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Improving the protection against Streptococcus pneumoniae with the new generation 13-valent pneumococcal conjugate
P Durando1, C Alicino, D De Florentiis
1Vaccines and Clinical Trials Unit, Department of Health Sciences, University of Genoa, Genoa, Italy.
Insights
The 13-valent Pneumococcal Conjugate Vaccine (PCV13) effectively prevents Invasive Pneumococcal Diseases (IPD), Community Acquired Pneumonia (CAP), and Acute Otitis Media (AOM) in children and adults. PCV13 addresses serotype replacement issues observed with the earlier PCV7 vaccine.
Area of Science:
- Infectious Diseases
- Vaccinology
- Pediatrics
- Public Health
Background:
- The 7-valent Pneumococcal Conjugate Vaccine (PCV7) significantly reduced Invasive Pneumococcal Diseases (IPD), Community Acquired Pneumonia (CAP), and Acute Otitis Media (AOM) in children and the unvaccinated population via herd protection.
- Widespread PCV7 use led to Streptococcus pneumoniae (Sp) serotype replacement, with non-PCV7 serotypes emerging and causing IPD, partially offsetting vaccination benefits.
- Newer conjugate vaccines with broader antigenic coverage were developed to address these limitations.
Purpose of the Study:
- To evaluate the efficacy of the 13-valent Pneumococcal Conjugate Vaccine (PCV13) in preventing IPD, CAP, and AOM in pediatric populations.
- To review clinical trial data on PCV13 use in both children and adults for pneumococcal disease prevention.
- To discuss the expanded indications for PCV13, including its use in adults aged 50 years and older.
Main Methods:
- Review of clinical trial data and published literature on PCV13 efficacy.
- Analysis of epidemiological data on Streptococcus pneumoniae (Sp) serotype distribution before and after PCV7 and PCV13 introduction.
- Examination of regulatory approvals and recommendations for PCV13 use in different age groups.
Main Results:
- PCV13 demonstrated significant effectiveness in preventing IPD, CAP, and AOM in infants and children.
- Clinical trials showed positive results for PCV13 use in adults aged 50 years and older for IPD prevention.
- PCV13 addresses serotype replacement issues, offering improved protection against a wider range of pneumococcal serotypes compared to PCV7.
Conclusions:
- PCV13 represents a significant advancement in pneumococcal conjugate vaccination, offering enhanced protection against IPD, CAP, and AOM in children.
- The expanded indication for PCV13 in adults aged 50 years and older presents new opportunities for comprehensive pneumococcal disease control.
- Continued monitoring of serotype epidemiology is crucial to assess the long-term impact of PCV13 and guide future vaccination strategies.
Abstract:
The wide use of the 7-valent Pneumococcal Conjugate Vaccine (PCV7) determined, during the last decade, a dramatic decline in the incidence of Invasive Pneumococcal Diseases (IPD) in infants and children, and also among the non-vaccinated population through the phenomenon known as "herd protection". Furthermore a significant reduction of some non-IPD, such as Community Acquired Pneumonia (CAP) and Acute Otitis Media (AOM) was reported among the pediatric population. At the same time, the high vaccination coverage rates reached with PCV7 contributed to modify the ecology of Streptococcus pneumoniae (Sp), favoring the emergence of some serotypes not included in PCV7 and involved in IPD (replacement phenomenon), thus partially affecting the positive effects of the pediatric immunization programs. To remedy these shortcomings, a new generation of conjugate vaccines, with an enlarged antigenic spectrum of activity than PCV7, has been available since 2010. In particular, the 13-valent Pneumococcal Conjugate Vaccine (PCV13) has been authorized for active prevention of IPD, CAP and AOM in infants and children aged between 6 months and 5 years. More recently, in September 2011, the European Medicine Agency extended the indication for its use to include active immunization of adults aged > or = 50 years for the prevention of IPD, thus opening new interesting opportunities to improve the control of pneumococcal disease among the entire population. The most interesting results from clinical trials using PCV13 in both children and adults are reported and discussed in details.
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