<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03835975</url>
  </required_header>
  <id_info>
    <org_study_id>B7471006</org_study_id>
    <secondary_id>2018-004278-91</secondary_id>
    <nct_id>NCT03835975</nct_id>
  </id_info>
  <brief_title>Trial to Evaluate the Safety and Immunogenicity of a 20-Valent Pneumococcal Vaccine in Adults 65 Years of Age or Older With Prior Pneumococcal Vaccination</brief_title>
  <official_title>A PHASE 3, RANDOMIZED, OPEN-LABEL TRIAL TO EVALUATE THE SAFETY AND IMMUNOGENICITY OF A 20-VALENT PNEUMOCOCCAL CONJUGATE VACCINE IN ADULTS ≥65 YEARS OF AGE WITH PRIOR PNEUMOCOCCAL VACCINATION</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Pfizer</agency>
      <agency_class>Industry</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Pfizer</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>Yes</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      This Phase 3 will describe the safety and immunogenicity of a 20-valent pneumococcal&#xD;
      conjugate vaccine formulation in adults 65 years of age or older with prior pneumococcal&#xD;
      vaccination&#xD;
    </textblock>
  </brief_summary>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">February 12, 2019</start_date>
  <completion_date type="Actual">February 12, 2020</completion_date>
  <primary_completion_date type="Actual">February 12, 2020</primary_completion_date>
  <phase>Phase 3</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Prevention</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Percentage of Participants With Local Reactions Within 10 Days After Vaccination</measure>
    <time_frame>Within 10 days after vaccination</time_frame>
    <description>Local reactions were recorded using an electronic diary (e-diary). Local reactions included redness, swelling and pain at the injection site. Redness and swelling were measured and recorded in measuring device units. 1 measuring device unit =0.5 centimeter (cm). Redness and swelling were graded as mild (greater than [&gt;] 2.0 to 5.0 cm), moderate (&gt;5.0 to 10.0 cm) and severe (&gt;10.0 cm). Pain at injection site was graded as mild (did not interfere with activity), moderate (interfered with activity), and severe (prevented daily activity).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Percentage of Participants With Systemic Events Within 7 Days After Vaccination</measure>
    <time_frame>Within 7 days after vaccination</time_frame>
    <description>Systemic events fever, fatigue, headache, muscle pain and joint pain were recorded by using an e-diary. Fever was defined as temperature &gt;=38.0 degree Celsius (C) and categorized to &gt;=38.0 to 38.4 degree C, &gt;38.4 to 38.9 degree C, &gt;38.9 to 40.0 degree C and &gt;40.0 degree C. Fatigue, headache, muscle pain and joint pain were graded as mild (did not interfere with activity), moderate (some interference with activity) and severe (prevented daily routine activity).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Percentage of Participants With Adverse Events (AEs) Within 1 Month After Vaccination</measure>
    <time_frame>Within 1 month after vaccination</time_frame>
    <description>An AE was any untoward medical occurrence in study participants who received study vaccine without regard to possibility of causal relationship with the treatment.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Percentage of Participants With Serious Adverse Events (SAEs) Within 6 Months After Vaccination</measure>
    <time_frame>Within 6 months after vaccination</time_frame>
    <description>An SAE was any untoward medical occurrence at any dose that results in death; is life-threatening (immediate risk of death); requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); results in congenital anomaly/birth defect or that is considered to be an important medical event.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Percentage of Participants With Newly Diagnosed Chronic Medical Conditions (NDCMCs) Within 6 Months After Vaccination</measure>
    <time_frame>Within 6 months after vaccination</time_frame>
    <description>An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or was otherwise long-lasting in its effects.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Pneumococcal Opsonophagocytic Activity (OPA) Geometric Mean Titers (GMTs) at 1 Month After Vaccination</measure>
    <time_frame>1 month after vaccination</time_frame>
    <description>OPA GMTs were determined for serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F. OPA titer was expressed as reciprocal of the highest serum dilution.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Pneumococcal OPA Geometric Mean Fold Rise (GMFR) From Before Vaccination to 1 Month After Vaccination</measure>
    <time_frame>From before vaccination to 1 month after vaccination</time_frame>
    <description>OPA GMFR is the ratio of OPA GMTs, 1 month after vaccination to before vaccination. OPA GMFRs from before to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants With &gt;=4-Fold Rise in Pneumococcal OPA Titers From Before Vaccination to 1 Month After Vaccination</measure>
    <time_frame>From before vaccination to 1 month after vaccination</time_frame>
    <description>Percentage of participants with a &gt;=4-fold rise in pneumococcal OPA titers from before vaccination to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants With Pneumococcal OPA Titers &gt;=Lower Limit of Quantitation (LLOQ) at 1 Month After Vaccination</measure>
    <time_frame>1 month after vaccination</time_frame>
    <description>The percentage of participants with OPA titers &gt;=LLOQ at 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
  </secondary_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Actual">875</enrollment>
  <condition>Pneumococcal Disease</condition>
  <arm_group>
    <arm_group_label>13vPnC</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Pneumococcal conjugate vaccine</description>
  </arm_group>
  <arm_group>
    <arm_group_label>PPSV23</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Pneumococcal polysaccharide vaccine</description>
  </arm_group>
  <arm_group>
    <arm_group_label>20vPnC</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Pneumococcal conjugate vaccine</description>
  </arm_group>
  <intervention>
    <intervention_type>Biological</intervention_type>
    <intervention_name>13vPnC</intervention_name>
    <description>Pneumococcal conjugate vaccine</description>
    <arm_group_label>13vPnC</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Biological</intervention_type>
    <intervention_name>PPSV23</intervention_name>
    <description>Pneumococcal polysaccharide vaccine</description>
    <arm_group_label>PPSV23</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Biological</intervention_type>
    <intervention_name>20vPnC</intervention_name>
    <description>Pneumococcal conjugate vaccine</description>
    <arm_group_label>20vPnC</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria&#xD;
&#xD;
          1. Male or female adults 65 years of age or greater.&#xD;
&#xD;
          2. Adults determined by clinical assessment, including medical history and clinical&#xD;
             judgment, to be eligible for the study, including adults with preexisting stable&#xD;
             disease, defined as disease not requiring significant change in therapy in the&#xD;
             previous 6 weeks or hospitalization for worsening disease within 12 weeks before&#xD;
             receipt of investigational product.&#xD;
&#xD;
          3. Female subject of nonchildbearing potential; male subject not able to father children&#xD;
             or who is able to father children and willing to use a highly effective method of&#xD;
             contraception.&#xD;
&#xD;
          4. Male or female adults who meet 1 of the following:&#xD;
&#xD;
               1. Vaccination with PPSV23 greater than or equal to 1 year and less than or equal to&#xD;
                  5 years prior to vaccination in the study, and no prior 13vPnC vaccination&#xD;
                  (Cohort A).&#xD;
&#xD;
               2. Vaccination with 13vPnC greater than or equal to 6 months prior to vaccination in&#xD;
                  the study, and no prior PPSV23 vaccination (Cohort B).&#xD;
&#xD;
               3. Vaccination with 13vPnC followed by PPSV23 (PPSV23 vaccination greater than or&#xD;
                  equal to 1 year prior to vaccination in the study) (Cohort C).&#xD;
&#xD;
        Exclusion Criteria&#xD;
&#xD;
          1. Serious chronic disorder including metastatic malignancy, severe chronic obstructive&#xD;
             pulmonary disease (COPD) requiring supplemental oxygen, end-stage renal disease with&#xD;
             or without dialysis, clinically unstable cardiac disease, or any other disorder that,&#xD;
             in the investigator's opinion, excludes the subject from participating in the study.&#xD;
&#xD;
          2. History of microbiologically proven invasive disease caused by S pneumoniae.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>65 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Pfizer CT.gov Call Center</last_name>
    <role>Study Director</role>
    <affiliation>Pfizer</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Coastal Clinical Research, Inc.</name>
      <address>
        <city>Mobile</city>
        <state>Alabama</state>
        <zip>36608</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>East Valley Gastroenterology and Hepatology Associates</name>
      <address>
        <city>Chandler</city>
        <state>Arizona</state>
        <zip>85224</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>The Pain Center of Arizona</name>
      <address>
        <city>Peoria</city>
        <state>Arizona</state>
        <zip>85381</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>HOPE Research Institute</name>
      <address>
        <city>Phoenix</city>
        <state>Arizona</state>
        <zip>85018</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>The Pain Center of Arizona</name>
      <address>
        <city>Phoenix</city>
        <state>Arizona</state>
        <zip>85018</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Anaheim Clinical Trials, LLC</name>
      <address>
        <city>Anaheim</city>
        <state>California</state>
        <zip>92801</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Diablo Clinical Research, Inc.</name>
      <address>
        <city>Walnut Creek</city>
        <state>California</state>
        <zip>94598</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinical Research Consulting, LLC</name>
      <address>
        <city>Milford</city>
        <state>Connecticut</state>
        <zip>06460</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Optimal Research, LLC</name>
      <address>
        <city>Melbourne</city>
        <state>Florida</state>
        <zip>32934</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Synexus Clinical Research US, Inc</name>
      <address>
        <city>The Villages</city>
        <state>Florida</state>
        <zip>32162</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Meridian Clinical Research, LLC</name>
      <address>
        <city>Savannah</city>
        <state>Georgia</state>
        <zip>31406</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinical Research Atlanta</name>
      <address>
        <city>Stockbridge</city>
        <state>Georgia</state>
        <zip>30281</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>East-West Medical Research Institute</name>
      <address>
        <city>Honolulu</city>
        <state>Hawaii</state>
        <zip>96814</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Heartland Research Associates, LLC</name>
      <address>
        <city>Wichita</city>
        <state>Kansas</state>
        <zip>67205</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Heartland Research Associates, LLC</name>
      <address>
        <city>Wichita</city>
        <state>Kansas</state>
        <zip>67207</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MedPharmics, LLC</name>
      <address>
        <city>Metairie</city>
        <state>Louisiana</state>
        <zip>70006</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Meridian Clinical Research, LLC</name>
      <address>
        <city>Rockville</city>
        <state>Maryland</state>
        <zip>20854</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Meridian Clinical Research, LLC</name>
      <address>
        <city>Norfolk</city>
        <state>Nebraska</state>
        <zip>68701</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MedPharmics, LLC</name>
      <address>
        <city>Albuquerque</city>
        <state>New Mexico</state>
        <zip>87102</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Carolina Institute for Clinical Research</name>
      <address>
        <city>Fayetteville</city>
        <state>North Carolina</state>
        <zip>28304</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>PMG Research of Wilmington, LLC</name>
      <address>
        <city>Wilmington</city>
        <state>North Carolina</state>
        <zip>28401</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CTI Clinical Research Center</name>
      <address>
        <city>Cincinnati</city>
        <state>Ohio</state>
        <zip>45212</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Sterling Research Group, Ltd.</name>
      <address>
        <city>Cincinnati</city>
        <state>Ohio</state>
        <zip>45246</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Prestige Clinical Research</name>
      <address>
        <city>Franklin</city>
        <state>Ohio</state>
        <zip>45005</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Lynn Health Science Institute</name>
      <address>
        <city>Oklahoma City</city>
        <state>Oklahoma</state>
        <zip>73112</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kaiser Permanente Center For Health Research</name>
      <address>
        <city>Portland</city>
        <state>Oregon</state>
        <zip>97227</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Columbia Research Group, Inc.</name>
      <address>
        <city>Portland</city>
        <state>Oregon</state>
        <zip>97239</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Medical Research South, LLC</name>
      <address>
        <city>Goose Creek</city>
        <state>South Carolina</state>
        <zip>29445</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ventavia Research Group</name>
      <address>
        <city>Keller</city>
        <state>Texas</state>
        <zip>76248</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>J. Lewis Research Inc. / Foothill Family Clinic Draper</name>
      <address>
        <city>Draper</city>
        <state>Utah</state>
        <zip>84020</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>J. Lewis Research, Inc. - Foothill Family Clinic</name>
      <address>
        <city>Salt Lake City</city>
        <state>Utah</state>
        <zip>84109</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>J. Lewis Research, Inc. / Foothill Family Clinic South</name>
      <address>
        <city>Salt Lake City</city>
        <state>Utah</state>
        <zip>84121</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>J. Lewis Research, Inc. / Jordan River Family Medicine</name>
      <address>
        <city>South Jordan</city>
        <state>Utah</state>
        <zip>84095</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kaiser Permanente Washington Health Research Institute</name>
      <address>
        <city>Seattle</city>
        <state>Washington</state>
        <zip>98101</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>PharmaSite</name>
      <address>
        <city>Malmo</city>
        <state>Skane</state>
        <zip>21152</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ladulaas Kliniska Studier</name>
      <address>
        <city>Boras</city>
        <zip>50630</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Infektionskliniken</name>
      <address>
        <city>Eskilstuna</city>
        <zip>63188</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CTC Gothia Forum</name>
      <address>
        <city>Goteborg</city>
        <zip>413 45</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ProbarE i Lund</name>
      <address>
        <city>Lund</city>
        <zip>22222</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Avdelningen for Kliniska Provningar</name>
      <address>
        <city>Orebro</city>
        <zip>703 62</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Karolinska Trial Alliance, KTA Prim</name>
      <address>
        <city>Stockholm</city>
        <zip>11361</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Akardo Med Site</name>
      <address>
        <city>Stockholm</city>
        <zip>11446</zip>
        <country>Sweden</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Sweden</country>
    <country>United States</country>
  </location_countries>
  <link>
    <url>https://pmiform.com/clinical-trial-info-request?StudyID=B7471006</url>
    <description>To obtain contact information for a study center near you, click here.</description>
  </link>
  <verification_date>February 2021</verification_date>
  <study_first_submitted>February 7, 2019</study_first_submitted>
  <study_first_submitted_qc>February 7, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">February 11, 2019</study_first_posted>
  <results_first_submitted>February 2, 2021</results_first_submitted>
  <results_first_submitted_qc>February 2, 2021</results_first_submitted_qc>
  <results_first_posted type="Actual">February 21, 2021</results_first_posted>
  <last_update_submitted>February 2, 2021</last_update_submitted>
  <last_update_submitted_qc>February 2, 2021</last_update_submitted_qc>
  <last_update_posted type="Actual">February 21, 2021</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Pneumococcal Infections</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Heptavalent Pneumococcal Conjugate Vaccine</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>Yes</sharing_ipd>
    <ipd_description>Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.</ipd_description>
    <ipd_url>https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests</ipd_url>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Statistical Analysis Plan</document_type>
      <document_has_protocol>No</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>March 23, 2020</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/75/NCT03835975/SAP_000.pdf</document_url>
    </provided_document>
    <provided_document>
      <document_type>Study Protocol</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>No</document_has_sap>
      <document_date>February 11, 2019</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/75/NCT03835975/Prot_001.pdf</document_url>
    </provided_document>
  </provided_document_section>

  <clinical_results>

    <participant_flow>
      <group_list>
        <group group_id="P1">
          <title>Cohort A: 20vPnC</title>
          <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
        </group>
        <group group_id="P2">
          <title>Cohort A: 13vPnC</title>
          <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
        </group>
        <group group_id="P3">
          <title>Cohort B: 20vPnC</title>
          <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
        </group>
        <group group_id="P4">
          <title>Cohort B: PPSV23</title>
          <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
        </group>
        <group group_id="P5">
          <title>Cohort C: 20vPnC</title>
          <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
        </group>
      </group_list>
      <period_list>
        <period>
          <title>Overall Study</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="253"/>
                <participants group_id="P2" count="122"/>
                <participants group_id="P3" count="248"/>
                <participants group_id="P4" count="127"/>
                <participants group_id="P5" count="125"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>Vaccinated</title>
              <participants_list>
                <participants group_id="P1" count="253"/>
                <participants group_id="P2" count="122"/>
                <participants group_id="P3" count="246"/>
                <participants group_id="P4" count="127"/>
                <participants group_id="P5" count="125"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>Safety Population</title>
              <participants_list>
                <participants group_id="P1" count="253"/>
                <participants group_id="P2" count="122"/>
                <participants group_id="P3" count="246"/>
                <participants group_id="P4" count="127"/>
                <participants group_id="P5" count="125"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>Evaluable Immunogenicity Population (for 20vPnC Cohorts)</title>
              <participants_list>
                <participants group_id="P1" count="247"/>
                <participants group_id="P2" count="0"/>
                <participants group_id="P3" count="243"/>
                <participants group_id="P4" count="0"/>
                <participants group_id="P5" count="121"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="250"/>
                <participants group_id="P2" count="119"/>
                <participants group_id="P3" count="245"/>
                <participants group_id="P4" count="126"/>
                <participants group_id="P5" count="125"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="3"/>
                <participants group_id="P2" count="3"/>
                <participants group_id="P3" count="3"/>
                <participants group_id="P4" count="1"/>
                <participants group_id="P5" count="0"/>
              </participants_list>
            </milestone>
          </milestone_list>
          <drop_withdraw_reason_list>
            <drop_withdraw_reason>
              <title>Lost to Follow-up</title>
              <participants_list>
                <participants group_id="P1" count="1"/>
                <participants group_id="P2" count="1"/>
                <participants group_id="P3" count="0"/>
                <participants group_id="P4" count="0"/>
                <participants group_id="P5" count="0"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>No longer met eligibility criteria</title>
              <participants_list>
                <participants group_id="P1" count="0"/>
                <participants group_id="P2" count="1"/>
                <participants group_id="P3" count="0"/>
                <participants group_id="P4" count="0"/>
                <participants group_id="P5" count="0"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>Protocol Violation</title>
              <participants_list>
                <participants group_id="P1" count="1"/>
                <participants group_id="P2" count="1"/>
                <participants group_id="P3" count="2"/>
                <participants group_id="P4" count="0"/>
                <participants group_id="P5" count="0"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>Withdrawal by Subject</title>
              <participants_list>
                <participants group_id="P1" count="1"/>
                <participants group_id="P2" count="0"/>
                <participants group_id="P3" count="1"/>
                <participants group_id="P4" count="1"/>
                <participants group_id="P5" count="0"/>
              </participants_list>
            </drop_withdraw_reason>
          </drop_withdraw_reason_list>
        </period>
      </period_list>
    </participant_flow>

    <baseline>
      <population>All randomized population.</population>
      <group_list>
        <group group_id="B1">
          <title>Cohort A: 20vPnC</title>
          <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
        </group>
        <group group_id="B2">
          <title>Cohort A: 13vPnC</title>
          <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
        </group>
        <group group_id="B3">
          <title>Cohort B: 20vPnC</title>
          <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
        </group>
        <group group_id="B4">
          <title>Cohort B: PPSV23</title>
          <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
        </group>
        <group group_id="B5">
          <title>Cohort C: 20vPnC</title>
          <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
        </group>
        <group group_id="B6">
          <title>Total</title>
          <description>Total of all reporting groups</description>
        </group>
      </group_list>
      <analyzed_list>
        <analyzed>
          <units>Participants</units>
          <scope>Overall</scope>
          <count_list>
            <count group_id="B1" value="253"/>
            <count group_id="B2" value="122"/>
            <count group_id="B3" value="248"/>
            <count group_id="B4" value="127"/>
            <count group_id="B5" value="125"/>
            <count group_id="B6" value="875"/>
          </count_list>
        </analyzed>
      </analyzed_list>
      <measure_list>
        <measure>
          <title>Age</title>
          <units>years</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="69.6" spread="3.88"/>
                    <measurement group_id="B2" value="70.2" spread="4.09"/>
                    <measurement group_id="B3" value="70.7" spread="5.70"/>
                    <measurement group_id="B4" value="70.6" spread="5.73"/>
                    <measurement group_id="B5" value="70.8" spread="4.26"/>
                    <measurement group_id="B6" value="70.3" spread="4.84"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Sex: Female, Male</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Female</title>
                  <measurement_list>
                    <measurement group_id="B1" value="140"/>
                    <measurement group_id="B2" value="64"/>
                    <measurement group_id="B3" value="140"/>
                    <measurement group_id="B4" value="68"/>
                    <measurement group_id="B5" value="65"/>
                    <measurement group_id="B6" value="477"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Male</title>
                  <measurement_list>
                    <measurement group_id="B1" value="113"/>
                    <measurement group_id="B2" value="58"/>
                    <measurement group_id="B3" value="108"/>
                    <measurement group_id="B4" value="59"/>
                    <measurement group_id="B5" value="60"/>
                    <measurement group_id="B6" value="398"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Ethnicity (NIH/OMB)</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>Hispanic or Latino</title>
                  <measurement_list>
                    <measurement group_id="B1" value="4"/>
                    <measurement group_id="B2" value="3"/>
                    <measurement group_id="B3" value="6"/>
                    <measurement group_id="B4" value="1"/>
                    <measurement group_id="B5" value="2"/>
                    <measurement group_id="B6" value="16"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Not Hispanic or Latino</title>
                  <measurement_list>
                    <measurement group_id="B1" value="247"/>
                    <measurement group_id="B2" value="117"/>
                    <measurement group_id="B3" value="233"/>
                    <measurement group_id="B4" value="122"/>
                    <measurement group_id="B5" value="113"/>
                    <measurement group_id="B6" value="832"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Unknown or Not Reported</title>
                  <measurement_list>
                    <measurement group_id="B1" value="2"/>
                    <measurement group_id="B2" value="2"/>
                    <measurement group_id="B3" value="9"/>
                    <measurement group_id="B4" value="4"/>
                    <measurement group_id="B5" value="10"/>
                    <measurement group_id="B6" value="27"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Race (NIH/OMB)</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <category_list>
                <category>
                  <title>American Indian or Alaska Native</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                    <measurement group_id="B4" value="0"/>
                    <measurement group_id="B5" value="0"/>
                    <measurement group_id="B6" value="2"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Asian</title>
                  <measurement_list>
                    <measurement group_id="B1" value="1"/>
                    <measurement group_id="B2" value="2"/>
                    <measurement group_id="B3" value="0"/>
                    <measurement group_id="B4" value="2"/>
                    <measurement group_id="B5" value="0"/>
                    <measurement group_id="B6" value="5"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Native Hawaiian or Other Pacific Islander</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="1"/>
                    <measurement group_id="B3" value="1"/>
                    <measurement group_id="B4" value="1"/>
                    <measurement group_id="B5" value="0"/>
                    <measurement group_id="B6" value="3"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Black or African American</title>
                  <measurement_list>
                    <measurement group_id="B1" value="15"/>
                    <measurement group_id="B2" value="8"/>
                    <measurement group_id="B3" value="14"/>
                    <measurement group_id="B4" value="6"/>
                    <measurement group_id="B5" value="4"/>
                    <measurement group_id="B6" value="47"/>
                  </measurement_list>
                </category>
                <category>
                  <title>White</title>
                  <measurement_list>
                    <measurement group_id="B1" value="236"/>
                    <measurement group_id="B2" value="110"/>
                    <measurement group_id="B3" value="228"/>
                    <measurement group_id="B4" value="118"/>
                    <measurement group_id="B5" value="117"/>
                    <measurement group_id="B6" value="809"/>
                  </measurement_list>
                </category>
                <category>
                  <title>More than one race</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="0"/>
                    <measurement group_id="B3" value="1"/>
                    <measurement group_id="B4" value="0"/>
                    <measurement group_id="B5" value="3"/>
                    <measurement group_id="B6" value="4"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Unknown or Not Reported</title>
                  <measurement_list>
                    <measurement group_id="B1" value="0"/>
                    <measurement group_id="B2" value="1"/>
                    <measurement group_id="B3" value="3"/>
                    <measurement group_id="B4" value="0"/>
                    <measurement group_id="B5" value="1"/>
                    <measurement group_id="B6" value="5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </measure_list>
    </baseline>

    <outcome_list>
      <outcome>
        <type>Primary</type>
        <title>Percentage of Participants With Local Reactions Within 10 Days After Vaccination</title>
        <description>Local reactions were recorded using an electronic diary (e-diary). Local reactions included redness, swelling and pain at the injection site. Redness and swelling were measured and recorded in measuring device units. 1 measuring device unit =0.5 centimeter (cm). Redness and swelling were graded as mild (greater than [&gt;] 2.0 to 5.0 cm), moderate (&gt;5.0 to 10.0 cm) and severe (&gt;10.0 cm). Pain at injection site was graded as mild (did not interfere with activity), moderate (interfered with activity), and severe (prevented daily activity).</description>
        <time_frame>Within 10 days after vaccination</time_frame>
        <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination. Here, &quot;Overall Number of Participants Analyzed&quot; refers to number of participants with any e-diary data reported after vaccination in the safety population.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort A: 13vPnC</title>
            <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O4">
            <title>Cohort B: PPSV23</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
          </group>
          <group group_id="O5">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Percentage of Participants With Local Reactions Within 10 Days After Vaccination</title>
          <description>Local reactions were recorded using an electronic diary (e-diary). Local reactions included redness, swelling and pain at the injection site. Redness and swelling were measured and recorded in measuring device units. 1 measuring device unit =0.5 centimeter (cm). Redness and swelling were graded as mild (greater than [&gt;] 2.0 to 5.0 cm), moderate (&gt;5.0 to 10.0 cm) and severe (&gt;10.0 cm). Pain at injection site was graded as mild (did not interfere with activity), moderate (interfered with activity), and severe (prevented daily activity).</description>
          <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination. Here, &quot;Overall Number of Participants Analyzed&quot; refers to number of participants with any e-diary data reported after vaccination in the safety population.</population>
          <units>percentage of participants</units>
          <param>Number</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="253"/>
                <count group_id="O2" value="121"/>
                <count group_id="O3" value="245"/>
                <count group_id="O4" value="126"/>
                <count group_id="O5" value="125"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Redness: Any</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="7.9" lower_limit="4.9" upper_limit="11.9"/>
                    <measurement group_id="O2" value="2.5" lower_limit="0.5" upper_limit="7.1"/>
                    <measurement group_id="O3" value="8.6" lower_limit="5.4" upper_limit="12.8"/>
                    <measurement group_id="O4" value="12.7" lower_limit="7.4" upper_limit="19.8"/>
                    <measurement group_id="O5" value="4.8" lower_limit="1.8" upper_limit="10.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Redness: Mild</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.6" lower_limit="1.6" upper_limit="6.6"/>
                    <measurement group_id="O2" value="1.7" lower_limit="0.2" upper_limit="5.8"/>
                    <measurement group_id="O3" value="2.9" lower_limit="1.2" upper_limit="5.8"/>
                    <measurement group_id="O4" value="4.8" lower_limit="1.8" upper_limit="10.1"/>
                    <measurement group_id="O5" value="1.6" lower_limit="0.2" upper_limit="5.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Redness: Moderate</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.2" lower_limit="1.4" upper_limit="6.1"/>
                    <measurement group_id="O2" value="0.8" lower_limit="0.0" upper_limit="4.5"/>
                    <measurement group_id="O3" value="5.3" lower_limit="2.9" upper_limit="8.9"/>
                    <measurement group_id="O4" value="7.1" lower_limit="3.3" upper_limit="13.1"/>
                    <measurement group_id="O5" value="3.2" lower_limit="0.9" upper_limit="8.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Redness: Severe</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.2" lower_limit="0.2" upper_limit="3.4"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0.4" lower_limit="0.0" upper_limit="2.3"/>
                    <measurement group_id="O4" value="0.8" lower_limit="0.0" upper_limit="4.3"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Swelling: Any</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="9.9" lower_limit="6.5" upper_limit="14.2"/>
                    <measurement group_id="O2" value="6.6" lower_limit="2.9" upper_limit="12.6"/>
                    <measurement group_id="O3" value="9.4" lower_limit="6.0" upper_limit="13.8"/>
                    <measurement group_id="O4" value="14.3" lower_limit="8.7" upper_limit="21.6"/>
                    <measurement group_id="O5" value="4.0" lower_limit="1.3" upper_limit="9.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Swelling: Mild</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.1" lower_limit="2.8" upper_limit="8.6"/>
                    <measurement group_id="O2" value="6.6" lower_limit="2.9" upper_limit="12.6"/>
                    <measurement group_id="O3" value="5.7" lower_limit="3.2" upper_limit="9.4"/>
                    <measurement group_id="O4" value="6.3" lower_limit="2.8" upper_limit="12.1"/>
                    <measurement group_id="O5" value="1.6" lower_limit="0.2" upper_limit="5.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Swelling: Moderate</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.6" lower_limit="1.6" upper_limit="6.6"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="3.7" lower_limit="1.7" upper_limit="6.9"/>
                    <measurement group_id="O4" value="7.1" lower_limit="3.3" upper_limit="13.1"/>
                    <measurement group_id="O5" value="2.4" lower_limit="0.5" upper_limit="6.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Swelling: Severe</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.2" lower_limit="0.2" upper_limit="3.4"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="0.8" lower_limit="0.0" upper_limit="4.3"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pain at the injection site: Any</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="50.2" lower_limit="43.9" upper_limit="56.5"/>
                    <measurement group_id="O2" value="43.0" lower_limit="34.0" upper_limit="52.3"/>
                    <measurement group_id="O3" value="61.2" lower_limit="54.8" upper_limit="67.4"/>
                    <measurement group_id="O4" value="56.3" lower_limit="47.2" upper_limit="65.2"/>
                    <measurement group_id="O5" value="52.8" lower_limit="43.7" upper_limit="61.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pain at the injection site: Mild</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="45.8" lower_limit="39.6" upper_limit="52.2"/>
                    <measurement group_id="O2" value="38.8" lower_limit="30.1" upper_limit="48.1"/>
                    <measurement group_id="O3" value="54.7" lower_limit="48.2" upper_limit="61.0"/>
                    <measurement group_id="O4" value="40.5" lower_limit="31.8" upper_limit="49.6"/>
                    <measurement group_id="O5" value="47.2" lower_limit="38.2" upper_limit="56.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pain at the injection site: Moderate</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.3" lower_limit="2.2" upper_limit="7.6"/>
                    <measurement group_id="O2" value="3.3" lower_limit="0.9" upper_limit="8.2"/>
                    <measurement group_id="O3" value="6.1" lower_limit="3.5" upper_limit="9.9"/>
                    <measurement group_id="O4" value="14.3" lower_limit="8.7" upper_limit="21.6"/>
                    <measurement group_id="O5" value="5.6" lower_limit="2.3" upper_limit="11.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Pain at the injection site: Severe</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0" lower_limit="0.0" upper_limit="1.4"/>
                    <measurement group_id="O2" value="0.8" lower_limit="0.0" upper_limit="4.5"/>
                    <measurement group_id="O3" value="0.4" lower_limit="0.0" upper_limit="2.3"/>
                    <measurement group_id="O4" value="1.6" lower_limit="0.2" upper_limit="5.6"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Percentage of Participants With Systemic Events Within 7 Days After Vaccination</title>
        <description>Systemic events fever, fatigue, headache, muscle pain and joint pain were recorded by using an e-diary. Fever was defined as temperature &gt;=38.0 degree Celsius (C) and categorized to &gt;=38.0 to 38.4 degree C, &gt;38.4 to 38.9 degree C, &gt;38.9 to 40.0 degree C and &gt;40.0 degree C. Fatigue, headache, muscle pain and joint pain were graded as mild (did not interfere with activity), moderate (some interference with activity) and severe (prevented daily routine activity).</description>
        <time_frame>Within 7 days after vaccination</time_frame>
        <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination. Here, &quot;Overall Number of Participants Analyzed&quot; refers to number of participants with any e-diary data reported after vaccination in the safety population.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort A: 13vPnC</title>
            <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O4">
            <title>Cohort B: PPSV23</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
          </group>
          <group group_id="O5">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Percentage of Participants With Systemic Events Within 7 Days After Vaccination</title>
          <description>Systemic events fever, fatigue, headache, muscle pain and joint pain were recorded by using an e-diary. Fever was defined as temperature &gt;=38.0 degree Celsius (C) and categorized to &gt;=38.0 to 38.4 degree C, &gt;38.4 to 38.9 degree C, &gt;38.9 to 40.0 degree C and &gt;40.0 degree C. Fatigue, headache, muscle pain and joint pain were graded as mild (did not interfere with activity), moderate (some interference with activity) and severe (prevented daily routine activity).</description>
          <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination. Here, &quot;Overall Number of Participants Analyzed&quot; refers to number of participants with any e-diary data reported after vaccination in the safety population.</population>
          <units>percentage of participants</units>
          <param>Number</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="253"/>
                <count group_id="O2" value="121"/>
                <count group_id="O3" value="245"/>
                <count group_id="O4" value="126"/>
                <count group_id="O5" value="125"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Fever: &gt;=38.0 degree C</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.8" lower_limit="0.1" upper_limit="2.8"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="1.6" lower_limit="0.2" upper_limit="5.6"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fever: &gt;=38.0 degree C to 38.4 degree C</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.8" lower_limit="0.1" upper_limit="2.8"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="0.8" lower_limit="0.0" upper_limit="4.3"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fever: &gt;38.4 degree C to 38.9 degree C</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0" lower_limit="0.0" upper_limit="1.4"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="0.8" lower_limit="0.0" upper_limit="4.3"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fever: &gt;38.9 degree C to 40.0 degree C</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0" lower_limit="0.0" upper_limit="1.4"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="0" lower_limit="0.0" upper_limit="2.9"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fever: &gt;40.0 degree C</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0" lower_limit="0.0" upper_limit="1.4"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="0" lower_limit="0.0" upper_limit="2.9"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fatigue: Any</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="28.9" lower_limit="23.4" upper_limit="34.9"/>
                    <measurement group_id="O2" value="22.3" lower_limit="15.2" upper_limit="30.8"/>
                    <measurement group_id="O3" value="31.0" lower_limit="25.3" upper_limit="37.2"/>
                    <measurement group_id="O4" value="33.3" lower_limit="25.2" upper_limit="42.3"/>
                    <measurement group_id="O5" value="32.8" lower_limit="24.7" upper_limit="41.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fatigue: Mild</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="17.8" lower_limit="13.3" upper_limit="23.1"/>
                    <measurement group_id="O2" value="9.9" lower_limit="5.2" upper_limit="16.7"/>
                    <measurement group_id="O3" value="19.6" lower_limit="14.8" upper_limit="25.1"/>
                    <measurement group_id="O4" value="19.8" lower_limit="13.3" upper_limit="27.9"/>
                    <measurement group_id="O5" value="19.2" lower_limit="12.7" upper_limit="27.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fatigue: Moderate</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="11.1" lower_limit="7.5" upper_limit="15.6"/>
                    <measurement group_id="O2" value="9.9" lower_limit="5.2" upper_limit="16.7"/>
                    <measurement group_id="O3" value="10.2" lower_limit="6.7" upper_limit="14.7"/>
                    <measurement group_id="O4" value="13.5" lower_limit="8.1" upper_limit="20.7"/>
                    <measurement group_id="O5" value="12.0" lower_limit="6.9" upper_limit="19.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Fatigue: Severe</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0" lower_limit="0.0" upper_limit="1.4"/>
                    <measurement group_id="O2" value="2.5" lower_limit="0.5" upper_limit="7.1"/>
                    <measurement group_id="O3" value="1.2" lower_limit="0.3" upper_limit="3.5"/>
                    <measurement group_id="O4" value="0" lower_limit="0.0" upper_limit="2.9"/>
                    <measurement group_id="O5" value="1.6" lower_limit="0.2" upper_limit="5.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Headache: Any</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="17.8" lower_limit="13.3" upper_limit="23.1"/>
                    <measurement group_id="O2" value="18.2" lower_limit="11.8" upper_limit="26.2"/>
                    <measurement group_id="O3" value="13.5" lower_limit="9.5" upper_limit="18.4"/>
                    <measurement group_id="O4" value="21.4" lower_limit="14.6" upper_limit="29.6"/>
                    <measurement group_id="O5" value="19.2" lower_limit="12.7" upper_limit="27.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Headache: Mild</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="12.6" lower_limit="8.8" upper_limit="17.4"/>
                    <measurement group_id="O2" value="12.4" lower_limit="7.1" upper_limit="19.6"/>
                    <measurement group_id="O3" value="9.8" lower_limit="6.4" upper_limit="14.2"/>
                    <measurement group_id="O4" value="20.6" lower_limit="13.9" upper_limit="28.8"/>
                    <measurement group_id="O5" value="12.8" lower_limit="7.5" upper_limit="20.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Headache: Moderate</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.7" lower_limit="2.5" upper_limit="8.1"/>
                    <measurement group_id="O2" value="5.8" lower_limit="2.4" upper_limit="11.6"/>
                    <measurement group_id="O3" value="3.7" lower_limit="1.7" upper_limit="6.9"/>
                    <measurement group_id="O4" value="0.8" lower_limit="0.0" upper_limit="4.3"/>
                    <measurement group_id="O5" value="5.6" lower_limit="2.3" upper_limit="11.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Headache: Severe</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.4" lower_limit="0.0" upper_limit="2.2"/>
                    <measurement group_id="O2" value="0" lower_limit="0.0" upper_limit="3.0"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="0" lower_limit="0.0" upper_limit="2.9"/>
                    <measurement group_id="O5" value="0.8" lower_limit="0.0" upper_limit="4.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Muscle Pain: Any</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="32.0" lower_limit="26.3" upper_limit="38.1"/>
                    <measurement group_id="O2" value="31.4" lower_limit="23.3" upper_limit="40.5"/>
                    <measurement group_id="O3" value="33.9" lower_limit="28.0" upper_limit="40.2"/>
                    <measurement group_id="O4" value="46.0" lower_limit="37.1" upper_limit="55.1"/>
                    <measurement group_id="O5" value="37.6" lower_limit="29.1" upper_limit="46.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Muscle Pain: Mild</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="26.1" lower_limit="20.8" upper_limit="32.0"/>
                    <measurement group_id="O2" value="24.0" lower_limit="16.7" upper_limit="32.6"/>
                    <measurement group_id="O3" value="25.3" lower_limit="20.0" upper_limit="31.2"/>
                    <measurement group_id="O4" value="31.7" lower_limit="23.7" upper_limit="40.6"/>
                    <measurement group_id="O5" value="28.0" lower_limit="20.3" upper_limit="36.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Muscle Pain: Moderate</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="5.5" lower_limit="3.1" upper_limit="9.1"/>
                    <measurement group_id="O2" value="5.0" lower_limit="1.8" upper_limit="10.5"/>
                    <measurement group_id="O3" value="8.6" lower_limit="5.4" upper_limit="12.8"/>
                    <measurement group_id="O4" value="11.9" lower_limit="6.8" upper_limit="18.9"/>
                    <measurement group_id="O5" value="8.8" lower_limit="4.5" upper_limit="15.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Muscle Pain: Severe</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.4" lower_limit="0.0" upper_limit="2.2"/>
                    <measurement group_id="O2" value="2.5" lower_limit="0.5" upper_limit="7.1"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="2.4" lower_limit="0.5" upper_limit="6.8"/>
                    <measurement group_id="O5" value="0.8" lower_limit="0.0" upper_limit="4.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Joint Pain: Any</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.7" lower_limit="4.0" upper_limit="10.5"/>
                    <measurement group_id="O2" value="10.7" lower_limit="5.8" upper_limit="17.7"/>
                    <measurement group_id="O3" value="11.8" lower_limit="8.1" upper_limit="16.6"/>
                    <measurement group_id="O4" value="15.9" lower_limit="10.0" upper_limit="23.4"/>
                    <measurement group_id="O5" value="16.8" lower_limit="10.7" upper_limit="24.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Joint Pain: Mild</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.7" lower_limit="2.5" upper_limit="8.1"/>
                    <measurement group_id="O2" value="5.0" lower_limit="1.8" upper_limit="10.5"/>
                    <measurement group_id="O3" value="7.8" lower_limit="4.7" upper_limit="11.8"/>
                    <measurement group_id="O4" value="10.3" lower_limit="5.6" upper_limit="17.0"/>
                    <measurement group_id="O5" value="12.8" lower_limit="7.5" upper_limit="20.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Joint Pain: Moderate</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.0" lower_limit="0.6" upper_limit="4.6"/>
                    <measurement group_id="O2" value="5.0" lower_limit="1.8" upper_limit="10.5"/>
                    <measurement group_id="O3" value="4.1" lower_limit="2.0" upper_limit="7.4"/>
                    <measurement group_id="O4" value="5.6" lower_limit="2.3" upper_limit="11.1"/>
                    <measurement group_id="O5" value="4.0" lower_limit="1.3" upper_limit="9.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Joint Pain: Severe</title>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0" lower_limit="0.0" upper_limit="1.4"/>
                    <measurement group_id="O2" value="0.8" lower_limit="0.0" upper_limit="4.5"/>
                    <measurement group_id="O3" value="0" lower_limit="0.0" upper_limit="1.5"/>
                    <measurement group_id="O4" value="0" lower_limit="0.0" upper_limit="2.9"/>
                    <measurement group_id="O5" value="0" lower_limit="0.0" upper_limit="2.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Percentage of Participants With Adverse Events (AEs) Within 1 Month After Vaccination</title>
        <description>An AE was any untoward medical occurrence in study participants who received study vaccine without regard to possibility of causal relationship with the treatment.</description>
        <time_frame>Within 1 month after vaccination</time_frame>
        <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort A: 13vPnC</title>
            <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O4">
            <title>Cohort B: PPSV23</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
          </group>
          <group group_id="O5">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Percentage of Participants With Adverse Events (AEs) Within 1 Month After Vaccination</title>
          <description>An AE was any untoward medical occurrence in study participants who received study vaccine without regard to possibility of causal relationship with the treatment.</description>
          <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination.</population>
          <units>percentage of participants</units>
          <param>Number</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="253"/>
                <count group_id="O2" value="122"/>
                <count group_id="O3" value="246"/>
                <count group_id="O4" value="127"/>
                <count group_id="O5" value="125"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="7.5" lower_limit="4.6" upper_limit="11.5"/>
                    <measurement group_id="O2" value="9.0" lower_limit="4.6" upper_limit="15.6"/>
                    <measurement group_id="O3" value="4.9" lower_limit="2.5" upper_limit="8.4"/>
                    <measurement group_id="O4" value="11.0" lower_limit="6.2" upper_limit="17.8"/>
                    <measurement group_id="O5" value="10.4" lower_limit="5.7" upper_limit="17.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Percentage of Participants With Serious Adverse Events (SAEs) Within 6 Months After Vaccination</title>
        <description>An SAE was any untoward medical occurrence at any dose that results in death; is life-threatening (immediate risk of death); requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); results in congenital anomaly/birth defect or that is considered to be an important medical event.</description>
        <time_frame>Within 6 months after vaccination</time_frame>
        <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort A: 13vPnC</title>
            <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O4">
            <title>Cohort B: PPSV23</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
          </group>
          <group group_id="O5">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Percentage of Participants With Serious Adverse Events (SAEs) Within 6 Months After Vaccination</title>
          <description>An SAE was any untoward medical occurrence at any dose that results in death; is life-threatening (immediate risk of death); requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); results in congenital anomaly/birth defect or that is considered to be an important medical event.</description>
          <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination.</population>
          <units>percentage of participants</units>
          <param>Number</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="253"/>
                <count group_id="O2" value="122"/>
                <count group_id="O3" value="246"/>
                <count group_id="O4" value="127"/>
                <count group_id="O5" value="125"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.8" lower_limit="0.1" upper_limit="2.8"/>
                    <measurement group_id="O2" value="1.6" lower_limit="0.2" upper_limit="5.8"/>
                    <measurement group_id="O3" value="2.4" lower_limit="0.9" upper_limit="5.2"/>
                    <measurement group_id="O4" value="1.6" lower_limit="0.2" upper_limit="5.6"/>
                    <measurement group_id="O5" value="1.6" lower_limit="0.2" upper_limit="5.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Percentage of Participants With Newly Diagnosed Chronic Medical Conditions (NDCMCs) Within 6 Months After Vaccination</title>
        <description>An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or was otherwise long-lasting in its effects.</description>
        <time_frame>Within 6 months after vaccination</time_frame>
        <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort A: 13vPnC</title>
            <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O4">
            <title>Cohort B: PPSV23</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
          </group>
          <group group_id="O5">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Percentage of Participants With Newly Diagnosed Chronic Medical Conditions (NDCMCs) Within 6 Months After Vaccination</title>
          <description>An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or was otherwise long-lasting in its effects.</description>
          <population>The safety population included participants who received 1 dose of 20vPnC, PPSV23, or 13vPnC and had safety follow-up after vaccination.</population>
          <units>percentage of participants</units>
          <param>Number</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="253"/>
                <count group_id="O2" value="122"/>
                <count group_id="O3" value="246"/>
                <count group_id="O4" value="127"/>
                <count group_id="O5" value="125"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.0" lower_limit="0.6" upper_limit="4.6"/>
                    <measurement group_id="O2" value="0.8" lower_limit="0.0" upper_limit="4.5"/>
                    <measurement group_id="O3" value="2.8" lower_limit="1.2" upper_limit="5.8"/>
                    <measurement group_id="O4" value="2.4" lower_limit="0.5" upper_limit="6.7"/>
                    <measurement group_id="O5" value="4.0" lower_limit="1.3" upper_limit="9.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Pneumococcal Opsonophagocytic Activity (OPA) Geometric Mean Titers (GMTs) at 1 Month After Vaccination</title>
        <description>OPA GMTs were determined for serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F. OPA titer was expressed as reciprocal of the highest serum dilution.</description>
        <time_frame>1 month after vaccination</time_frame>
        <population>Evaluable immunogenicity population: All participants who received 20vPnC as randomized, enrolled in appropriate cohort based on prior vaccination history, had Visit 2 blood collection within 27 to 49 days after vaccination, had at least 1 valid and determinate OPA titer for any serotype for Visit 2, had no major protocol deviations. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number Analyzed =number of participants evaluable for each serotypes.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Pneumococcal Opsonophagocytic Activity (OPA) Geometric Mean Titers (GMTs) at 1 Month After Vaccination</title>
          <description>OPA GMTs were determined for serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F. OPA titer was expressed as reciprocal of the highest serum dilution.</description>
          <population>Evaluable immunogenicity population: All participants who received 20vPnC as randomized, enrolled in appropriate cohort based on prior vaccination history, had Visit 2 blood collection within 27 to 49 days after vaccination, had at least 1 valid and determinate OPA titer for any serotype for Visit 2, had no major protocol deviations. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number Analyzed =number of participants evaluable for each serotypes.</population>
          <units>titer</units>
          <param>Geometric Mean</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="247"/>
                <count group_id="O2" value="243"/>
                <count group_id="O3" value="121"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Serotype 1</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="246"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="50.8" lower_limit="41.6" upper_limit="62.0"/>
                    <measurement group_id="O2" value="115.3" lower_limit="96.3" upper_limit="137.9"/>
                    <measurement group_id="O3" value="82.1" lower_limit="61.2" upper_limit="110.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 3</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="31.1" lower_limit="26.7" upper_limit="36.1"/>
                    <measurement group_id="O2" value="54.3" lower_limit="46.9" upper_limit="62.8"/>
                    <measurement group_id="O3" value="39.3" lower_limit="32.0" upper_limit="48.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 4</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="236"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="116"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="149.9" lower_limit="118.2" upper_limit="190.1"/>
                    <measurement group_id="O2" value="334.9" lower_limit="273.8" upper_limit="409.5"/>
                    <measurement group_id="O3" value="193.7" lower_limit="143.2" upper_limit="262.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 5</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="244"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="62.8" lower_limit="52.7" upper_limit="74.9"/>
                    <measurement group_id="O2" value="87.3" lower_limit="73.2" upper_limit="104.2"/>
                    <measurement group_id="O3" value="83.5" lower_limit="64.8" upper_limit="107.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="242"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="121"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="748.7" lower_limit="576.7" upper_limit="972.0"/>
                    <measurement group_id="O2" value="1080.9" lower_limit="880.2" upper_limit="1327.4"/>
                    <measurement group_id="O3" value="1085.3" lower_limit="796.9" upper_limit="1478.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="121"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="727.3" lower_limit="573.6" upper_limit="922.1"/>
                    <measurement group_id="O2" value="1159.4" lower_limit="950.7" upper_limit="1413.8"/>
                    <measurement group_id="O3" value="1033.3" lower_limit="754.6" upper_limit="1414.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 7F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="240"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="378.1" lower_limit="316.4" upper_limit="451.9"/>
                    <measurement group_id="O2" value="555.4" lower_limit="466.8" upper_limit="660.9"/>
                    <measurement group_id="O3" value="345.8" lower_limit="277.0" upper_limit="431.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 9V</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="241"/>
                    <count group_id="O2" value="237"/>
                    <count group_id="O3" value="117"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="550.3" lower_limit="454.0" upper_limit="666.9"/>
                    <measurement group_id="O2" value="1085.0" lower_limit="893.5" upper_limit="1317.5"/>
                    <measurement group_id="O3" value="723.4" lower_limit="558.1" upper_limit="937.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 14</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="240"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="391.2" lower_limit="314.6" upper_limit="486.3"/>
                    <measurement group_id="O2" value="664.9" lower_limit="554.1" upper_limit="797.9"/>
                    <measurement group_id="O3" value="580.5" lower_limit="433.7" upper_limit="777.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 18C</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="240"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="551.9" lower_limit="445.1" upper_limit="684.4"/>
                    <measurement group_id="O2" value="845.9" lower_limit="692.5" upper_limit="1033.1"/>
                    <measurement group_id="O3" value="621.2" lower_limit="469.9" upper_limit="821.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="242"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="238.6" lower_limit="197.5" upper_limit="288.4"/>
                    <measurement group_id="O2" value="365.1" lower_limit="303.0" upper_limit="440.0"/>
                    <measurement group_id="O3" value="340.6" lower_limit="264.1" upper_limit="439.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="244"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="118"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="159.0" lower_limit="131.4" upper_limit="192.3"/>
                    <measurement group_id="O2" value="242.3" lower_limit="199.4" upper_limit="294.3"/>
                    <measurement group_id="O3" value="217.7" lower_limit="168.1" upper_limit="281.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 23F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="151.6" lower_limit="115.3" upper_limit="199.3"/>
                    <measurement group_id="O2" value="450.2" lower_limit="357.8" upper_limit="566.4"/>
                    <measurement group_id="O3" value="292.6" lower_limit="203.6" upper_limit="420.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 8</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="230"/>
                    <count group_id="O2" value="226"/>
                    <count group_id="O3" value="109"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="211.9" lower_limit="172.0" upper_limit="261.0"/>
                    <measurement group_id="O2" value="602.9" lower_limit="482.9" upper_limit="752.8"/>
                    <measurement group_id="O3" value="293.8" lower_limit="220.0" upper_limit="392.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 10A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="219"/>
                    <count group_id="O2" value="210"/>
                    <count group_id="O3" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1012.1" lower_limit="806.7" upper_limit="1269.8"/>
                    <measurement group_id="O2" value="2005.4" lower_limit="1586.0" upper_limit="2535.7"/>
                    <measurement group_id="O3" value="1580.3" lower_limit="1175.9" upper_limit="2123.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 11A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="216"/>
                    <count group_id="O2" value="206"/>
                    <count group_id="O3" value="102"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1473.2" lower_limit="1192.4" upper_limit="1820.2"/>
                    <measurement group_id="O2" value="1908.2" lower_limit="1541.5" upper_limit="2362.2"/>
                    <measurement group_id="O3" value="1566.6" lower_limit="1140.7" upper_limit="2151.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 12F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="224"/>
                    <count group_id="O2" value="214"/>
                    <count group_id="O3" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1054.5" lower_limit="822.0" upper_limit="1352.7"/>
                    <measurement group_id="O2" value="1763.4" lower_limit="1371.8" upper_limit="2266.7"/>
                    <measurement group_id="O3" value="1401.2" lower_limit="1001.8" upper_limit="1959.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 15B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="225"/>
                    <count group_id="O2" value="201"/>
                    <count group_id="O3" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="647.1" lower_limit="490.8" upper_limit="853.1"/>
                    <measurement group_id="O2" value="1479.5" lower_limit="1093.0" upper_limit="2002.8"/>
                    <measurement group_id="O3" value="1066.9" lower_limit="721.3" upper_limit="1578.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 22F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="218"/>
                    <count group_id="O2" value="206"/>
                    <count group_id="O3" value="108"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1772.8" lower_limit="1354.7" upper_limit="2319.8"/>
                    <measurement group_id="O2" value="4156.5" lower_limit="3243.8" upper_limit="5326.2"/>
                    <measurement group_id="O3" value="2717.8" lower_limit="1978.4" upper_limit="3733.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 33F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="216"/>
                    <count group_id="O2" value="208"/>
                    <count group_id="O3" value="103"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2026.2" lower_limit="1684.3" upper_limit="2437.4"/>
                    <measurement group_id="O2" value="3174.9" lower_limit="2579.1" upper_limit="3908.3"/>
                    <measurement group_id="O3" value="2182.9" lower_limit="1638.6" upper_limit="2907.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Pneumococcal OPA Geometric Mean Fold Rise (GMFR) From Before Vaccination to 1 Month After Vaccination</title>
        <description>OPA GMFR is the ratio of OPA GMTs, 1 month after vaccination to before vaccination. OPA GMFRs from before to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
        <time_frame>From before vaccination to 1 month after vaccination</time_frame>
        <population>Evaluable immunogenicity population was analyzed. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number analyzed= number of participants evaluable with OPA titers available at both time points for each serotype.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Pneumococcal OPA Geometric Mean Fold Rise (GMFR) From Before Vaccination to 1 Month After Vaccination</title>
          <description>OPA GMFR is the ratio of OPA GMTs, 1 month after vaccination to before vaccination. OPA GMFRs from before to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
          <population>Evaluable immunogenicity population was analyzed. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number analyzed= number of participants evaluable with OPA titers available at both time points for each serotype.</population>
          <units>fold rise</units>
          <param>Geometric Mean</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="247"/>
                <count group_id="O2" value="243"/>
                <count group_id="O3" value="121"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Serotype 1</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.2" lower_limit="1.9" upper_limit="2.5"/>
                    <measurement group_id="O2" value="3.4" lower_limit="2.9" upper_limit="4.1"/>
                    <measurement group_id="O3" value="2.0" lower_limit="1.7" upper_limit="2.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 3</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="240"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.4" lower_limit="2.1" upper_limit="2.8"/>
                    <measurement group_id="O2" value="3.5" lower_limit="3.1" upper_limit="4.1"/>
                    <measurement group_id="O3" value="1.9" lower_limit="1.6" upper_limit="2.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 4</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="231"/>
                    <count group_id="O2" value="235"/>
                    <count group_id="O3" value="115"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.9" lower_limit="3.9" upper_limit="6.1"/>
                    <measurement group_id="O2" value="5.0" lower_limit="4.1" upper_limit="6.2"/>
                    <measurement group_id="O3" value="2.4" lower_limit="1.9" upper_limit="3.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 5</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="241"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.3" lower_limit="2.0" upper_limit="2.6"/>
                    <measurement group_id="O2" value="2.3" lower_limit="2.0" upper_limit="2.6"/>
                    <measurement group_id="O3" value="1.8" lower_limit="1.5" upper_limit="2.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="239"/>
                    <count group_id="O2" value="234"/>
                    <count group_id="O3" value="118"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="12.6" lower_limit="9.5" upper_limit="16.7"/>
                    <measurement group_id="O2" value="8.3" lower_limit="6.6" upper_limit="10.4"/>
                    <measurement group_id="O3" value="6.5" lower_limit="4.7" upper_limit="9.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="238"/>
                    <count group_id="O2" value="238"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.6" lower_limit="5.2" upper_limit="8.4"/>
                    <measurement group_id="O2" value="6.7" lower_limit="5.4" upper_limit="8.3"/>
                    <measurement group_id="O3" value="4.0" lower_limit="3.0" upper_limit="5.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 7F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="233"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.3" lower_limit="1.9" upper_limit="2.7"/>
                    <measurement group_id="O2" value="2.6" lower_limit="2.2" upper_limit="3.0"/>
                    <measurement group_id="O3" value="1.6" lower_limit="1.4" upper_limit="2.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 9V</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="226"/>
                    <count group_id="O2" value="228"/>
                    <count group_id="O3" value="114"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.4" lower_limit="2.1" upper_limit="2.9"/>
                    <measurement group_id="O2" value="3.1" lower_limit="2.6" upper_limit="3.6"/>
                    <measurement group_id="O3" value="2.1" lower_limit="1.7" upper_limit="2.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 14</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="236"/>
                    <count group_id="O2" value="237"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.8" lower_limit="1.5" upper_limit="2.1"/>
                    <measurement group_id="O2" value="2.3" lower_limit="1.9" upper_limit="2.8"/>
                    <measurement group_id="O3" value="1.7" lower_limit="1.4" upper_limit="2.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 18C</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="240"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.2" lower_limit="2.5" upper_limit="3.9"/>
                    <measurement group_id="O2" value="3.9" lower_limit="3.2" upper_limit="4.8"/>
                    <measurement group_id="O3" value="2.2" lower_limit="1.8" upper_limit="2.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="239"/>
                    <count group_id="O2" value="239"/>
                    <count group_id="O3" value="117"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.9" lower_limit="2.4" upper_limit="3.4"/>
                    <measurement group_id="O2" value="2.9" lower_limit="2.4" upper_limit="3.4"/>
                    <measurement group_id="O3" value="1.9" lower_limit="1.6" upper_limit="2.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="118"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.6" lower_limit="2.2" upper_limit="3.1"/>
                    <measurement group_id="O2" value="2.7" lower_limit="2.3" upper_limit="3.2"/>
                    <measurement group_id="O3" value="1.9" lower_limit="1.5" upper_limit="2.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 23F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="242"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="6.6" lower_limit="5.1" upper_limit="8.5"/>
                    <measurement group_id="O2" value="9.3" lower_limit="7.4" upper_limit="11.8"/>
                    <measurement group_id="O3" value="4.5" lower_limit="3.4" upper_limit="6.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 8</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="223"/>
                    <count group_id="O2" value="219"/>
                    <count group_id="O3" value="101"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.6" lower_limit="2.9" upper_limit="4.4"/>
                    <measurement group_id="O2" value="22.5" lower_limit="17.2" upper_limit="29.4"/>
                    <measurement group_id="O3" value="2.1" lower_limit="1.6" upper_limit="2.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 10A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="198"/>
                    <count group_id="O2" value="199"/>
                    <count group_id="O3" value="109"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.5" lower_limit="3.5" upper_limit="5.7"/>
                    <measurement group_id="O2" value="14.4" lower_limit="10.9" upper_limit="19.0"/>
                    <measurement group_id="O3" value="4.4" lower_limit="3.3" upper_limit="6.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 11A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="184"/>
                    <count group_id="O2" value="183"/>
                    <count group_id="O3" value="91"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.5" lower_limit="2.0" upper_limit="3.2"/>
                    <measurement group_id="O2" value="6.7" lower_limit="5.0" upper_limit="9.0"/>
                    <measurement group_id="O3" value="3.1" lower_limit="2.2" upper_limit="4.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 12F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="208"/>
                    <count group_id="O2" value="200"/>
                    <count group_id="O3" value="103"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="7.2" lower_limit="5.5" upper_limit="9.5"/>
                    <measurement group_id="O2" value="31.7" lower_limit="23.1" upper_limit="43.4"/>
                    <measurement group_id="O3" value="3.8" lower_limit="2.7" upper_limit="5.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 15B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="211"/>
                    <count group_id="O2" value="184"/>
                    <count group_id="O3" value="99"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="4.3" lower_limit="3.3" upper_limit="5.7"/>
                    <measurement group_id="O2" value="18.9" lower_limit="13.0" upper_limit="27.4"/>
                    <measurement group_id="O3" value="4.8" lower_limit="3.1" upper_limit="7.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 22F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="207"/>
                    <count group_id="O2" value="191"/>
                    <count group_id="O3" value="104"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="11.1" lower_limit="8.0" upper_limit="15.3"/>
                    <measurement group_id="O2" value="66.9" lower_limit="46.5" upper_limit="96.4"/>
                    <measurement group_id="O3" value="9.8" lower_limit="6.2" upper_limit="15.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 33F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="203"/>
                    <count group_id="O2" value="196"/>
                    <count group_id="O3" value="99"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.8" lower_limit="1.5" upper_limit="2.2"/>
                    <measurement group_id="O2" value="5.4" lower_limit="4.2" upper_limit="6.8"/>
                    <measurement group_id="O3" value="1.8" lower_limit="1.4" upper_limit="2.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Percentage of Participants With &gt;=4-Fold Rise in Pneumococcal OPA Titers From Before Vaccination to 1 Month After Vaccination</title>
        <description>Percentage of participants with a &gt;=4-fold rise in pneumococcal OPA titers from before vaccination to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
        <time_frame>From before vaccination to 1 month after vaccination</time_frame>
        <population>Evaluable immunogenicity population: All participants who received 20vPnC as randomized, enrolled in appropriate cohort based on prior vaccination history, had Visit 2 blood collection within 27 to 49 days after vaccination, had at least 1 valid and determinate OPA titer for any serotype for Visit 2, had no major protocol deviations. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number Analyzed =number of participants evaluable for each serotype.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Percentage of Participants With &gt;=4-Fold Rise in Pneumococcal OPA Titers From Before Vaccination to 1 Month After Vaccination</title>
          <description>Percentage of participants with a &gt;=4-fold rise in pneumococcal OPA titers from before vaccination to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
          <population>Evaluable immunogenicity population: All participants who received 20vPnC as randomized, enrolled in appropriate cohort based on prior vaccination history, had Visit 2 blood collection within 27 to 49 days after vaccination, had at least 1 valid and determinate OPA titer for any serotype for Visit 2, had no major protocol deviations. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number Analyzed =number of participants evaluable for each serotype.</population>
          <units>percentage of participants</units>
          <param>Number</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="247"/>
                <count group_id="O2" value="243"/>
                <count group_id="O3" value="121"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Serotype 1</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="22.9" lower_limit="17.8" upper_limit="28.6"/>
                    <measurement group_id="O2" value="40.3" lower_limit="34.1" upper_limit="46.8"/>
                    <measurement group_id="O3" value="20.8" lower_limit="14.0" upper_limit="29.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 3</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="240"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="29.6" lower_limit="24.0" upper_limit="35.8"/>
                    <measurement group_id="O2" value="41.3" lower_limit="35.0" upper_limit="47.8"/>
                    <measurement group_id="O3" value="18.5" lower_limit="12.0" upper_limit="26.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 4</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="231"/>
                    <count group_id="O2" value="235"/>
                    <count group_id="O3" value="115"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="41.1" lower_limit="34.7" upper_limit="47.8"/>
                    <measurement group_id="O2" value="41.3" lower_limit="34.9" upper_limit="47.9"/>
                    <measurement group_id="O3" value="25.2" lower_limit="17.6" upper_limit="34.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 5</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="241"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="25.7" lower_limit="20.3" upper_limit="31.7"/>
                    <measurement group_id="O2" value="27.2" lower_limit="21.7" upper_limit="33.2"/>
                    <measurement group_id="O3" value="15.8" lower_limit="9.8" upper_limit="23.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="239"/>
                    <count group_id="O2" value="234"/>
                    <count group_id="O3" value="118"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="61.5" lower_limit="55.0" upper_limit="67.7"/>
                    <measurement group_id="O2" value="56.4" lower_limit="49.8" upper_limit="62.9"/>
                    <measurement group_id="O3" value="44.9" lower_limit="35.7" upper_limit="54.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="238"/>
                    <count group_id="O2" value="238"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="53.4" lower_limit="46.8" upper_limit="59.8"/>
                    <measurement group_id="O2" value="55.0" lower_limit="48.5" upper_limit="61.5"/>
                    <measurement group_id="O3" value="35.3" lower_limit="26.8" upper_limit="44.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 7F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="233"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="26.2" lower_limit="20.7" upper_limit="32.3"/>
                    <measurement group_id="O2" value="30.3" lower_limit="24.6" upper_limit="36.5"/>
                    <measurement group_id="O3" value="14.3" lower_limit="8.5" upper_limit="21.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 9V</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="226"/>
                    <count group_id="O2" value="228"/>
                    <count group_id="O3" value="114"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="28.3" lower_limit="22.5" upper_limit="34.7"/>
                    <measurement group_id="O2" value="36.0" lower_limit="29.7" upper_limit="42.6"/>
                    <measurement group_id="O3" value="20.2" lower_limit="13.2" upper_limit="28.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 14</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="236"/>
                    <count group_id="O2" value="237"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="15.7" lower_limit="11.3" upper_limit="21.0"/>
                    <measurement group_id="O2" value="24.9" lower_limit="19.5" upper_limit="30.9"/>
                    <measurement group_id="O3" value="16.0" lower_limit="9.9" upper_limit="23.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 18C</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="240"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="29.4" lower_limit="23.8" upper_limit="35.5"/>
                    <measurement group_id="O2" value="38.3" lower_limit="32.2" upper_limit="44.8"/>
                    <measurement group_id="O3" value="17.6" lower_limit="11.3" upper_limit="25.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="239"/>
                    <count group_id="O2" value="239"/>
                    <count group_id="O3" value="117"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="29.7" lower_limit="24.0" upper_limit="35.9"/>
                    <measurement group_id="O2" value="29.3" lower_limit="23.6" upper_limit="35.5"/>
                    <measurement group_id="O3" value="15.4" lower_limit="9.4" upper_limit="23.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="118"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="29.2" lower_limit="23.6" upper_limit="35.4"/>
                    <measurement group_id="O2" value="32.8" lower_limit="26.9" upper_limit="39.1"/>
                    <measurement group_id="O3" value="16.9" lower_limit="10.7" upper_limit="25.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 23F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="242"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="49.6" lower_limit="43.1" upper_limit="56.1"/>
                    <measurement group_id="O2" value="58.7" lower_limit="52.2" upper_limit="64.9"/>
                    <measurement group_id="O3" value="42.9" lower_limit="33.8" upper_limit="52.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 8</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="223"/>
                    <count group_id="O2" value="219"/>
                    <count group_id="O3" value="101"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="39.9" lower_limit="33.4" upper_limit="46.7"/>
                    <measurement group_id="O2" value="72.6" lower_limit="66.2" upper_limit="78.4"/>
                    <measurement group_id="O3" value="30.7" lower_limit="21.9" upper_limit="40.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 10A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="198"/>
                    <count group_id="O2" value="199"/>
                    <count group_id="O3" value="109"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="45.5" lower_limit="38.4" upper_limit="52.7"/>
                    <measurement group_id="O2" value="70.9" lower_limit="64.0" upper_limit="77.1"/>
                    <measurement group_id="O3" value="44.0" lower_limit="34.5" upper_limit="53.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 11A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="184"/>
                    <count group_id="O2" value="183"/>
                    <count group_id="O3" value="91"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="30.4" lower_limit="23.9" upper_limit="37.6"/>
                    <measurement group_id="O2" value="54.6" lower_limit="47.1" upper_limit="62.0"/>
                    <measurement group_id="O3" value="35.2" lower_limit="25.4" upper_limit="45.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 12F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="208"/>
                    <count group_id="O2" value="200"/>
                    <count group_id="O3" value="103"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="51.4" lower_limit="44.4" upper_limit="58.4"/>
                    <measurement group_id="O2" value="76.5" lower_limit="70.0" upper_limit="82.2"/>
                    <measurement group_id="O3" value="40.8" lower_limit="31.2" upper_limit="50.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 15B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="211"/>
                    <count group_id="O2" value="184"/>
                    <count group_id="O3" value="99"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="37.4" lower_limit="30.9" upper_limit="44.3"/>
                    <measurement group_id="O2" value="66.3" lower_limit="59.0" upper_limit="73.1"/>
                    <measurement group_id="O3" value="38.4" lower_limit="28.8" upper_limit="48.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 22F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="207"/>
                    <count group_id="O2" value="191"/>
                    <count group_id="O3" value="104"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="57.0" lower_limit="50.0" upper_limit="63.8"/>
                    <measurement group_id="O2" value="83.2" lower_limit="77.2" upper_limit="88.2"/>
                    <measurement group_id="O3" value="54.8" lower_limit="44.7" upper_limit="64.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 33F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="203"/>
                    <count group_id="O2" value="196"/>
                    <count group_id="O3" value="99"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="18.7" lower_limit="13.6" upper_limit="24.8"/>
                    <measurement group_id="O2" value="53.6" lower_limit="46.3" upper_limit="60.7"/>
                    <measurement group_id="O3" value="19.2" lower_limit="12.0" upper_limit="28.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Percentage of Participants With Pneumococcal OPA Titers &gt;=Lower Limit of Quantitation (LLOQ) at 1 Month After Vaccination</title>
        <description>The percentage of participants with OPA titers &gt;=LLOQ at 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
        <time_frame>1 month after vaccination</time_frame>
        <population>Evaluable immunogenicity population: All participants who received 20vPnC as randomized, enrolled in appropriate cohort based on prior vaccination history, had Visit 2 blood collection within 27 to 49 days after vaccination, had at least 1 valid and determinate OPA titer for any serotype for Visit 2, had no major protocol deviations. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number Analyzed =number of participants evaluable for each serotype.</population>
        <group_list>
          <group group_id="O1">
            <title>Cohort A: 20vPnC</title>
            <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
          </group>
          <group group_id="O2">
            <title>Cohort B: 20vPnC</title>
            <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
          <group group_id="O3">
            <title>Cohort C: 20vPnC</title>
            <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
          </group>
        </group_list>
        <measure>
          <title>Percentage of Participants With Pneumococcal OPA Titers &gt;=Lower Limit of Quantitation (LLOQ) at 1 Month After Vaccination</title>
          <description>The percentage of participants with OPA titers &gt;=LLOQ at 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.</description>
          <population>Evaluable immunogenicity population: All participants who received 20vPnC as randomized, enrolled in appropriate cohort based on prior vaccination history, had Visit 2 blood collection within 27 to 49 days after vaccination, had at least 1 valid and determinate OPA titer for any serotype for Visit 2, had no major protocol deviations. Data for this outcome measure were planned to be analyzed for 20vPnC groups of each cohort. Number Analyzed =number of participants evaluable for each serotype.</population>
          <units>percentage of participants</units>
          <param>Number</param>
          <dispersion>95% Confidence Interval</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="247"/>
                <count group_id="O2" value="243"/>
                <count group_id="O3" value="121"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <title>Serotype 1</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="246"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="65.4" lower_limit="59.1" upper_limit="71.4"/>
                    <measurement group_id="O2" value="87.7" lower_limit="82.8" upper_limit="91.5"/>
                    <measurement group_id="O3" value="77.5" lower_limit="69.0" upper_limit="84.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 3</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="76.1" lower_limit="70.3" upper_limit="81.3"/>
                    <measurement group_id="O2" value="90.5" lower_limit="86.1" upper_limit="93.9"/>
                    <measurement group_id="O3" value="87.4" lower_limit="80.1" upper_limit="92.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 4</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="236"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="116"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="76.7" lower_limit="70.8" upper_limit="81.9"/>
                    <measurement group_id="O2" value="91.7" lower_limit="87.5" upper_limit="94.9"/>
                    <measurement group_id="O3" value="87.1" lower_limit="79.6" upper_limit="92.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 5</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="244"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="64.8" lower_limit="58.4" upper_limit="70.7"/>
                    <measurement group_id="O2" value="74.9" lower_limit="69.0" upper_limit="80.2"/>
                    <measurement group_id="O3" value="72.5" lower_limit="63.6" upper_limit="80.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="242"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="121"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="84.3" lower_limit="79.1" upper_limit="88.6"/>
                    <measurement group_id="O2" value="93.8" lower_limit="89.9" upper_limit="96.5"/>
                    <measurement group_id="O3" value="90.9" lower_limit="84.3" upper_limit="95.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 6B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="243"/>
                    <count group_id="O2" value="241"/>
                    <count group_id="O3" value="121"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="86.8" lower_limit="81.9" upper_limit="90.8"/>
                    <measurement group_id="O2" value="93.8" lower_limit="89.9" upper_limit="96.5"/>
                    <measurement group_id="O3" value="91.7" lower_limit="85.3" upper_limit="96.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 7F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="240"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="74.2" lower_limit="68.1" upper_limit="79.6"/>
                    <measurement group_id="O2" value="84.8" lower_limit="79.6" upper_limit="89.0"/>
                    <measurement group_id="O3" value="79.2" lower_limit="70.8" upper_limit="86.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 9V</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="241"/>
                    <count group_id="O2" value="237"/>
                    <count group_id="O3" value="117"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="76.8" lower_limit="70.9" upper_limit="81.9"/>
                    <measurement group_id="O2" value="89.5" lower_limit="84.8" upper_limit="93.1"/>
                    <measurement group_id="O3" value="85.5" lower_limit="77.8" upper_limit="91.3"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 14</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="240"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="119"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="85.8" lower_limit="80.8" upper_limit="90.0"/>
                    <measurement group_id="O2" value="95.0" lower_limit="91.5" upper_limit="97.4"/>
                    <measurement group_id="O3" value="93.3" lower_limit="87.2" upper_limit="97.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 18C</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="240"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="91.8" lower_limit="87.7" upper_limit="94.9"/>
                    <measurement group_id="O2" value="96.3" lower_limit="93.0" upper_limit="98.3"/>
                    <measurement group_id="O3" value="95.8" lower_limit="90.5" upper_limit="98.6"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="242"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="93.8" lower_limit="90.0" upper_limit="96.5"/>
                    <measurement group_id="O2" value="95.9" lower_limit="92.5" upper_limit="98.0"/>
                    <measurement group_id="O3" value="98.3" lower_limit="94.1" upper_limit="99.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 19F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="244"/>
                    <count group_id="O2" value="242"/>
                    <count group_id="O3" value="118"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="71.7" lower_limit="65.6" upper_limit="77.3"/>
                    <measurement group_id="O2" value="84.3" lower_limit="79.1" upper_limit="88.6"/>
                    <measurement group_id="O3" value="84.7" lower_limit="77.0" upper_limit="90.7"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 23F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="245"/>
                    <count group_id="O2" value="243"/>
                    <count group_id="O3" value="120"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="76.3" lower_limit="70.5" upper_limit="81.5"/>
                    <measurement group_id="O2" value="93.8" lower_limit="90.0" upper_limit="96.5"/>
                    <measurement group_id="O3" value="87.5" lower_limit="80.2" upper_limit="92.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 8</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="230"/>
                    <count group_id="O2" value="226"/>
                    <count group_id="O3" value="109"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="85.2" lower_limit="80.0" upper_limit="89.5"/>
                    <measurement group_id="O2" value="94.7" lower_limit="90.9" upper_limit="97.2"/>
                    <measurement group_id="O3" value="90.8" lower_limit="83.8" upper_limit="95.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 10A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="219"/>
                    <count group_id="O2" value="210"/>
                    <count group_id="O3" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="92.2" lower_limit="87.9" upper_limit="95.4"/>
                    <measurement group_id="O2" value="95.7" lower_limit="92.0" upper_limit="98.0"/>
                    <measurement group_id="O3" value="96.4" lower_limit="91.0" upper_limit="99.0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 11A</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="216"/>
                    <count group_id="O2" value="206"/>
                    <count group_id="O3" value="102"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="91.2" lower_limit="86.6" upper_limit="94.6"/>
                    <measurement group_id="O2" value="94.7" lower_limit="90.6" upper_limit="97.3"/>
                    <measurement group_id="O3" value="89.2" lower_limit="81.5" upper_limit="94.5"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 12F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="224"/>
                    <count group_id="O2" value="214"/>
                    <count group_id="O3" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="87.9" lower_limit="82.9" upper_limit="91.9"/>
                    <measurement group_id="O2" value="93.0" lower_limit="88.7" upper_limit="96.0"/>
                    <measurement group_id="O3" value="91.8" lower_limit="85.0" upper_limit="96.2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 15B</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="225"/>
                    <count group_id="O2" value="201"/>
                    <count group_id="O3" value="110"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="84.9" lower_limit="79.5" upper_limit="89.3"/>
                    <measurement group_id="O2" value="91.0" lower_limit="86.2" upper_limit="94.6"/>
                    <measurement group_id="O3" value="90.0" lower_limit="82.8" upper_limit="94.9"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 22F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="218"/>
                    <count group_id="O2" value="206"/>
                    <count group_id="O3" value="108"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="94.0" lower_limit="90.0" upper_limit="96.8"/>
                    <measurement group_id="O2" value="99.0" lower_limit="96.5" upper_limit="99.9"/>
                    <measurement group_id="O3" value="98.1" lower_limit="93.5" upper_limit="99.8"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
            <class>
              <title>Serotype 33F</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="O1" value="216"/>
                    <count group_id="O2" value="208"/>
                    <count group_id="O3" value="103"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="88.9" lower_limit="83.9" upper_limit="92.7"/>
                    <measurement group_id="O2" value="91.8" lower_limit="87.2" upper_limit="95.2"/>
                    <measurement group_id="O3" value="87.4" lower_limit="79.4" upper_limit="93.1"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
    </outcome_list>

    <reported_events>
      <time_frame>Other AEs: local reactions within 10 days after vaccination, systemic events: within 7 days after vaccination (systematic assessment), non serious AEs up to 1 month after Vaccination; SAEs: up to 6 months after vaccination</time_frame>
      <desc>Same event may appear as AE and SAE, what is presented are distinct events. Event may be categorized as serious in 1 participant and as non-serious in another participant or 1 participant may have experienced both serious and non-serious event during study. Safety population was analyzed.</desc>
      <group_list>
        <group group_id="E1">
          <title>Cohort A: 20vPnC</title>
          <description>Participants with receipt of 23-valent pneumococcal polysaccharide vaccine (PPSV23) greater than or equal to (&gt;=) 1 to less than or equal to (&lt;=) 5 years, and no 13-valent pneumococcal conjugate vaccine (13vPnC), prior to study vaccination, and randomized to receive a single dose of 0.5 milliliter (mL) intramuscular injection of 20-valent pneumococcal conjugate vaccine (20vPnC) on Day 1.</description>
        </group>
        <group group_id="E2">
          <title>Cohort A: 13vPnC</title>
          <description>Participants with receipt of PPSV23, &gt;=1 to &lt;=5 years, and no 13vPnC, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 13vPnC on Day 1.</description>
        </group>
        <group group_id="E3">
          <title>Cohort B: 20vPnC</title>
          <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
        </group>
        <group group_id="E4">
          <title>Cohort B: PPSV23</title>
          <description>Participants with receipt of 13vPnC, &gt;=6 months, and no PPSV23, prior to study vaccination, and randomized to receive a single dose of 0.5 mL intramuscular injection of PPSV23 on Day 1.</description>
        </group>
        <group group_id="E5">
          <title>Cohort C: 20vPnC</title>
          <description>Participants with receipt of 13vPnC followed by PPSV23 (PPSV23 dose &gt;=1 year) prior to study vaccination, received a single dose of 0.5 mL intramuscular injection of 20vPnC on Day 1.</description>
        </group>
      </group_list>
      <serious_events>
        <default_vocab>MedDRA v22.1</default_vocab>
        <default_assessment>Non-systematic Assessment</default_assessment>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, all-cause mortality</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Total, serious adverse events</sub_title>
                <counts group_id="E1" subjects_affected="2" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="2" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="6" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="2" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="2" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Cardiac disorders</title>
            <event_list>
              <event>
                <sub_title>Acute myocardial infarction</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="1" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Cardiac failure congestive</sub_title>
                <counts group_id="E1" subjects_affected="1" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Gastrointestinal disorders</title>
            <event_list>
              <event>
                <sub_title>Dysphagia</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="1" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Gastrointestinal haemorrhage</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="1" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Hepatobiliary disorders</title>
            <event_list>
              <event>
                <sub_title>Cholecystitis</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="1" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Infections and infestations</title>
            <event_list>
              <event>
                <sub_title>Appendicitis</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="1" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Clostridium difficile colitis</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="1" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Pneumonia</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="1" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Investigations</title>
            <event_list>
              <event>
                <sub_title>Blood pressure decreased</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="1" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Metabolism and nutrition disorders</title>
            <event_list>
              <event>
                <sub_title>Dehydration</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="1" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Musculoskeletal and connective tissue disorders</title>
            <event_list>
              <event>
                <sub_title>Osteoarthritis</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="1" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Neoplasms benign, malignant and unspecified (incl cysts and polyps)</title>
            <event_list>
              <event>
                <sub_title>Prostate cancer</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="1" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Nervous system disorders</title>
            <event_list>
              <event>
                <sub_title>Carotid artery stenosis</sub_title>
                <counts group_id="E1" subjects_affected="1" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Syncope</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="2" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Surgical and medical procedures</title>
            <event_list>
              <event>
                <sub_title>Cardiac pacemaker replacement</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="1" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </serious_events>
      <other_events>
        <frequency_threshold>1</frequency_threshold>
        <default_vocab>MedDRA v22.1</default_vocab>
        <default_assessment>Systematic Assessment</default_assessment>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, other adverse events</sub_title>
                <counts group_id="E1" subjects_affected="173" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="69" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="178" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="96" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="86" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>General disorders</title>
            <event_list>
              <event>
                <sub_title>Fatigue (FATIGUE)</sub_title>
                <counts group_id="E1" subjects_affected="73" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="27" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="76" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="42" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="41" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Injection site erythema (REDNESS)</sub_title>
                <counts group_id="E1" subjects_affected="20" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="3" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="21" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="16" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="6" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Injection site pain (PAIN)</sub_title>
                <counts group_id="E1" subjects_affected="127" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="52" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="150" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="71" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="66" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Injection site swelling (SWELLING)</sub_title>
                <counts group_id="E1" subjects_affected="25" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="8" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="23" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="18" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="5" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Pyrexia (FEVER)</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="2" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Infections and infestations</title>
            <event_list>
              <event>
                <sub_title>Nasopharyngitis</sub_title>
                <assessment>Non-systematic Assessment</assessment>
                <counts group_id="E1" subjects_affected="3" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="1" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Urinary tract infection</sub_title>
                <assessment>Non-systematic Assessment</assessment>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="2" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="0" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="0" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Musculoskeletal and connective tissue disorders</title>
            <event_list>
              <event>
                <sub_title>Arthralgia (JOINT PAIN)</sub_title>
                <counts group_id="E1" subjects_affected="17" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="13" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="29" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="20" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="21" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Myalgia (MUSCLE PAIN)</sub_title>
                <counts group_id="E1" subjects_affected="81" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="38" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="83" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="58" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="47" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
          <category>
            <title>Nervous system disorders</title>
            <event_list>
              <event>
                <sub_title>Dizziness</sub_title>
                <assessment>Non-systematic Assessment</assessment>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="1" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="2" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="0" subjects_at_risk="125"/>
              </event>
              <event>
                <sub_title>Headache (HEADACHE)</sub_title>
                <assessment>Non-systematic Assessment</assessment>
                <counts group_id="E1" subjects_affected="45" subjects_at_risk="253"/>
                <counts group_id="E2" subjects_affected="22" subjects_at_risk="122"/>
                <counts group_id="E3" subjects_affected="33" subjects_at_risk="246"/>
                <counts group_id="E4" subjects_affected="27" subjects_at_risk="127"/>
                <counts group_id="E5" subjects_affected="24" subjects_at_risk="125"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </other_events>
    </reported_events>

    <certain_agreements>
      <pi_employee>Principal Investigators are NOT employed by the organization sponsoring the study.</pi_employee>
      <restrictive_agreement>Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.</restrictive_agreement>
    </certain_agreements>
    <point_of_contact>
      <name_or_title>Pfizer ClinicalTrials.gov Call Center</name_or_title>
      <organization>Pfizer Inc.</organization>
      <phone>1-800-718-1021</phone>
      <email>ClinicalTrials.gov_Inquiries@pfizer.com</email>
    </point_of_contact>
  </clinical_results>
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03835975
org study id: B7471006
secondary id: 2018-004278-91
nct id: NCT03835975
lead sponsor: 
has dmc: Yes
is fda regulated drug: Yes
is fda regulated device: No
This Phase 3 will describe the safety and immunogenicity of a 20-valent pneumococcal
      conjugate vaccine formulation in adults 65 years of age or older with prior pneumococcal
      vaccination
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Prevention
masking: None (Open Label)
measure: Percentage of Participants With Local Reactions Within 10 Days After Vaccination
time frame: Within 10 days after vaccination
description: Local reactions were recorded using an electronic diary (e-diary). Local reactions included redness, swelling and pain at the injection site. Redness and swelling were measured and recorded in measuring device units. 1 measuring device unit =0.5 centimeter (cm). Redness and swelling were graded as mild (greater than [>] 2.0 to 5.0 cm), moderate (>5.0 to 10.0 cm) and severe (>10.0 cm). Pain at injection site was graded as mild (did not interfere with activity), moderate (interfered with activity), and severe (prevented daily activity).
measure: Percentage of Participants With Systemic Events Within 7 Days After Vaccination
time frame: Within 7 days after vaccination
description: Systemic events fever, fatigue, headache, muscle pain and joint pain were recorded by using an e-diary. Fever was defined as temperature >=38.0 degree Celsius (C) and categorized to >=38.0 to 38.4 degree C, >38.4 to 38.9 degree C, >38.9 to 40.0 degree C and >40.0 degree C. Fatigue, headache, muscle pain and joint pain were graded as mild (did not interfere with activity), moderate (some interference with activity) and severe (prevented daily routine activity).
measure: Percentage of Participants With Adverse Events (AEs) Within 1 Month After Vaccination
time frame: Within 1 month after vaccination
description: An AE was any untoward medical occurrence in study participants who received study vaccine without regard to possibility of causal relationship with the treatment.
measure: Percentage of Participants With Serious Adverse Events (SAEs) Within 6 Months After Vaccination
time frame: Within 6 months after vaccination
description: An SAE was any untoward medical occurrence at any dose that results in death; is life-threatening (immediate risk of death); requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); results in congenital anomaly/birth defect or that is considered to be an important medical event.
measure: Percentage of Participants With Newly Diagnosed Chronic Medical Conditions (NDCMCs) Within 6 Months After Vaccination
time frame: Within 6 months after vaccination
description: An NDCMC was defined as a disease or medical condition, not previously identified, that was expected to be persistent or was otherwise long-lasting in its effects.
measure: Pneumococcal Opsonophagocytic Activity (OPA) Geometric Mean Titers (GMTs) at 1 Month After Vaccination
time frame: 1 month after vaccination
description: OPA GMTs were determined for serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F. OPA titer was expressed as reciprocal of the highest serum dilution.
measure: Pneumococcal OPA Geometric Mean Fold Rise (GMFR) From Before Vaccination to 1 Month After Vaccination
time frame: From before vaccination to 1 month after vaccination
description: OPA GMFR is the ratio of OPA GMTs, 1 month after vaccination to before vaccination. OPA GMFRs from before to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.
measure: Percentage of Participants With >=4-Fold Rise in Pneumococcal OPA Titers From Before Vaccination to 1 Month After Vaccination
time frame: From before vaccination to 1 month after vaccination
description: Percentage of participants with a >=4-fold rise in pneumococcal OPA titers from before vaccination to 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.
measure: Percentage of Participants With Pneumococcal OPA Titers >=Lower Limit of Quantitation (LLOQ) at 1 Month After Vaccination
time frame: 1 month after vaccination
description: The percentage of participants with OPA titers >=LLOQ at 1 month after vaccination were calculated for pneumococcal serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F, 8, 10A, 11A, 12F, 15B, 22F and 33F.
arm group label: 13vPnC
arm group type: Active Comparator
description: Pneumococcal conjugate vaccine
arm group label: PPSV23
arm group type: Active Comparator
description: Pneumococcal polysaccharide vaccine
arm group label: 20vPnC
arm group type: Experimental
description: Pneumococcal conjugate vaccine
intervention type: Biological
intervention name: 13vPnC
description: Pneumococcal conjugate vaccine
arm group label: 13vPnC
intervention type: Biological
intervention name: PPSV23
description: Pneumococcal polysaccharide vaccine
arm group label: PPSV23
intervention type: Biological
intervention name: 20vPnC
description: Pneumococcal conjugate vaccine
arm group label: 20vPnC
criteria: 
gender: All
minimum age: 65 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Pfizer CT.gov Call Center
role: Study Director
affiliation: Pfizer
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country: Sweden
country: United States
url: https://pmiform.com/clinical-trial-info-request?StudyID=B7471006
description: To obtain contact information for a study center near you, click here.
responsible party type: Sponsor
mesh term: Pneumococcal Infections
mesh term: Heptavalent Pneumococcal Conjugate Vaccine
sharing ipd: Yes
ipd description: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
ipd url: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests
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