The nasopharynx is the home to several bacteria that normally live in symbiosis with another but have the capacity to cause disease. Nasopharyngeal acquisition of these bacteria (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis) represents the first step in disease pathogenesis.1,2 Streptococcus pneumoniae is a leading cause of serious disease among children worldwide.3 The effort to identify pneumococcus in the nasopharynx of children with respiratory infection may provide insight of the causative pathogen and appropriate treatment.1,2 Surveillance of pneumococcal colonization in the pediatric population in a community provides an overview of the serotype distribution, antimicrobial susceptibility, and potential impact of pneumococcal conjugate vaccines (PCVs). A repeated surveillance will provide proof of the impact of PCVs on pneumococcal ecology by detecting changes in serotype distribution and antimicrobial susceptibility.4 
Nasopharyngeal carriage study is an important benchmark for pneumococcal disease in countries like Indonesia where etiologic studies are a challenge. A study conducted in 2016 among 302 children aged 1 to 2 years from Bandung, Lombok, and Padang identified 15B/C as the most common serotype among 164 NPC isolates, followed by 23F, NT2 (an acapsular pneumococci), 19F, and 6A; serotypes 19A, and 3 were also detected. Overall, 46.3% of isolates were covered by PCV13, with regional variation in coverage from 36% in Bandung to 58% in Padang.5
A qualitative study conducted in 2011 on knowledge, perceptions, and attitudes of Indonesian mothers and healthcare providers toward PCVs showed that both populations had limited knowledge about PCVs.6 Therefore we, pediatricians, play an important role to increase the awareness of pneumococcal disease and its prevention.