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Combined schedules of pneumococcal conjugate and polysaccharide vaccines: is hyporesponsiveness an issue?

Katherine L O'Brien1, Michael Hochman, David Goldblatt

  • 1Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. klobrien@jhsph.edu

The Lancet. Infectious Diseases
|August 24, 2007
PubMed

Insights

Pneumococcal conjugate vaccines (PCVs) can prevent pneumococcal disease in young children. Combining PCVs with PPV23 may broaden protection, but repeated doses might cause immune hyporesponsiveness.

Area of Science:

  • Pediatric infectious diseases
  • Vaccinology
  • Immunology

Background:

  • Streptococcus pneumoniae causes significant childhood morbidity and mortality globally.
  • Pneumococcal conjugate vaccines (PCVs) offer effective prevention in children under 5.
  • Combining PCVs with 23-valent pneumococcal polysaccharide vaccine (PPV23) is explored for broader serotype coverage.

Purpose of the Study:

  • To review evidence for and against immune hyporesponsiveness to repeated polysaccharide vaccine doses.
  • To explore potential mechanisms underlying vaccine-induced hyporesponsiveness.

Main Methods:

  • Review of existing studies on pneumococcal and meningococcal polysaccharide vaccines.
  • Analysis of data on immune responses following combined and repeated vaccine schedules.

Main Results:

  • Evidence suggests that repeated exposure to polysaccharide vaccine antigens, including PPV23, may lead to immune hyporesponsiveness.
  • The occurrence and clinical significance of this hyporesponsiveness require further investigation.

Conclusions:

  • While combining PCVs and PPV23 may enhance serotype coverage, potential immune hyporesponsiveness warrants careful consideration.
  • Further research is needed to understand and mitigate risks associated with repeated polysaccharide vaccine administration.

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