Abstract
It all used to seem so simple with conjugate vaccines. You added them to your infant schedule and, faster than anyone had dared to hope, the disease more or less vanished.1, 2 Not only did immunisation protect against invasive disease but it reduced upper respiratory carriage rates too,3 so there was herd immunity. Even when odd, unexpected mixing problems cropped up out of the blue—like acellular pertussis and Haemophilus influenzae type b (Hib) combinations4, 5—it didn’t really seem to matter.6 In 1999 we watched as meningococcus group C (MenC) set off down the path to oblivion7, 8 previously trod by Hib in 1992.9

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