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This suggests that some adults may act as reservoirs of pneumococci and hence, depending on the social structure of a community, the magnitude of herd effects potentially attainable through children vaccination may vary. These findings are important when designing strategies to prevent pneumococcal disease in adults. The pneumococcal carrier state in healthy adults is more dynamic than generally assumed acquisition is frequent and duration of carriage is often long. This suggests that some adults may act as reservoirs of pneumococci and