[Immunization against pneumococci with conjugate vaccine]

Three years after the generalization of the recommendation of Pneumococcal conjugate vaccine for all infants under two years of age, the rate of vaccine coverage is satisfactory for the primovaccination (above 85%) with a 2 + 1 schedule. Vaccine coverage is too low for the booster which is given too late (at 14,5 months of age) and not at of 12 months. This conjugate vaccine has a direct effect, due to the vaccine in the target population and indirect effect due to the action on the strains carriage which decreases the broadcasting of the vaccine serotype strains and protect non vaccinated populations. In 2007, invasive pneumococcal diseases (meningitis and bacteremia) have decreased about 3% in infants under two years of age but globally, the incidence of invasive pneumococcal disease has not been modified. There is a substitution for strains and a change in the serotypes distribution with a prominence of 19A and 7 F and 1 serotype. Added to the benefit on invasive pneumococcal diseases, there are others on pneumonia, otitis media and antibiotic resistance of pneumococcus. Six serotypes have been added to obtain the Prevenar 13 which replaces the seven valent vaccine. Prevenar 13 has the same recommendations as Prevenar and can be given by the same schedule 2 + 1 (2 months, 4 months, and 12 months) except in high risk children and premature newborns who have to be vaccinated by a 3 + 1 schedule. Epidemological surveillance of the strains has to be done, As for adults, the data are currently being analyzed.