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A second-generation pneumococcal conjugate vaccine for prevention of pneumococcal diseases in children
Carlos G Grijalva1, Stephen I Pelton
1Department of Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
The 13-valent pneumococcal conjugate vaccine (PCV13) addresses remaining pneumococcal disease burdens after PCV7. PCV13 offers broader serotype coverage, including drug-resistant strains, for enhanced child immunization.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health
Background:
- The 7-valent pneumococcal conjugate vaccine (PCV7) significantly reduced pneumococcal diseases in the USA.
- Residual disease burden, emergence of non-vaccine serotypes, and multidrug-resistant strains necessitate improved vaccine formulations.
- Serotype 19A strains resistant to antibiotics like ceftriaxone pose a growing public health concern.
Purpose of the Study:
- To review lessons learned from PCV7 implementation.
- To evaluate the impact of PCV13 on residual pneumococcal disease burden.
- To provide rationale for current PCV13 recommendations for children up to 5 years old.
Main Methods:
- Review of data from a decade of PCV7 use.
- Analysis of disease trends related to vaccine and non-vaccine serotypes.
- Comparison of PCV13's potential impact on invasive pneumococcal disease versus non-bacteremic pneumonia and acute otitis media.
Main Results:
- PCV7 led to a substantial decline in vaccine-type pneumococcal diseases.
- Increased incidence of diseases caused by non-vaccine serotypes, including empyema.
- Emergence of multidrug-resistant serotype 19A strains highlights the need for broader serotype coverage.
Conclusions:
- PCV13 is recommended for universal immunization of children up to age 5.
- PCV13 aims to address the limitations of PCV7, particularly concerning non-vaccine serotypes and antibiotic resistance.
- Immunization with PCV13 provides both direct and indirect population protection against pneumococcal diseases.
Purpose Of Review:
A second-generation 13-valent pneumococcal conjugate vaccine (PCV13) was licensed and recommended for universal immunization of children through age 5 years in 2010. Its introduction is intended to address the residual burden of pneumococcal diseases that persists a decade after the introduction of PCV7.
Recent Findings:
Immunization with PCV7 has resulted in a substantial decline in pneumococcal diseases caused by vaccine serotypes in both vaccinated and unvaccinated persons in the USA. However, an increase in disease due to nonvaccine serotypes, including empyema; the emergence of multidrug, including ceftriaxone, resistant serotype 19A strains; and the need for broader serotype coverage to address the global disease burden provides a rationale for a second-generation conjugate vaccine that includes serotypes 1, 3, 5, 6A, 7F and 19A.
Summary:
This article reviews the lessons learned from a decade of experience with PCV7, the increasing problem of disease due to nonvaccine serotypes, and the likelihood of PCV13 to impact the residual disease burden. We contrast the potential differences in prevention of invasive pneumococcal disease compared with nonbacteremic pneumonia and acute otitis media. We conclude with the current recommendations for PCV13 providing a rationale for immunization through age 5 years to create both direct and indirect protection in the population.
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