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Pneumococci produce chains of 1 of 92 immunologically unique polysaccharide subunits that are attached to the surface of the cell wall. The primary method of removing pneumococci from the lung, complement-mediated opsonophagocytosis, is prevented by these polysaccharide chains. An clear early target antigen, the production of this polysaccharide chain is necessary for pneumococcal colonisation and pathogenicity. Due to their high immunogenicity, these polysaccharide subunits cause the production of antibodies that react with the homologous serotype. Continent-to-continent variation in the incidence of specific capsular serotypes results in varying degrees of protection for those who have received the vaccine. As a result, capsular serotypes have been under international surveillance since they were first used as Pneumococcal Vaccines antigens.
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