Time for changes in pneumococcal vaccination of adults?

Because Streptococcus pneumoniae continues to be an important cause of morbidity and mortality, especially among young children and elderly adults, Healthy People 2020 includes several objectives for decreasing invasive pneumococcal disease and increasing pneumococcal vaccine uptake. Current recommendations of the Advisory Committee on Immunization Practices regarding pneumococcal vaccination for adults have not changed appreciatively in several years. However, it is possible that ongoing research may lead to changes in these recommendations within the next few years. Since the licensure of the 7-valent pneumococcal conjugate vaccine for children in 2000, impressive decreases in pneumonia-related diseases caused by strains in the vaccine have been noted among all age groups receiving vaccination. Coupled with continued concerns about the efficacy of the 23-valent pneumococcal polysaccharide vaccine for adults, particularly in regard to nonbacteremic pneumonia, questions are raised about the potential efficacy and viability of conjugate vaccines for adults.