[Antipneumococcal vaccine: up date and prospective]

The authors, after a brief survey of the historical evolution of the antipneumococcal vaccines, concentrate on the most recent acquisitions concerning epidemiologic infections of pneumococcus in Italy and abroad. What emerged is the importance of prevention through an efficacious vaccination of the invasive forms particularly frequent in infants. Among there, and above all, meningitis; when not fatal, is very often the cause of serious illness. For this motive with the availability today of efficacious conjugated vaccine in infancy, a period with more frequent and invasive forms, it was first proposed to offer an antipneumococcal vaccination to children under 5 years of age that present particular clinical pathological conditions and later reconsidered the opportunity to extend the vaccination. Discussed and underlined are the differences between antipneumococcal vaccines available today, the importance of vaccinal coverage with conjugated vaccine from the first months of birth, and the fact that on extended vaccination campaign with such a vaccine can reduce the state of nasopharyngeal carriage of serotypes contained in the vaccine ever though penicillin resistant with an increase, however, of the state of carriage for serotypes not contained in the vaccine giving place to a phenomenon some call ''replacement'' of pathogens with non-pathogen germs. An ulterior benefit over the pneumococcal pathology is represented by the significative effect of ''herd immunity'' on subjects not vaccinated, factor that underscores the opportunity to extend the vaccination as much as possible. The importance of a precocious and rapid diagnosis with the tests available today and the necessity to vaccinate ever subjects that have overcome a serious pneumococcal infection in order to protect the subject from other types of pneumococcal particularly aggressive. Even though the vaccines actually available do not represent a final solution in the prevention of pneumococcus disease and the struggle against such pathology is destined to continue, the success obtained merits a certain satisfaction.