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Human Vaccines & Immunotherapeutics Dec 2023Immunocompetent adults with certain medical and behavioral factors are at increased risk of pneumococcal disease. In some countries, sequential vaccination with...
Phase 3 trial to evaluate the safety, tolerability, and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine, followed by 23-valent pneumococcal polysaccharide vaccine 6 months later, in at-risk adults 18-49 years of age (PNEU-DAY): A subgroup analysis by baseline risk factors.
Immunocompetent adults with certain medical and behavioral factors are at increased risk of pneumococcal disease. In some countries, sequential vaccination with 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for at-risk adults. This subgroup analysis from a phase 3 study evaluated the safety, tolerability, and immunogenicity of sequential administration of either V114 (a 15-valent PCV containing serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F) or PCV13, followed 6 months later by PPSV23, in immunocompetent adults 18-49 years of age with pre-defined risk factors for pneumococcal disease. Safety and immunogenicity post-vaccination were analyzed by type and baseline number of risk factors for pneumococcal disease (1 and ≥2 risk factors). This analysis included 1,131 participants randomized 3:1 to receive either V114 or PCV13, followed by PPSV23. The majority (73.1%) of participants had at least one risk factor. Safety and tolerability profiles of V114 and PCV13 were similar across risk factor groups. V114 administered either alone or sequentially with PPSV23 6 months later was immunogenic for all 15 serotypes, including those not contained in PCV13, regardless of the number of baseline risk factors. V114 has the potential to broaden serotype coverage for at-risk adults.
Topics: Humans; Adult; Streptococcus pneumoniae; Vaccines, Conjugate; Double-Blind Method; Pneumococcal Infections; Pneumococcal Vaccines; Antibodies, Bacterial; Immunogenicity, Vaccine
PubMed: 36864601
DOI: 10.1080/21645515.2023.2177066 -
Indian Journal of Pediatrics Jan 2018Streptococcus pneumoniae causes meningitis, pneumonia, septicemia, arthritis, sinusitis and otitis media specially in children and over 65 y age groups. It contributes... (Review)
Review
Streptococcus pneumoniae causes meningitis, pneumonia, septicemia, arthritis, sinusitis and otitis media specially in children and over 65 y age groups. It contributes significantly to under-five mortality and morbidity worldwide as well as in India. Use of pneumococcal vaccine seems to be the most effective measure to decrease the disease burden and reduction of under-five mortality. Many countries have already included Pneumococcal Conjugate Vaccines (PCV) in their National Immunization Programmes (NIP). Government of India has announced recently to include PCV13 in NIP in a phased manner. Superiority of a vaccine over the other depends upon serotype coverage, vaccine efficacy, cost effectiveness and safety profile. These facts will be discussed for the vaccines available in India. Further research is warranted to know the disease burden and develop vaccines to have more serotype coverage.
Topics: Child; Humans; India; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae
PubMed: 28887787
DOI: 10.1007/s12098-017-2449-3 -
Current Opinion in Pulmonary Medicine May 2017Preventing pneumonia in the elderly and individuals with comorbidities is an unmet clinical need. Streptococcus pneumoniae is the commonest bacterial cause of pneumonia,... (Review)
Review
PURPOSE OF REVIEW
Preventing pneumonia in the elderly and individuals with comorbidities is an unmet clinical need. Streptococcus pneumoniae is the commonest bacterial cause of pneumonia, and we summarize recent findings regarding current S. pneumoniae vaccines, and debate their efficacy and cost-effectiveness in risk groups. We also discuss potential future vaccine strategies such as protein antigen vaccines.
RECENT FINDINGS
Current vaccination with pneumococcal polysaccharide vaccine does not prevent S. pneumoniae pneumonia. Vaccination with pneumococcal conjugated vaccine (PCV) prevents nasopharyngeal colonization, but although PCV13 has recently been shown to prevent S. pneumoniae pneumonia in adults, its overall efficacy was relatively low. The results of cost-effectiveness studies of PCV vaccination in adults are variable with some showing this is a cost-effective strategy, whereas others have not. The lack of cost-effectiveness is predominantly because of the current cost of the PCV vaccine and the existing herd immunity effect from childhood PCV vaccination on vaccine serotypes.
SUMMARY
S. pneumoniae pneumonia is a vaccine-preventable disease but remains a common cause of morbidity and mortality. Advances in vaccination using approaches that induce serotypes-independent immunity and are immunogenic in high-risk groups are required to reduce the burden of disease because of S. pneumoniae.
Topics: Adult; Cost-Benefit Analysis; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae; Vaccination
PubMed: 28198725
DOI: 10.1097/MCP.0000000000000369 -
Clinical and Vaccine Immunology : CVI May 2016Controversy exists regarding the optimal use of the 23-valent pneumococcal conjugate vaccine for the protection of high-risk individuals, such as children and adults... (Review)
Review
Controversy exists regarding the optimal use of the 23-valent pneumococcal conjugate vaccine for the protection of high-risk individuals, such as children and adults with immunocompromising conditions and the elderly. The effectiveness and immunogenicity of 23-valent pneumococcal polysaccharide vaccine (PPV23) are limited in such high-risk populations compared to the healthy, with meta-analyses failing to provide robust evidence on vaccine efficacy against invasive pneumococcal disease (IPD) or pneumonia. Moreover, several studies have demonstrated a PPV23-induced state of immune tolerance or hyporesponsiveness to subsequent vaccination, where the response to revaccination does not reach the levels achieved with primary vaccination. The clinical significance of hyporesponsiveness is not yet clarified, but attenuated humoral and cellular response could lead to reduced levels of protection and increased susceptibility to pneumococcal disease. As disease epidemiology among high-risk groups shows that we are still in need of maximum serotype coverage, the optimal use of PPV23 in the context of combined conjugate/polysaccharide vaccine schedules is an important priority. In this minireview, we discuss PPV23-induced hyporesponsiveness and its implications in designing highly effective vaccination schedules for the optimal protection for high-risk individuals.
Topics: Adult; Aged; Child; Humans; Immune Tolerance; Immunization Schedule; Immunization, Secondary; Immunocompromised Host; Immunogenicity, Vaccine; Pneumococcal Infections; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Risk Factors; Vaccination
PubMed: 27009210
DOI: 10.1128/CVI.00721-15 -
The Journal of Family Practice Dec 2019ACIP no longer recommends routine use of PCV13 in immunocompetent adults ≥ 65 years. Three simple statements summarize guidance on intervals to follow when...
ACIP no longer recommends routine use of PCV13 in immunocompetent adults ≥ 65 years. Three simple statements summarize guidance on intervals to follow when administering both PCV13 and PPSV23.
Topics: Aged; Aged, 80 and over; Family Practice; Female; Humans; Immunization Schedule; Immunocompromised Host; Male; Pneumococcal Infections; Pneumococcal Vaccines; Practice Guidelines as Topic; Vaccines, Conjugate
PubMed: 31860700
DOI: No ID Found -
The Journal of Infection Oct 2014Pneumococcal polysaccharide vaccines (PPVs) and conjugate vaccines (PCVs), of which PPV23 and PCV13 are the current front runners, have had a significant, beneficial... (Review)
Review
Pneumococcal polysaccharide vaccines (PPVs) and conjugate vaccines (PCVs), of which PPV23 and PCV13 are the current front runners, have had a significant, beneficial impact on public health. With regard to PPV23, there has been some debate, however, about its protective efficacy against all-cause pneumonia, as opposed to invasive pneumococcal disease, in high-risk cases. PCVs, on the other hand, have been included in many national immunisation programmes for prevention of severe pneumococcal disease in infants and young children, as well as for adults in various high-risk categories. Although innovative and effective, the protective efficacy of PCVs, the composition of which is based on the geographic prevalence and virulence of pneumococcal serotypes, is limited due to colonisation of the nasopharynx with non-vaccine serotypes. This phenomenon of serotype replacement has provided the impetus for development of new generation recombinant protein and whole cell pneumococcal vaccines with the potential to provide serotype-independent protection. In addition to an overview of the successes and limitations of PPVs and PCVs, this review is focused on emerging and pipeline protein-based and whole cell vaccines, preceded by a consideration of conserved pneumococcal virulence factors which are potential vaccine candidates.
Topics: Antigens, Bacterial; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae; Vaccines, Synthetic
PubMed: 24968238
DOI: 10.1016/j.jinf.2014.06.006 -
Frontiers in Immunology 2019Current guidelines encourage administering pneumococcal vaccine Prevnar-13 to patients with lupus, but whether such vaccinations affect disease severity is unclear. To...
Current guidelines encourage administering pneumococcal vaccine Prevnar-13 to patients with lupus, but whether such vaccinations affect disease severity is unclear. To address this issue, we treated 3-month-old MRL- mice, that spontaneously develop a lupus-like syndrome, with Prevnar-13 or vehicle control. After 3 months, we quantified circulating anti-Pneumococcal polysaccharide capsule (PPS) antibodies and signs of disease severity, including albuminuria, renal histology and skin severity score. We also compared immunophenotypes and function of T and B cells from treated and untreated animals. Prevnar-13 elicited the formation of anti-pneumococcal IgM and IgG. Prevnar-13 treated animals showed reduced albuminuria, renal histological lesions, and milder dermatitis compared to vehicle-treated controls. Mitigated disease severity was associated with reduced and increased T follicular helper cells (T) and T follicular regulatory cells (T), respectively, in Prevnar-treated animals. T cells from Prevnar-13 vaccinated mice showed differential cytokine production after aCD3/aCD28 stimulation, with significantly decreased IL-17 and IL-4, and increased IL-10 production compared to non-vaccinated mice. In conclusion, pneumococcal vaccination elicits anti-pneumococcal antibody response and ameliorates disease severity in MRL- mice, which associates with fewer T and increased T. Together, the data support use of Prevnar vaccination in individuals with SLE.
Topics: Animals; Antibodies, Bacterial; Disease Models, Animal; Lupus Erythematosus, Systemic; Mice; Mice, Inbred MRL lpr; Pneumococcal Vaccines; T-Lymphocytes
PubMed: 31824490
DOI: 10.3389/fimmu.2019.02695 -
Nihon Naika Gakkai Zasshi. the Journal... Nov 2015
Topics: Humans; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae
PubMed: 28520386
DOI: 10.2169/naika.104.2297 -
Value in Health : the Journal of the... Jun 2022We aimed to determine the effectiveness of pneumococcal vaccines on otitis media (OM) and acute otitis media (AOM) in children. (Review)
Review
OBJECTIVES
We aimed to determine the effectiveness of pneumococcal vaccines on otitis media (OM) and acute otitis media (AOM) in children.
METHODS
We conducted a systematic search in databases PubMed (MEDLINE), Embase, Lilacs, and Web of Science. We included observational studies that evaluated any pneumococcal vaccine - including 7, 10, and 13-valent pneumococcal conjugate vaccines (PCV7, PCV10, and PCV13) and 23-valent polysaccharide vaccines (PPSV23) as the intervention, in children aged less than five years.
RESULTS
Out of the 2112 screened studies, 48 observational studies complied with the eligibility criteria and therefore were included in this review. Of the included studies, 30 (63%) were before-after, eleven (23%) cohort, six (13%) time series, and one (2%) case-control study designs. Vaccine effectiveness (VE) in preventing OM or AOM varied by vaccine type. In children under 24 months VE ranged from 8% and 42.7% (PCV7), 5.6% to 84% (PCV10) and 2.2% to 68% (PCV13). In children aged less than 60 months, VE ranged between 13.2% and 39% for PCV7, 11% to 39% for PCV10 (only children under 48 months), and 39% to 41% (PCV13).
CONCLUSIONS
Our results demonstrate significant effect of pneumococcal vaccination in decreasing OM or AOM in children under five years old in several countries supporting the public health value of introducing PCVs in national immunization programs.
Topics: Case-Control Studies; Child; Child, Preschool; Humans; Immunization Programs; Infant; Otitis Media; Pneumococcal Infections; Pneumococcal Vaccines; Vaccines, Conjugate
PubMed: 35667776
DOI: 10.1016/j.jval.2021.12.012 -
Expert Review of Vaccines Jan 2018Adults, particularly those with underlying chronic conditions, eg, cardiovascular, liver, and pulmonary diseases and diabetes mellitus, have a persistent pneumococcal... (Review)
Review
INTRODUCTION
Adults, particularly those with underlying chronic conditions, eg, cardiovascular, liver, and pulmonary diseases and diabetes mellitus, have a persistent pneumococcal disease burden. Thirteen-valent pneumococcal conjugate vaccine (PCV13) is recommended in the United States for all adults aged ≥65 years and immunocompromised adults aged <65 years to protect against vaccine-serotype (VT) invasive pneumococcal disease (IPD) and pneumonia. PCV13 is not recommended for immunocompetent adults aged ≥18 years with comorbidities associated with increased pneumococcal disease risk.
AREAS COVERED
This US-focused review summarizes PCV13-type IPD and community-acquired pneumonia burden in adults aged <50 years, PCV13 immunogenicity and safety in this population, and adult pneumococcal vaccination recommendations.
EXPERT COMMENTARY
Considering (i) PCV13 has demonstrated efficacy against VT-IPD and pneumonia in adults aged ≥65 years (with or without underlying chronic conditions), and (ii) immune responses to PCV13 in younger adults are comparable or better than in older adults, PCV13 would likely have similar efficacy in adults aged <50 years. Recommending PCV13 for at-risk adults aged <50 years would provide direct immunologic benefit of a conjugate vaccine and could address an important unmet medical need for pneumococcal pneumonia prevention. Although not directly addressed here, this benefit would likely extend to at-risk adults aged 50-64 years.
Topics: Adult; Age Factors; Aged; Community-Acquired Infections; Humans; Middle Aged; Pneumococcal Infections; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Streptococcus pneumoniae; Vaccines, Conjugate
PubMed: 29183235
DOI: 10.1080/14760584.2018.1411196