\/td><\/tr>
Senegal<\/td>Children<\/td>Hybrid Period<\/td>Pre-PCV, PCV13(2013)<\/td>3365<\/td>2010-2016<\/td>91.4<\/td> <\/td> <\/td>6.9<\/td>58<\/td><\/tr>
South Africa<\/td>Children<\/td>PCV-hv<\/td>PCV13(2011)<\/td>2575<\/td>2013-2014<\/td>28.2<\/td>31.6<\/td>39.9<\/td>0.3<\/td>291<\/td><\/tr>
All Ages<\/td>PCV-hv<\/td>PCV13(2011)<\/td>3614<\/td>2012<\/td>53.6<\/td>20.4<\/td>2.3<\/td>3.9<\/td>1631<\/td><\/tr>
Togo<\/td>Children<\/td>PCV-hv<\/td>PCV13(2014)<\/td>1111<\/td>2014-2016<\/td>60.0<\/td> <\/td> <\/td>40.0<\/td> <\/td><\/tr>
Zambia<\/td>Children<\/td>PCV-hv<\/td>PCV10(2013)<\/td>4033<\/td>2014-2019<\/td>52.0<\/td>2.0<\/td> <\/td> <\/td>50<\/td><\/tr>
\u591a\u56fd<\/td>Children<\/td>Hybrid Period<\/td>Pre-PCV, PCV-hv<\/td>3261<\/td>2010-2016<\/td>33.5<\/td>4.1<\/td> <\/td>62.4<\/td>370<\/td><\/tr>
EMRO<\/td>Kuwait<\/td>All Ages<\/td>PCV-hy<\/td>PCV13(2010)<\/td>2771<\/td>2010-2013<\/td>28.9<\/td>26.7<\/td>33.3<\/td>1.1<\/td>45<\/td><\/tr>
Morocco<\/td>Children<\/td>PCV-hv<\/td>PCV13(2011), PCV10
2012)<\/td>		807<\/td>2011-2014<\/td>95.9<\/td> <\/td> <\/td>4.1<\/td>68<\/td><\/tr>
Oman<\/td>Children<\/td>PCV-hv<\/td>PCV13(2012)<\/td>1290<\/td>2014-2016<\/td>25.7<\/td> <\/td>22.9<\/td>51.4<\/td>35<\/td><\/tr>
Adults<\/td>PCV-hv<\/td>PCV13(2012)<\/td>1290<\/td>2014-2016<\/td>40.0<\/td> <\/td>3.3<\/td>51.7<\/td>60<\/td><\/tr>
All Ages<\/td>PCV-hv<\/td>PCV13(2012)<\/td>1290<\/td>2014-2016<\/td>32.4<\/td> <\/td>8.1<\/td>59.5<\/td>37<\/td><\/tr>
Pakistan<\/td>Children<\/td>PCV-hv<\/td>PCV10(2012)<\/td>916<\/td>2013-2017<\/td>21.7<\/td> <\/td> <\/td>78.3<\/td>92<\/td><\/tr>
All Ages<\/td>Hybrid Period<\/td>Pre-PCV, PCV10(2012)<\/td>3275<\/td>2005-2013<\/td>42.3<\/td>5.4<\/td>14.4<\/td>37.8<\/td>111<\/td><\/tr>
  Qatar  <\/td>All Ages<\/td>Transitional Period<\/td>PCV7(2005)<\/td>302<\/td>2005-2009<\/td>77.9<\/td>7.4<\/td>12.3<\/td>2.5<\/td>122<\/td><\/tr>
Saudi Arabia<\/td>Children<\/td>Hybrid Period<\/td>PCV7(2009), PCV13
(2010)<\/td>		19<\/td>2009-2012<\/td>84.6<\/td>2.6<\/td>6.4<\/td>6.4<\/td>78<\/td><\/tr>
All Ages<\/td>Hybrid Period<\/td>Pre-PCV, PCV7(2009),
PCV13(2010)<\/td>		2772<\/td>2000-2016<\/td>91.7<\/td>7.9<\/td>9.0<\/td>8.7<\/td>277<\/td><\/tr>
WPRO<\/td>Cambodia<\/td>Children<\/td>Hybrid Period<\/td>Pre-PCV, PCV13(2015)<\/td>3514<\/td>2012-2018<\/td>86.4<\/td> <\/td>13.6<\/td> <\/td>22<\/td><\/tr>

Singapore<\/td>		Adults<\/td>PCV-hv<\/td>PCV13(2011)<\/td>554<\/td>2012-2017<\/td>71.4<\/td>1.1<\/td>12.7<\/td> <\/td> <\/td><\/tr>
All Ages<\/td>Transitional Period<\/td>Pre-PCV, PCV13(2011)<\/td>689<\/td>1997-2013<\/td>70.5<\/td>7.4<\/td>16.9<\/td>5.2<\/td>757<\/td><\/tr>
Taiwan, China<\/td>Children<\/td>Transitional Period<\/td>PCV7(2005)\/PCV13
(2015) c<\/sup><\/td>		191<\/td>2013-2014<\/td>80.5<\/td>5.5<\/td>13.9<\/td> <\/td>36<\/td><\/tr>
PCV-hv<\/td>PCV13(2015)<\/td>2590<\/td>2015-2017<\/td>39.0<\/td>9.3<\/td>51.7<\/td> <\/td>205<\/td><\/tr>
Adults<\/td>Hybrid Period<\/td>PCV7(2005)\/PCV13
2015) c<\/sup><\/td>		599<\/td>2011-2015<\/td>66.0<\/td>1.3<\/td>18.0<\/td>4.7<\/td>50<\/td><\/tr>
PCV-hv<\/td>PCV13(2015)<\/td>189<\/td>2017-2020<\/td>44.7<\/td>9.7<\/td>41.8<\/td>3.8<\/td>237<\/td><\/tr>
All Ages<\/td>Transitional Period<\/td>PCV7(2005)\/PCV13
(2015) c<\/sup><\/td>		3399<\/td>2012-2014<\/td>76.9<\/td>7.7<\/td>15.4<\/td>1.0<\/td>104<\/td><\/tr>
Hybrid Period<\/td>PCV7(2005)\/PCV13
2015) c<\/sup>, PCV13(2015)<\/td>		182<\/td>2013-2017<\/td>57.8<\/td>17.5<\/td>23.8<\/td>1.0<\/td>206<\/td><\/tr>
PCV-hv<\/td>PCV13(2015)<\/td>3702<\/td>2016-2018<\/td>44.4<\/td>16.2<\/td>33.3<\/td>6.1<\/td>99<\/td><\/tr>
 <\/td><\/tr>
PCV13: Serotypes covered by both PCV7 and PCV13: 4, 6B, 9V, 14, 19F, 18C, 23; Serotypes additionally covered by PCV13 compared to PCV7: 1, 5, 7F, 3, 6A, 6A\/6B, 19A PCV20: PCV20\uff0822F, 33F, 8, 10A, 11A, 12F, 15B, 15C, 15B\/C, 15B\/15C\uff09. Non-PCV20: Refers to serotypes specific to PPSV23 (2, 9N, 17F, 20, 20A, 20B) and NVST. Non-vaccine serotypes: Indistinguishable, unrecognizable serotypes. PCV-hv: Higher valent PCV vaccination period. For example: PCV10 or PCV13 as the latest vaccine applied in the national immunization schedule. *Data extracted from percentage numbers, the sum of percentages may not always equal 100%. a <\/sup>Hounde and Kaya Region. b <\/sup>Titao Region. c<\/sup> catch-up vaccination for older children (Source\uff1aFletcher, M. A., Daigle, D., Siapka, M., Baay, M., Hanquet, G., & Morales, G. D. C. (2024). Serotype distribution of invasive pneumococcal disease from countries of the WHO Africa, Americas, Eastern Mediterranean, South-East Asia, and Western Pacific regions: A systematic literature review from 2010 to 2021. Frontiers in Public Health, 12.\uff09  <\/td><\/tr><\/tbody><\/table><\/figure>\n<\/div>\n\n\n\n

Currently available pneumococcal vaccines include the pneumococcal polysaccharide vaccine (PPV) and the pneumococcal conjugate vaccine (PCV), which cover the most common serotypes causing PD. The serotypes covered vary among different vaccines (Figure 3).<\/p>\n\n\n

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Figure 3 \u00a0Serotypes Covered by Pneumococcal-Related Vaccines<\/strong>
Source: Liu, X., & Chen, M. (2022). Carbohydrate-based vaccines of Streptococcus pneumoniae<\/em>. Acta Microbiologica Sinica<\/em>, 62<\/em>(2), 446\u2013457.<\/figcaption><\/figure>\n<\/div>\n\n\n

Content Editor: Tianyi Deng, Ziqi Liu<\/p>\n\n\n\n

Page Editor: Ziqi Liu<\/p>\n\n\n\n

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References<\/strong><\/p>\n\n\n\n

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  13. Men, W., Dong, Q., Shi, W. et al. Serotype distribution and antimicrobial resistance patterns of invasive pneumococcal disease isolates from children in mainland China\u2014a systematic review. Braz J Microbiol.2020,51(2): 665\u2013672. https:\/\/doi.org\/10.1007\/s42770-019-00198-9<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Streptococcus pneumoniae (Spn) is a lancet-shaped, Gram-positive, facultative anaerobic bacterium first identified in 18811. It is a major opportunistic pathogen that commonly colonizes the human nasopharynx, with colonization rates ranging from 27% to 65% in children and less than 10% in adults 1,2. Generally, it does not cause disease, depending on host characteristics and changes in […]<\/p>\n","protected":false},"author":13,"featured_media":0,"parent":12981,"menu_order":1,"template":"","format":"standard","meta":{"articles_list_all":"","type_label":"none_selected"},"evidence-tag-expert":[120],"class_list":["post-14978","evidence-db-expert","type-evidence-db-expert","status-publish","format-standard","hentry","evidence-tag-expert-pcv"],"_links":{"self":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/evidence-db-expert\/14978","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/evidence-db-expert"}],"about":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/types\/evidence-db-expert"}],"author":[{"embeddable":true,"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/users\/13"}],"up":[{"embeddable":true,"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/evidence-db-expert\/12981"}],"wp:attachment":[{"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/media?parent=14978"}],"wp:term":[{"taxonomy":"evidence-tag-expert","embeddable":true,"href":"https:\/\/vaxlab.dukekunshan.edu.cn\/en\/wp-json\/wp\/v2\/evidence-tag-expert?post=14978"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}