[The importance of pneumococcal vaccination - a clinician's view]

Reliable epidemiological surveillance of pneumococcal diseases is crucial for rational decisions concerning the introduction of vaccination strategies. In countries with such close surveillance (e.g. in the USA or Belgium), the acquired epidemiological data warranted universal vaccination. Pneumococci cause short-time asymptomatic colonization of the human nasopharynx. If defense mechanisms fail, pneumococci may penetrate to previously sterile areas and cause local infections in the upper airways. In case they reach the bloodstream, invasive infections occur that threaten health or even lives of both children and adults. Therapeutic options are limited due to increasing resistance of pneumococci to antibiotics. Possible prevention of particularly invasive infections is vaccination of adults with a 23-valent polysaccharide vaccine and children over two months of age with a polyvalent conjugate vaccine. Therefore, the WHO recommends that the pneumococcal conjugate vaccine is included in national vaccination programmes as soon as possible.