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Published on: February 23, 2014
Pneumococcal vaccination of children
1University of New Mexico Health Sciences Center, Albuquerque 87131, USA. goverturf@salud.unm.edu
Insights
Pneumococcal protein conjugate vaccines offer superior protection against invasive bacterial infections in young children compared to older polysaccharide vaccines. These conjugate vaccines are recommended for all infants starting at two months of age.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Streptococcus pneumoniae is a leading cause of invasive bacterial infections in children under two, with higher risks in specific populations.
- Pneumococcal infections also commonly manifest as pneumonia, sinusitis, and otitis media.
- Children with sickle cell disease, splenectomy, or HIV have significantly elevated risks of invasive pneumococcal disease.
Purpose of the Study:
- To evaluate the efficacy of pneumococcal vaccines in young children.
- To compare the immunogenicity of polysaccharide versus protein conjugate vaccines.
- To inform vaccination recommendations for preventing invasive pneumococcal disease in pediatric populations.
Main Methods:
- Review of existing literature on pneumococcal vaccines and their use in children.
- Comparison of antibody responses induced by pneumococcal polysaccharide polyvalent vaccines versus pneumococcal protein conjugate vaccines.
- Analysis of vaccine effectiveness data in infants and high-risk children.
Main Results:
- Pneumococcal polysaccharide vaccines are ineffective in children younger than two years due to poor antibody response and lack of immunologic memory.
- Pneumococcal protein conjugate vaccines elicit protective responses in infants under six months.
- Immunologic memory is established with conjugate vaccines, enhancing booster dose responses.
Conclusions:
- Pneumococcal protein conjugate vaccines are crucial for protecting young children against invasive pneumococcal disease.
- Current recommendations include routine administration of a heptavalent pneumococcal protein conjugate vaccine to all infants from two months of age.
- High-risk children aged 24-59 months also benefit from this conjugate vaccine for preventing invasive disease.
Abstract:
Streptococcus pneumoniae is the most frequent cause of invasive bacterial infection in children younger than 2 years of age, reaching a peak incidence at 6 to 12 months of age. Pneumococci also cause many cases of pneumonia, sinusitis, and otitis media. Incidence rates of invasive infection in children with sickle cell disease, acquired or congenital splenectomy, or human immunodeficiency virus infection are 20- to 100-fold higher than are those of healthy children during the first 5 years of life. Other healthy children, such as those of American Indian, Native Alaskan, or African American descent, also have high rates of invasive infection, and those children enrolled in out-of-home care may have modestly increased risks. Pneumococcal polysaccharide polyvalent vaccines have been available for more than 2 decades but are limited in their usefulness for children because of their inability to induce protective antibody responses in children younger than 2 years of age and lack of immunologic memory. In contrast, pneumococcal protein conjugate vaccines induce presumptive protective responses in infants younger than 6 months, and immunologic memory further enhances responses after booster doses are given. Currently, a single heptavalent pneumococcal protein conjugate vaccine is licensed for use in the United States and is recommended for routine administration to all children, beginning at 2 months of age. It also is recommended for children between 24 and 59 months of age who are at high risk of acquiring invasive disease.
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