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Expert Review of Vaccines Jan 2011Streptococcus pneumoniae is the leading cause of vaccine-preventable deaths among children younger than 5 years of age worldwide. The 7-valent pneumococcal conjugate... (Review)
Review
Streptococcus pneumoniae is the leading cause of vaccine-preventable deaths among children younger than 5 years of age worldwide. The 7-valent pneumococcal conjugate vaccine (PCV7) is currently licensed in more than 90 countries and has contributed to significant declines in the incidence of invasive pneumococcal disease (IPD). Recent studies report an increased incidence of IPD caused by non-PCV7 vaccine serotypes (NVTs). Seroepidemiology of IPD caused by NVTs following the introduction of PCV7 is of interest, and this article provides a comprehensive global summary of the prevailing and emerging serotypes causing IPD in children. Currently, globally emerging or persistent NVTs include serotypes 1, 3, 5, 6A, 7F and 19A. Serotypes included in the recently licensed 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13) account for pneumococcal disease burdens in most developed countries of 65-85% and 80-90%, respectively. The seroprevalence of NVTs after widespread use of PCV10 and PCV13 requires ongoing monitoring.
Topics: Bacterial Typing Techniques; Heptavalent Pneumococcal Conjugate Vaccine; Humans; Incidence; Pandemics; Pneumococcal Infections; Pneumococcal Vaccines; Serotyping; Streptococcus pneumoniae
PubMed: 21162625
DOI: 10.1586/erv.10.145 -
Vaccine Sep 2011Streptococcus pneumoniae is one of the leading bacterial pathogens causing invasive disease and non-invasive infections at both extremes of life: in children younger...
Streptococcus pneumoniae is one of the leading bacterial pathogens causing invasive disease and non-invasive infections at both extremes of life: in children younger than 5 years and in elderly persons of 65 years or more. Pneumococcal infections result in substantial morbidity and mortality among children under 5 years of age; it is estimated that 1,600,000 deaths occur per year in that age range alone, mostly in developing countries, thus representing a serious public health problem around the globe. Infections caused by S. pneumoniae are considered by the World Health Organization (WHO) as the number one vaccine-preventable cause of death in children younger than 5 years of age. In 2000, the first heptavalent conjugated pneumococcal vaccine (PCV7) was licensed in the United States, differing from the already available non-conjugated polysaccharide pneumococcal vaccine in its ability to induce a protective immune response in children under 2 years of age. Initial efficacy studies in the United States with PCV7 revealed a 97.4% efficacy against invasive pneumococcal disease (IPD) caused by vaccine serotypes (4, 9V, 14, 19F, 23F, 18C and 6B). PCV7 was introduced into the National Immunization Program (NIP) of various countries starting in year 2000 and, after 11 years of use, the data confirm that PCV7 introduction resulted in a major reduction of S. pneumoniae IPD, non-bacteremic pneumonia, otitis media medical visits, the need for tympanic tubes, the number of cases of otorrhea and of various antimicrobial resistant strains in children <5 years of age. Additionally, reductions in S. pneumoniae infections have been observed in unvaccinated children above 5 years of age and adults including individuals older than 65 years of age (herd effect). Effectiveness has been observed in countries using a 4-dose regimen (3 infant doses followed by a booster during the second year of life) but also in countries with modified reduced doses (2 infant doses and a booster during the second year of life or after 3 infant doses with no booster).
Topics: Aged; Child; Child, Preschool; Heptavalent Pneumococcal Conjugate Vaccine; Humans; Immunity, Herd; Immunization Programs; Infant; Pneumococcal Infections; Pneumococcal Vaccines; Randomized Controlled Trials as Topic; Serotyping; Streptococcus pneumoniae; Treatment Outcome; United States
PubMed: 21896350
DOI: 10.1016/j.vaccine.2011.06.104 -
Clinical Infectious Diseases : An... Nov 2012Clinical use of the 7-valent pneumococcal protein conjugate (PCV7) vaccine, which includes serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F, dramatically reduced invasive... (Review)
Review
Clinical use of the 7-valent pneumococcal protein conjugate (PCV7) vaccine, which includes serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F, dramatically reduced invasive pneumococcal disease (IPD); however, the effectiveness was diminished due to serotype shift. Although shift due to known serotypes was anticipated, shift by misidentified serotypes was unexpected. We describe the experience with newly recognized serotypes 6C and 6D, which were mistyped as serotypes 6A and 6B, respectively. Although serotype 6D caused only occasional infections, IPD due to serotype 6C disease expanded in the PCV7 era. Subsequent studies showed that PCV7 provided cross-protection against serotype 6A but not serotype 6C. The 13-valent pneumococcal protein conjugate (PCV13) vaccine, which includes PCV7 serotypes plus serotypes 1, 3, 5, 6A, 7F, 19A, may provide protection against IPD due to serotypes 6C and 6D. Regardless, this narrative illustrates the potential impact of unrecognized serotypes on the efficacy of a serotype-specific vaccine.
Topics: Heptavalent Pneumococcal Conjugate Vaccine; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Serotyping; Streptococcus pneumoniae
PubMed: 22903767
DOI: 10.1093/cid/cis691 -
Prescrire International Feb 2002(1) Infants under two years of age are the children most exposed to invasive pneumococcal infections (meningitis and bacteraemia). The estimated incidence in France is...
(1) Infants under two years of age are the children most exposed to invasive pneumococcal infections (meningitis and bacteraemia). The estimated incidence in France is about 45 cases per year per 100,000 in the first year of life. The 23-valent pneumococcal polysaccharide vaccine is ineffective in children under two years of age. (2) Marketing authorization has now been granted for a 7-valent pneumococcal conjugate vaccine for children under two years. It is the first pneumococcal vaccine specifically designed for this age group. (3) Its immunogenicity in 2 year old children has been carefully documented. (4) A comparative, randomised, double-blind trial involving nearly 38,000 Californian infants showed a lower incidence of both all invasive pneumococcal infections (approximately 1 case avoided per 400 children vaccinated), and those due to the 7 serotypes covered by the vaccine. (5) These results are not directly applicable to France, where the pneumococcal serotype distribution (especially the 7 serotypes covered by the vaccine) seems to be somewhat different, and where the incidence of invasive pneumococcal infections is much lower. (6) The 7-valent vaccine has not been assessed adequately in children who are at high risk for invasive pneumococcal infection. Some small studies of children with sickle-cell disease show adequate immunogenicity. (7) The known adverse effects of the 7-valent vaccine are acceptable, mainly comprising local reactions and fever. (8) The risk of an epidemiological shift towards serotypes not covered by the vaccine (through pharyngeal carriage and invasive infection) cannot been ruled out. In otitis media, an increase in pneumococcal infections due to serotypes not covered by the vaccine negates the benefit of vaccination. (9) In practice, considering the severity of invasive pneumococcal infections and the documented efficacy and safety of the 7-valent conjugate vaccine, vaccination is warranted for individual children under two years of age, especially those at risk, but epidemiological monitoring and pharmacovigilance must continue.
Topics: Bacteremia; Child; Child Health Services; Clinical Trials as Topic; Drug Approval; Europe; Humans; Infant; Meningitis; Otitis Media; Pneumococcal Infections; Pneumococcal Vaccines; United States; Vaccines, Conjugate
PubMed: 11985376
DOI: No ID Found -
Expert Review of Pharmacoeconomics &... Apr 2021Pneumococcal diseases including invasive pneumococcal disease (IPD), pneumonia, and acute otitis media (AOM) impose a substantial public health burden. This study... (Comparative Study)
Comparative Study
Pneumococcal diseases including invasive pneumococcal disease (IPD), pneumonia, and acute otitis media (AOM) impose a substantial public health burden. This study performed a budget impact analysis of the use of pneumococcal conjugate vaccines (PCVs) in the National Immunization Program (NIP) in Colombia. We compared the direct medical cost of the scenario without and with PCV vaccination using either pneumococcal non-typeable protein D conjugate vaccine (PHiD-CV) or 13-valent pneumococcal conjugate vaccine (PCV-13) over 5 years (2020-2024) from the health-care system perspective. Vaccine efficacy estimates were obtained from published sources and vaccine prices were taken from the Pan-American Health Organization Revolving Fund. Vaccine coverage was assumed to be 90% based on Colombia data. Using PHiD-CV in the NIP in Colombia would reduce the estimated cost for treating pneumococcal disease by US$46.1 m over the 2020-2024 period (US$40.2 m using PCV-13), with a budget impact of US$100.1 m for PHiD-CV (US$121.4 m for PCV-13), and would cost US$3.1 m less per year on vaccine doses than using PCV-13. These findings are potentially valuable for the selection of vaccines for their national immunization programs under conditions of budgetary constraint.
Topics: Budgets; Colombia; Cost of Illness; Humans; Immunization Programs; Pneumococcal Infections; Pneumococcal Vaccines; Vaccination
PubMed: 33249948
DOI: 10.1080/14737167.2021.1855978 -
Medical Decision Making : An... 2002Routine vaccination for Streptococcus pneumoniae has been recommended as a cost-effective measure for elderly and immunocompromised patients, yet no analysis has been...
OBJECTIVES
Routine vaccination for Streptococcus pneumoniae has been recommended as a cost-effective measure for elderly and immunocompromised patients, yet no analysis has been performed for healthy younger adults in America. The authors evaluated the cost-effectiveness of the pneumococcal vaccine and determined the net health benefits conferred for the healthy young adult population.
METHODS
The authors developed a decision model to compare the health and economic outcomes of vaccinate versus do not vaccinate for S. pneumoniae.
RESULTS
Vaccinating patients for S. pneumoniae generates benefits that are dependent on incidence rates and the efficacy of the vaccine. In the 22-year-old patient with a pneumonia incidence of 0.3/1000, the vaccine would need to be > 71 percent effective for the vaccination strategy to cost less than $50,000/QALY gained. At an incidence of 0.4/1000, the threshold efficacy is 53 percent, whereas at 0.5/1000 it is 43 percent. In the 35-year-old patient where the incidence of pneumococcal pneumonia is higher (0.85/1000), the vaccine would be cost-effective with an efficacy as low as 30 percent.
CONCLUSIONS
Use of the S. pneumoniae vaccine in young adults would provide modest reductions in pneumonia-associated morbidity and mortality. Vaccination of young adults is moderately expensive unless vaccine efficacy is above 50% to 60%. In 35-year-old adults, use of the vaccine is cost-effective even with moderate efficacy.
Topics: Adult; Age Factors; Cost of Illness; Cost-Benefit Analysis; Decision Support Techniques; Health Status; Humans; Incidence; Markov Chains; Morbidity; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Quality-Adjusted Life Years; Safety; Sensitivity and Specificity; United States
PubMed: 12369231
DOI: 10.1177/027298902237705 -
Clinical Infectious Diseases : An... Sep 2015
Topics: Female; Humans; Male; Meningitis, Pneumococcal; Pneumococcal Vaccines; Streptococcus pneumoniae
PubMed: 25972021
DOI: 10.1093/cid/civ371 -
Zhonghua Liu Xing Bing Xue Za Zhi =... Dec 2020Pneumococcal disease is a serious global public health problem and a leading cause of morbidity and mortality of children and adults in China. Antibiotics are commonly... (Review)
Review
Pneumococcal disease is a serious global public health problem and a leading cause of morbidity and mortality of children and adults in China. Antibiotics are commonly used to treat pneumococcal disease. However, antibiotic resistance to Streptococcus pneumoniae has become a severe problem around the world due to widespread antibiotic use. Immunoprophylaxis of pneumococcal disease with pneumococcal vaccines is therefore of great importance. In this article, we review the etiology, clinical presentation, epidemiology, and disease burden of pneumococcal disease and the vaccinology of pneumococcal vaccines. Our review is based on the Expert Consensus on Immunoprophylaxis of Pneumococcal Disease (2017 version), the Pneumococcal Vaccines WHO Position Paper (2019), and recent national and international scientific advances. This consensus article aims to provide public health and vaccination staff with appropriate evidence for pneumococcal vaccine use and to improve professional capacity for pneumococcal disease prevention and control.
Topics: Adult; Child; China; Consensus; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae; Vaccines, Conjugate
PubMed: 33261246
DOI: 10.3760/cma.j.cn112338-20201111-01322 -
Scientific Reports Sep 2016The aim of this study was to compare the immunologic response to a prime-boost immunization strategy combining the 13-valent conjugate pneumococcal vaccine (PCV13) with... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this study was to compare the immunologic response to a prime-boost immunization strategy combining the 13-valent conjugate pneumococcal vaccine (PCV13) with the 23-valent polysaccharide pneumococcal vaccine (PPSV23) versus the PPSV23 alone in HIV-infected adults. HIV-infected adults were randomized to receive PCV13 at week 0 followed by PPSV23 at week 4 (n = 31, prime-boost group) or PPSV23 alone at week 4 (n = 33, PPSV23-alone group). Serotype specific IgG geometric mean concentration (GMC) and functional oposonophagocytic (OPA) geometric mean titer (GMT) were compared for 12 pneumococcal serotypes shared by both vaccines at week 8 and week 28. The prime-boost vaccine group were more likely to achieve a ≥2-fold increase in IgG GMC and a GMC >1 ug/ml at week 8 (odds ratio (OR) 2.00, 95% confidence interval (CI) 1.46-2.74, p < 0.01) and week 28 (OR 1.95, 95% CI 1.40-2.70, p < 0.01). Similarly, the prime-boost vaccine group were more likely to achieve a ≥4-fold increase in GMT at week 8 (OR 1.71, 95% CI 1.22-2.39, p < 0.01) and week 28 (OR 1.6, 95% CI 1.15-2.3, p < 0.01). This study adds to evidence supporting current pneumococcal vaccination recommendations combining the conjugate and polysaccharide pneumococcal vaccines in the United States and Europe for HIV-infected individuals.
Topics: Adult; Antibodies, Bacterial; Female; HIV Infections; Humans; Male; Pneumococcal Vaccines; Pneumonia, Pneumococcal
PubMed: 27580688
DOI: 10.1038/srep32076 -
Clinical Infectious Diseases : An... Apr 2014
Topics: Community-Acquired Infections; Female; Humans; Male; Pneumococcal Vaccines; Pneumonia, Pneumococcal
PubMed: 24532545
DOI: 10.1093/cid/ciu007