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Toward Universal Protection: A Comprehensive Review of Pneumococcal Disease, Emerging Vaccination Challenges and
Mayla Sgrulletti1, Maria Felicia Mastrototaro2, Alessandra Beni3
1Pediatric Immunopathology and Allergology Unit, Policlinico Tor Vergata, University of Rome Tor Vergata, 00133 Rome, Italy.
Vaccines
|December 24, 2025
Summary
Pneumococcal Conjugate Vaccines (PCVs) have reduced Invasive Pneumococcal Disease (IPD), but serotype replacement necessitates new vaccines. PPSV23 aids in diagnosing Inborn Errors of Immunity (IEI), with future focus on universal protein-based vaccines.
Area of Science:
- * Infectious Disease Epidemiology
- * Vaccinology
- * Immunology
Background:
- * *Streptococcus pneumoniae* causes significant global morbidity, mortality, and healthcare costs via Invasive Pneumococcal Disease (IPD).
- * Pneumococcal Conjugate Vaccines (PCVs) have achieved success in reducing IPD incidence and establishing herd protection.
- * Serotype replacement by non-vaccine serotypes poses a challenge to ongoing disease control efforts.
Purpose of the Study:
- * To review the epidemiology of pneumococcal disease and the evolution of vaccine strategies.
- * To examine challenges in global pneumococcal disease control, including serotype replacement and diagnostic limitations.
- * To highlight the role of pneumococcal vaccination in diagnosing Inborn Errors of Immunity (IEI).
Main Methods:
- * Comprehensive literature review of pneumococcal disease epidemiology, vaccine development, and diagnostic applications.
- * Analysis of the impact of Pneumococcal Conjugate Vaccines (PCVs) and serotype replacement.
- * Evaluation of pneumococcal polysaccharide vaccine (PPSV23) as a diagnostic tool for Inborn Errors of Immunity (IEI).
Main Results:
- * PCVs have significantly reduced vaccine-type IPD but led to serotype replacement, driving the need for higher-valency vaccines (PCV15, PCV20, PCV21).
- * PPSV23 is a crucial diagnostic for Inborn Errors of Immunity (IEI), particularly humoral defects, though diagnostic assays face challenges.
- * Vaccine effectiveness can be compromised in high-risk groups, necessitating personalized strategies.
Conclusions:
- * Expanded PCV coverage and personalized strategies are essential for managing residual pneumococcal disease burden.
- * Development of universal protein-based vaccines targeting conserved virulence factors is a scientific priority.
- * An integrated approach combining advanced PCVs and novel vaccine technologies is critical for global pneumococcal disease control.
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