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Clinics in Chest Medicine Dec 2018Streptococcus pneumoniae is the most frequent pathogen in community-acquired pneumonia and also causes invasive diseases like bacteremia and meningitis. Young children... (Review)
Review
Streptococcus pneumoniae is the most frequent pathogen in community-acquired pneumonia and also causes invasive diseases like bacteremia and meningitis. Young children and elderly are especially at risk for pneumococcal diseases and are, therefore, eligible for pneumococcal vaccination in most countries. This reviews provides an overview of the current epidemiology of pneumococcal infections, history and evidence of available pneumococcal polysaccharide and conjugate vaccines, and current recommendations.
Topics: Community-Acquired Infections; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Pneumonia; Vaccination; Vaccines, Conjugate
PubMed: 30390745
DOI: 10.1016/j.ccm.2018.07.007 -
Expert Review of Vaccines 2016Streptococcus pneumoniae is a leading cause of illness and death in adults. A polysaccharide vaccine has been available for over 30 years, but despite significant use,... (Review)
Review
Streptococcus pneumoniae is a leading cause of illness and death in adults. A polysaccharide vaccine has been available for over 30 years, but despite significant use, the public health impact of this vaccine has been limited. The 13-valent pneumococcal conjugate vaccine (PCV13) has been licensed by the US Food and Drug Administration and other international regulatory authorities with the assumption that induction of a T cell-dependent immune response and noninferior immunogenicity to vaccine antigens when compared with the polysaccharide vaccine would be important to satisfy a significant unmet medical need. PCV13 efficacy against vaccine-type pneumococcal community-acquired pneumonia was confirmed in a large randomized controlled trial in older adults and its use is now increasingly recommended globally.
Topics: Adult; Community-Acquired Infections; Humans; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Randomized Controlled Trials as Topic; United States; Vaccines, Conjugate
PubMed: 26651847
DOI: 10.1586/14760584.2016.1132171 -
International Journal of Chronic... 2017Patients with COPD and other chronic respiratory diseases are especially vulnerable to viral and bacterial pulmonary infections, which are major causes of exacerbations,... (Review)
Review
Patients with COPD and other chronic respiratory diseases are especially vulnerable to viral and bacterial pulmonary infections, which are major causes of exacerbations, hospitalization, disease progression, and mortality in COPD patients. Effective vaccines could reduce the burden of respiratory infections and acute exacerbations in COPD patients, but what is the evidence for this? This article reviews and discusses the existing evidence for pneumococcal vaccination efficacy and its changing role in patients with chronic respiratory diseases, especially COPD. Specifically, the recent Community-Acquired Pneumonia Immunization Trial in Adults (CAPITA) showed the efficacy of pneumococcal conjugate vaccine in older adults, many of whom had additional risk factors for pneumococcal disease, including chronic lung diseases. Taken together, the evidence suggests that pneumococcal and influenza vaccinations can prevent community-acquired pneumonia and acute exacerbations in COPD patients, while pneumococcal vaccination early in the course of COPD could help maintain stable health status. Despite the need to prevent pulmonary infections in patients with chronic respiratory diseases and evidence for the efficacy of pneumococcal conjugate vaccine, pneumococcal vaccine coverage and awareness are low and need to be improved. Respiratory physicians need to communicate the benefits of vaccination more effectively to their patients who suffer from chronic respiratory diseases.
Topics: Disease Progression; Health Status; Humans; Lung; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Pulmonary Disease, Chronic Obstructive; Risk Factors; Treatment Outcome; Vaccination
PubMed: 29255353
DOI: 10.2147/COPD.S140378 -
The Senior Care Pharmacist Apr 2023To review the current literature available regarding the efficacy and safety of the 20-valent l vaccine in older people and summarize the current recommendation for use... (Review)
Review
To review the current literature available regarding the efficacy and safety of the 20-valent l vaccine in older people and summarize the current recommendation for use in this patient population. PubMed was searched using the following terms: (PCV20 [Title] or 20-valent [Title] or 20-valent conjugate vaccine [Title]) and English (Language). The current recommendations from the Advisory Committee on Immunization Practices and manufacturer package inserts were also reviewed. Nine articles on 20-valent vaccine were identified based on the above search terms. Those selected for inclusion were randomized control trials including primary or subgroup analysis of PCV20 in older people. Two randomized controlled trials have assessed the immunogenicity and safety of PCV20 in adults 65 years of age and older, one in a population previously vaccinated with PPSV23 and one in a vaccine-naive population. Both trials demonstrated PCV20 elicited a robust immune response one month after vaccination. PCV20 was well-tolerated with adverse events similar to earlier vaccine formulations. The simplified vaccine regimen of a singular PCV20 vaccination offers a compelling advancement. Longer-term studies are needed to show if PCV20 will improve vaccination rates and reduce morbidity and mortality.
Topics: Aged; Humans; Pneumococcal Vaccines; Streptococcus pneumoniae; Vaccination; Vaccines, Conjugate
PubMed: 36949560
DOI: 10.4140/TCP.n.2023.148 -
The Cochrane Database of Systematic... Aug 2014Invasive pneumococcal disease is associated with significant mortality and many countries have introduced routine pneumococcal vaccination into their childhood... (Review)
Review
BACKGROUND
Invasive pneumococcal disease is associated with significant mortality and many countries have introduced routine pneumococcal vaccination into their childhood immunisation programmes. Whilst pneumococcal disease in cystic fibrosis is uncommon, pneumococcal immunisation may offer some protection against pulmonary exacerbations caused by this pathogen. In the USA and UK pneumococcal vaccination is currently recommended for all children and adults with cystic fibrosis.
OBJECTIVES
To assess the efficacy of pneumococcal vaccines in reducing morbidity in people with cystic fibrosis.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Cystic Fibrosis Trials Register, which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. In addition, the pharmaceutical manufacturers of the polysaccharide and conjugate pneumococcal vaccines were approached.Date of the most recent search: 15 May 2014.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials comparing pneumococcal vaccination (with either a polysaccharide or conjugate pneumococcal vaccine) with non-vaccination or placebo in children or adults with cystic fibrosis were eligible for inclusion.
DATA COLLECTION AND ANALYSIS
No relevant trials were identified.
MAIN RESULTS
There are no trials included in this review.
AUTHORS' CONCLUSIONS
As no trials were identified we cannot draw conclusions on the efficacy of routine pneumococcal immunisation in people with cystic fibrosis in reducing their morbidity or mortality. As many countries now include pneumococcal immunisation in their routine childhood vaccination schedule it is unlikely that future randomised controlled trials will be initiated. Rigorously conducted epidemiological studies may offer the opportunity to evaluate the efficacy of pneumococcal vaccination in reducing morbidity and mortality in people with cystic fibrosis.
Topics: Adult; Child; Cystic Fibrosis; Humans; Pneumococcal Infections; Pneumococcal Vaccines
PubMed: 25093421
DOI: 10.1002/14651858.CD008865.pub3 -
Annals of the American Thoracic Society Jun 2016Streptococcus pneumoniae is an important global pathogen that causes a wide range of clinical disease in children and adults. Pneumococcal pneumonia is by far the common... (Review)
Review
Streptococcus pneumoniae is an important global pathogen that causes a wide range of clinical disease in children and adults. Pneumococcal pneumonia is by far the common presentation of noninvasive and invasive pneumococcal disease and affects the young, the elderly, and the immunocompromised disproportionately. Patients with chronic pulmonary diseases are also at higher risk for pneumococcal infections. Substantial progress over the century has been made in the understanding of pneumococcal immunobiology and the prevention of invasive pneumococcal disease through vaccination. Currently, two pneumococcal vaccines are available for individuals at risk of pneumococcal disease: the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the 13-valent pneumococcal protein-conjugate vaccine (PCV13). The goal of pneumococcal vaccination is to stimulate effective antipneumococcal antibody and mucosal immunity response and immunological memory. Vaccination of infants and young children with pneumococcal conjugate vaccine has led to significant decrease in nasal carriage rates and pneumococcal disease in all age groups. Recent pneumococcal vaccine indication and schedule recommendations on the basis of age and risk factors are outlined in this Focused Review. As new pneumococcal vaccine recommendations are being followed, continued efforts are needed to address the vaccine efficacy in the waning immunity of the ever-aging population, the implementation of vaccines using two different vaccines under very specific schedules and their real world clinical and cost effectiveness, and the development of next generation pneumococcal vaccines.
Topics: Cost-Benefit Analysis; Humans; Immunity, Herd; Immunization Schedule; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Randomized Controlled Trials as Topic; Risk Factors; Streptococcus pneumoniae; Vaccines, Conjugate
PubMed: 27088424
DOI: 10.1513/AnnalsATS.201511-778FR -
Microbial Pathogenesis Sep 2018Despite the fact that pneumococcal conjugate vaccines (PCVs) have significantly reduced the rate of invasive pneumococcal diseases through the use of vaccine serotypes,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Despite the fact that pneumococcal conjugate vaccines (PCVs) have significantly reduced the rate of invasive pneumococcal diseases through the use of vaccine serotypes, infection with Streptococcus pneumoniae remains a major public health hazard. Serotype-independent vaccines that are economically viable species of common protein antigens such as whole-cell vaccines (WCVs) are needed. Considering the ongoing debate about the effectiveness of WCVs, a systematic literature review and meta-analysis was carried out to determine the efficacy of WCVs against colonization in mice.
MATERIAL AND METHODS
A systematic review was undertaken of published studies on the protection (colonized/uncolonized) of whole cell pneumococcal vaccine in mice. The search terms used were "whole cell vaccine" and "Streptococcus pneumoniae" in PubMed, Google Scholar, Embase, Web of Science and Scopus engines. Data was extracted from original publications and a meta-analysis was performed on studies divided into sub-groups by the number of inoculations, type of sample, type of adjuvant, time of sampling, design of study and quality of study.
RESULTS
Ten eligible articles published from 2000 to 2016 were included in this review. The meta-analysis was performed on eight out of 10 studies and demonstrated that the estimated pooled risk ratios (RRs) for comparison of colonization between the vaccinated and unvaccinated mice for outcomes 1 and 2 were 0.18 and 0.24, respectively. Lower RRs were observed in sub-groups that were inoculated with vaccines three times, those using cholera toxin (CT) adjuvants and those obtained as tracheal specimens from the mice.
CONCLUSIONS
The best protocol for use of a WCV is its application with CT adjuvant administered intranasally in three inoculations at doses of 10⁸ CFU. Further studies performed under similar conditions to obtain accurate results on the effectiveness of this vaccine are recommended.
Topics: Adjuvants, Immunologic; Administration, Intranasal; Animals; Disease Models, Animal; Mice; Pneumococcal Infections; Pneumococcal Vaccines; Vaccines, Inactivated
PubMed: 29908308
DOI: 10.1016/j.micpath.2018.06.026 -
Expert Review of Vaccines Feb 2017Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the... (Review)
Review
Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the implementation of polysaccharide and/or conjugate vaccines for pneumococcal diseases in adults and the elderly in many countries. The aim of this paper is to systematically review the economic profile of pneumococcal vaccines in adults in terms of costs and benefits. Areas covered: The search for economic studies on pneumococcal vaccination was carried out in Pubmed, Embase, Scopus, and the HTA and NHS EED databases and through a manual search in journals dealing with economic evaluations. We included original articles and reviews with economic evaluation of polysaccharide 23-valent (PPV23) and/or conjugate pneumococcal vaccine 13-valent (PCV13) use in adults, the elderly, and at-risk groups to provide a systematic review of economical evaluation. Expert commentary: Pneumococcal vaccination is strongly recommended for all adults, especially subjects at risk and the elderly. Pneumococcal vaccination with PCV13 or PPV23 in adults is good value for money and should be a priority for the decision-makers. The main issue is how vaccination could be offered.
Topics: Adult; Aged; Aged, 80 and over; Cost-Benefit Analysis; Humans; Middle Aged; Pneumococcal Infections; Pneumococcal Vaccines; Vaccination
PubMed: 27680425
DOI: 10.1080/14760584.2017.1242419 -
Expert Opinion on Drug Safety Jun 2016A number of pneumococcal vaccines have long been available and have been used to reduce the medical, social, and economic problems associated with Streptococcus... (Review)
Review
INTRODUCTION
A number of pneumococcal vaccines have long been available and have been used to reduce the medical, social, and economic problems associated with Streptococcus pneumoniae-related diseases.
AREAS COVERED
The main purpose of this review was to analyze what has been, until recently, the established doctrine regarding the safety and tolerability of pneumococcal vaccines that have been used in the past and are currently being used in children.
EXPERT OPINION
Pneumococcal vaccines available on the market are all safe and are highly recommended in clinical practice. In children, pneumococcal conjugate vaccines (PCVs) are considered the preparations of choice because of their enhanced immunogenicity and superior ability to impact nasopharyngeal carriage. All PCVs are considered safe because the incidence of severe adverse events (AEs) is marginal. Nonetheless, evidence has emerged from post-marketing surveillance regarding the occurrence of very rare but significant potential AEs following PCV administration. Therefore, post-marketing surveillance should be maintained to confirm the existence of these AEs. Over the next few years, other pneumococcal vaccines will be developed. When these new products are licensed and reach the market, new technologies and innovative epidemiological methods will permit a more rapid and more effective evaluation of AEs.
Topics: Child; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Product Surveillance, Postmarketing; Streptococcus pneumoniae; Vaccines, Conjugate
PubMed: 26923347
DOI: 10.1517/14740338.2016.1160056 -
Human Vaccines & Immunotherapeutics 2019Thirteen-valent pneumococcal conjugate vaccine (PCV13) was licensed in adults to address the unmet medical need of vaccine-type community acquired pneumonia (CAP) and...
Thirteen-valent pneumococcal conjugate vaccine (PCV13) was licensed in adults to address the unmet medical need of vaccine-type community acquired pneumonia (CAP) and the limitations of previous plain-polysaccharide vaccines. Since then, some have questioned the utility of adult PCV13 use, arguing that: i) high PCV13 uptake in young children would provide indirect effects that, by themselves, would sufficiently protect unvaccinated adults and ii) no data describing the real-world effectiveness of PCV13 use in adults, especially with immunocompromising conditions, exist. Even in countries like the United States where PCV13 has been routinely recommended for all adults aged ≥ 65 years, the recommendation is contingent on a re-evaluation to determine if continued use is needed in the context of a mature PCV13 pediatric immunization program. Emerging evidence, however, suggests that i) a meaningful burden of PCV13-type pneumococcal pneumonia still persists in adults at increased risk for pneumococcal disease, despite indirect effects from long-standing pediatric PCV13 use, ii) adult PCV13 use is effective and has reduced pneumococcal CAP, even in the elderly and those with chronic medical or immunocompromising conditions - and disease could come back if PCV13 were removed, and iii) ethical and pragmatic vaccine policy considerations support continued adult PCV13 use in countries that have already introduced the vaccine (eg, disparities in adult PCV13 uptake, confusion stemming from removing a previously-recommended vaccine for a non-safety-related concern, and the reality that next-generation PCVs are only a few years away). Together, these findings suggest that continued PCV13 vaccination in adults is needed to control vaccine-type CAP.
Topics: Adult; Child; Community-Acquired Infections; Decision Making; Humans; Immunization Programs; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Public Health; Randomized Controlled Trials as Topic
PubMed: 30352017
DOI: 10.1080/21645515.2018.1538611