Streptococcus pneumoniae infection primary prevention

Streptococcus pneumoniae infection Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Vaccination in the USA

In the USA, a heptavalent pneumococcal conjugate vaccine vaccine (PCV 7) (e.g. Prevnar) is recommended since 2000 for all children aged 2-23 months and for at-risk children aged 24-59 months. The normally 4-doses series is given at 2, 4, 6 & 12 - 14 months of age. Protection is good against deep pneumococcal infections (especially septicemia and meningitis). Similar 9- and 13-valent vaccines are being tested. Yet, if the child is exposed to a serotype of pneumococcus that is not contained in the vaccine, he/she is not afforded any protection. This limitation, and the ability of capsular-polysaccharide conjugate vaccines to promote the spread of non-covered serotypes, has led to research into vaccines that would provide species-wide protection.

Pneumococcal polysaccharide vaccine (Pneumovax™ is one brand) gives at least 85% protection in those under 55 years of age for five years or longer. Immunization is suggested for those at highest risk of infection, including those 65 years or older, and generally should be a single lifetime dose (high risk side effects if repeated). The standard 23-valent vaccines are ineffective for children under two years old.

The current guidelines of the American College of Physicians call for administration of the immunization between ages 2 and 65 when indicated, or at age 65. If someone received the immunization before age 60, the guidelines call for a one-time revaccination.

Revaccination at periodic intervals is also indicated for those with other conditions such as asplenia or nephrotic syndrome.

Vaccination in the UK

It was announced in February 2006 that the UK government would introduce vaccination with the conjugate vaccine in children aged 2, 4 and 13 months. This is expected to start on September 4, 2006 and is to include changes to the immunisation programme in general.

Vaccination Worldwide

Pneumococcal vaccines Accelerated Development and Introduction Plan (PnemoADIP) is a program to accelerate the evaluation and access to new pneumococcal vaccines in the developing world. PneumoADIP is funded by the Global Alliance for Vaccines and Immunization (GAVI). Thirty GAVI countries have expressed interest in participating by 2010. PneumoADIP aims to save 5.4 million children by 2030.

References

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