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Article History

Received: 18 February 2026

Accepted: 7 July 2026

First Online: 27 August 2026

Declarations

Ethics approval and consent to participate: Not applicable.

Consent for publication: Not applicable.

Competing interests: Muloongo Simuzingili, Nicole Cossrow, Zinan Yi, Kelly D. Johnson and Kwame Owusu-Edusei are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and may hold stock or stock options in Merck & Co., Inc., Rahway, NJ, USA. Silva Fernández-Soberón is an employee of MSD Spain USA and may hold stock or stock options in Merck & Co., Inc., Rahway, NJ, USA. PCV21 (Capvaxive) was developed by Merck & Co., Inc., Rahway, NJ, USA. PCV21 (Capvaxive) was developed by Merck & Co., Inc., Rahway, NJ, USA.

: PCV21 (Capvaxive) was developed by Merck & Co., Inc., Rahway, NJ, USA.

: The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in – or financial conflict with – the subject matter or materials discussed in this manuscript apart from those disclosed herewith.

: Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.