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Expert Opinion on Biological Therapy Jan 2012Worldwide, Streptococcus pneumoniae causes significant morbidity and mortality. The 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been recommended for use... (Review)
Review
INTRODUCTION
Worldwide, Streptococcus pneumoniae causes significant morbidity and mortality. The 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been recommended for use in persons aged 65 years and over and in adults with certain chronic medical conditions. Pneumococcal conjugate vaccines (PCVs) have been developed for use in infants and children aged less than 5 years, and are being studied for use in adult populations.
AREAS COVERED
The different types of pneumococcal vaccines are discussed. Studies comparing PPSV23 and PCVs, as well as the results of the widespread use of 7-valent PCV are covered. The possible extension of the use of 13-valent PCV to adults, particularly to vulnerable populations, is discussed. The MEDLINE database was used to identify relevant studies from literature published in English between January 1977 and January 2011. All studies of adults aged over 18 years were considered for the review.
EXPERT OPINION
Elderly individuals and adults with chronic medical conditions who are at increased risk for pneumococcal disease would benefit from more effective prevention than is provided by the currently recommended PPSV23.
Topics: Adult; Aged; Child; Chronic Disease; Drug Resistance, Bacterial; Humans; Models, Biological; Penicillins; Placebos; Pneumococcal Infections; Pneumococcal Vaccines; Randomized Controlled Trials as Topic; Risk; Streptococcus pneumoniae; Vaccination
PubMed: 22074323
DOI: 10.1517/14712598.2012.636348 -
Clinical Infectious Diseases : An... Jul 2012A 13-valent pneumococcal conjugate vaccine has been studied in adults aged ≥ 50 years to compare the immune response to that induced by the 23-valent pneumococcal... (Comparative Study)
Comparative Study
A 13-valent pneumococcal conjugate vaccine has been studied in adults aged ≥ 50 years to compare the immune response to that induced by the 23-valent pneumococcal polysaccharide vaccine, which has been the standard of care over the past 30 years. The results demonstrate that adults, regardless of whether they are naive or previously vaccinated with the polysaccharide vaccine, have an overall superior antibody response when vaccinated with the conjugate vaccine compared with the pneumococcal polysaccharide vaccine. More importantly, the nature of the response is indicative of a T-cell-dependent response that elicits immunological memory and, therefore, primes the immune system for either natural exposure or subsequent booster vaccination with either conjugate or polysaccharide vaccine. The conjugate vaccine, which has been successful in reducing pneumococcal disease in children, now provides a new approach to preventing pneumococcal disease, including community-acquired pneumonia, in adults.
Topics: Aged; Aged, 80 and over; Antibodies, Bacterial; Community-Acquired Infections; Humans; Immunologic Memory; Middle Aged; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae; T-Lymphocytes
PubMed: 22495545
DOI: 10.1093/cid/cis359 -
Immunology and Cell Biology Sep 2019Existing capsular polysaccharide-based vaccines against pneumococcal disease are highly effective against vaccine-included serotypes, but they are unable to combat...
Existing capsular polysaccharide-based vaccines against pneumococcal disease are highly effective against vaccine-included serotypes, but they are unable to combat serotype replacement. We have developed a novel pneumococcal vaccine that confers serotype-independent protection, and could therefore constitute a "universal" vaccine formulation. This preparation is comprised of whole un-encapsulated pneumococci inactivated with gamma irradiation (γ-PN), and we have previously reported induction of cross-reactive immunity after nonadjuvanted intranasal vaccination. To further enhance vaccine immunogenicity and safety, we modified the pneumococcal vaccine strain to induce a stressed state during growth. Specifically, the substrate binding component of the psaBCA operon for manganese import was mutated to create a pneumococcal surface antigen A (psaA) defective vaccine strain. psaA mutation severely attenuated the growth of the vaccine strain in vitro without negatively affecting pneumococcal morphology, thereby enhancing vaccine safety. In addition, antibodies raised against vaccine preparations based on the modified strain [γ-PN(ΔPsaA)] showed more diversified reactivity to wild-type pneumococcal challenge strains compared to those induced by the original formulation. The modified vaccine also induced comparable protective T 17 responses in the lung, and conferred greater protection against lethal heterologous pneumococcal challenge. Overall, the current study demonstrates successful refinement of a serotype-independent pneumococcal vaccine candidate to enhance safety and immunogenicity.
Topics: Adhesins, Bacterial; Administration, Intranasal; Animals; Antigens, Surface; Disease Models, Animal; Female; HEK293 Cells; Humans; Immunogenicity, Vaccine; Lipoproteins; Lung; Mice; Mutation; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae; Th17 Cells; Vaccination; Vaccines, Inactivated
PubMed: 31050022
DOI: 10.1111/imcb.12257 -
Annali Di Igiene : Medicina Preventiva... 2001
Review
Topics: Humans; Pneumococcal Vaccines; Pneumonia, Pneumococcal
PubMed: 11760437
DOI: No ID Found -
Epidemiology and Infection Dec 2014For decades, vaccination with the 23-valent polysaccharide pneumococcal vaccine (PPV23) has been available for risk groups aged ⩾2 years to prevent invasive... (Review)
Review
For decades, vaccination with the 23-valent polysaccharide pneumococcal vaccine (PPV23) has been available for risk groups aged ⩾2 years to prevent invasive pneumococcal disease (IPD). Recently, a 13-valent pneumococcal conjugated vaccine (PCV13) has been licensed for use in all age groups. PCV13 may induce better protection than PPV23 because of different immunogenic properties. This called for a revision of vaccine recommendations for risk groups. We therefore reviewed literature on risk groups for IPD, and effectiveness and safety of pneumococcal vaccines and supplemented that with information from public health institutes, expert consultations and data on IPD epidemiology. We included 187 articles. We discuss the implications of the heterogenic vulnerability for IPD within and between risk groups, large indirect effects of childhood immunization, and limited knowledge on additional clinical benefits of PCV13 in combination with PPV23 for the Norwegian recommendations. These are now step-wise and consider the need for vaccination, choice of pneumococcal vaccines, and re-vaccination interval by risk group.
Topics: Adolescent; Adult; Child; Child, Preschool; Health Policy; Humans; Norway; Pneumococcal Infections; Pneumococcal Vaccines; Vaccines, Conjugate
PubMed: 24932959
DOI: 10.1017/S0950268814001514 -
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 -
The Pediatric Infectious Disease Journal Jan 2014Pneumonia is the leading cause of morbidity and mortality among children <5 years of age globally. Pneumococcal conjugate vaccines (PCVs) are known to provide protection... (Review)
Review
BACKGROUND
Pneumonia is the leading cause of morbidity and mortality among children <5 years of age globally. Pneumococcal conjugate vaccines (PCVs) are known to provide protection against vaccine serotype pneumococcal pneumonia; uncertainty exists regarding the optimum PCV dosing schedule.
METHODS
We conducted a systematic review of studies published from 1994 to 2010 (supplemented post hoc with studies from 2011) documenting the effect of PCV dosing schedules on clinical and radiologically confirmed pneumonia, pneumococcal pneumonia and empyema among children of ages targeted to receive vaccine. Data on 2- and 3-dose schedules were included. Percent change of pneumonia incidence rates from baseline to most recent year post-PCV introduction was calculated.
RESULTS
We identified 42 primary citations that evaluated PCV schedules and pneumonia. Thirty-seven (88%) were from North America, Europe or Australia; 37 (88%) evaluated PCV7 and 1 (2%) PCV10. Two studies (both observational) compared multiple schedules within the study. We found evidence of reduced clinical and radiologically confirmed pneumonia incidence for all schedules, including 2+1 (1 nonrandomized trial, 5 observational studies), 3+0 (5 randomized trials, 2 observational studies) and 3+1 (5 clinical trials, 24 observational studies) schedules. The magnitude of disease impact did not differ among schedules. Evidence for impact on pneumococcal pneumonia and empyema varied.
CONCLUSIONS
All schedules (2+1, 3+0 and 3+1) reduced clinical and radiologically confirmed pneumonia. Quantifying differences in pneumonia disease impact between schedules was difficult due to heterogeneity among studies in design, case definition and population. These findings support World Health Organization recommendations for 3-dose schedules administered as either 3+0 or 2+1 regimens. Pneumonia impact data are still needed on expanded serotype PCV products, developing country settings and the role for a booster dose.
Topics: Child, Preschool; Heptavalent Pneumococcal Conjugate Vaccine; Humans; Immunization Schedule; Infant; Observational Studies as Topic; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Randomized Controlled Trials as Topic; Vaccines, Conjugate
PubMed: 24336056
DOI: 10.1097/INF.0000000000000082 -
JAMA Sep 2013
Topics: Female; Humans; Immunization Schedule; Male; Pneumococcal Infections; Pneumococcal Vaccines; Streptococcus pneumoniae
PubMed: 24002275
DOI: 10.1001/jama.2013.228062 -
Prescrire International Feb 2013In adults, the 13-valent pneumococcal conjugate vaccine seems to be more immunogenic than the 23-valent polysaccharide pneumococcal vaccine for most of the 12 shared... (Review)
Review
In adults, the 13-valent pneumococcal conjugate vaccine seems to be more immunogenic than the 23-valent polysaccharide pneumococcal vaccine for most of the 12 shared serotypes. However, in mid-2012, routine vaccination of adults has no proven efficacy.
Topics: Age Factors; Humans; Middle Aged; Patient Selection; Pneumococcal Infections; Pneumococcal Vaccines; Risk Assessment; Risk Factors; Vaccination
PubMed: 23444498
DOI: No ID Found -
Indian Journal of Medical Microbiology 2013
Topics: Child, Preschool; Health Policy; Humans; Immunization Schedule; India; Molecular Typing; Pneumococcal Infections; Pneumococcal Vaccines; Serotyping; Streptococcus pneumoniae
PubMed: 23508420
DOI: 10.4103/0255-0857.108701