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Cecilia Trucchi Department of Health Sciences (DiSSal) University of Genoa Via A. Pastore, 1 16132 Genoa (Italy) Genoa, 25/08/2015 Dear Editor, We wish to submit a new manuscript entitled “Methodological criticisms in the evaluation of Pneumococcal Conjugate Vaccine effectiveness” for consideration by the Journal of Preventive Medicine and Hygiene. We confirm that this work is original and has not been published elsewhere nor is it currently under consideration for publication elsewhere. In this paper, we discuss the variability in available estimates in Low Respiratory Tract Infections (LRTIs) and associated risk factors, and the methodological criticism in their evaluation. This is relevant in the light of the gradual introduction of PCV13 immunization strategy targeted to elderly and risk groups in middle-high income countries. We think that the paper should be of interest to readers in the areas of epidemiology and Public Health immunization strategies. We declare that Prof. Filippo Ansaldi has received research fundings as investigator or principal investigator and has participated at speaker’s bureaus and advisory board meetings sponsored by Pfizer, Sanofi Pasteur and GSK. Dr. Cecilia Trucchi and Chiara Paganino have no conflict of interest. No other relationships/conditions/circumstances that present a potential conflict of interest exist. Thank you for your consideration of this manuscript. Sincerely, The Authors Cecilia Trucchi, Chiara Paganino and Filippo Ansaldi