 In Nepal, invasive pneumococcal disease IPD is responsible for a substantial disease burden in children. Surveillance conducted since 2005 at Patan Hospital, Kathmandu indicates the majority of IPD is due to serotypes 1, 5 and 14, and that the greater proportion occurs in late infancy and toddlerhood.7 Vaccine introduction began in January 2015 with PCV10. GAVI has funded an impact assessment programme including IPD, pneumonia, NP colonization and health economics, which is underway. 