The vaccination status of all children was known; 37 had not been vaccinated against IPD. A conjugated pneumococcal vaccine had been administered to 11 children prior to IPD; seven children received PCV7 and four received PCV13. In those who received PCV7, two children suffered from serotype 19A, a 4-year-old female who received one dose of PCV7 suffered from serotype 6A, and in four children, the serotypes were unknown. Of those who received PCV13, a 2-year-old female who received one dose of PCV13 suffered from serotype 6B, a 2-year-old male who received one dose of PCV13 suffered from serotype 19A, one child suffered from a non-typeable type, and in one child, the serotype was unknown. In the meningitis group, no patient had received a pneumococcal conjugated vaccine. However, at least 60 % of serotypes of the patients with meningitis were covered by PCV13The symptoms and signs of IPD are related to host immunity, S. pneumoniae virulence, and the site of infection [1]. Early recognition and prompt diagnosis remain challenges. There have been few studies analyzing the early clinical presentation in severe IPD in children since the introduction of PCV7 in Taiwan. We designed this study to characterize the clinical features and outcomes of IPD in a pediatric intensive care unit (PICU) under partial PCV immunization.