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[Value of pneumococcal vaccination in infants and young children]
1Universität München, Dr.-von-Haunersches Kinderspital, Abteilung für antimikrobielle Therapie, München.
Insights
Vaccinating children under two years old against Streptococcus pneumoniae can significantly reduce invasive pneumococcal diseases and otitis media. This is crucial due to high infection rates and the ineffectiveness of older vaccines in this age group.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Bacterial pathogenesis
Context:
- Streptococcus pneumoniae causes severe childhood illnesses like meningitis, pneumonia, and otitis media.
- Invasive pneumococcal disease (IPD) rates are highest in children under 24 months.
- Germany experiences substantial annual cases of pneumococcal-related meningitis, pneumonia, and otitis media.
Purpose:
- To highlight the significant burden of pneumococcal infections in young children.
- To evaluate the efficacy of the heptavalent pneumococcal conjugate vaccine in preventing IPD and otitis media.
- To advocate for universal vaccination of children under two years against pneumococcal disease.
Summary:
- The heptavalent pneumococcal conjugate vaccine can decrease invasive pneumococcal diseases by approximately 80% in children up to 2 years old.
- The vaccine also reduces cases of otitis media and recurrent otitis media by 6% and 9-16%, respectively.
- High rates of macrolide resistance and the inefficacy of the 23-valent vaccine in infants necessitate the use of the conjugate vaccine.
Impact:
- Universal vaccination can drastically lower the incidence of severe pneumococcal infections in infants and young children.
- Reduced disease burden translates to fewer hospitalizations, lower mortality rates, and decreased long-term neurological sequelae.
- Widespread use of effective vaccines is essential for public health, especially given antibiotic resistance challenges.
Abstract:
Streptococcus pneumoniae is a common cause of meningitis, sepsis, pneumonia, acute otitis media, and sinusitis in children. Children younger than 24 months have the highest rates of invasive pneumococcal infections (Germany 1997-1999: 19.5/100,000/year). Pneumococcal infections cause in Germany 220-250 cases of meningitis, about 50,000 of pneumonia (children younger than 5 years) and more than 1 million cases of otitis media (children) annually. The case-fatality rate for invasive pneumococcal diseases is high (1997-1999 5.5%, meningitis 8.3%). 20-30% of survivors from meningitis suffer from CNS-related sequelea. In children up to 2 years vaccination with the heptavalent pneumococcal conjugate vaccine can reduce invasive pneumococcal diseases by about 80% and otitis media and recurrent otitis media by 6% and 9-16%, respectively. Due to the increased risk of pneumococcal infections in the first two years of live all children of this age group should be vaccinated. The high rate of resistance of pneumococci against macrolides in Germany, the high rate of non-licensed antibiotics in infants and the inefficacy of the 23-valent vaccine in children younger than 2 years makes the new vaccine to a necessary alternative.