A prospective surveillance was conducted in children <5 years in southern Israel.
We assessed the impact of PCV7/PCV13 sequential introduction on the dynamics of serotypes 6C/6D.
PCV introduction resulted in decreased carriage rates and conjunctivitis caused by 6C/6D.
Incidences of 6C/6D decreased in otitis media and dropped to zero in IPD in the PCV13 era.
We conclude that 6C/6D do not act as replacement serotypes for 6A/6B following PCV13 vaccination.