Controlling invasive pneumococcal disease: is vaccination of at-risk groups sufficient?

Abstract

Summary Risk factors for invasive pneumococcal disease (IPD) include young and old age, comorbidities (such as splenic dysfunction, immunodeficiencies, chronic renal disease, chronic heart or lung disease or cerebral spinal fluid leak), crowded environments or poor socioeconomic conditions. Universal use of the 7‐valent pneumococcal conjugate (7vPncCRM) vaccine for infants and young children has led to significant decreases in IPD in the vaccinated population (direct protection), and there has also been a decrease in the incidence of IPD among the nonvaccinated population (indirect immunity; herd protection). While 7vPncCRM vaccine is administered universally to children in USA, many countries of the European Union have chosen to target children with comorbidities. This review aims to highlight individual risk factors for IPD, describe studies that evaluated pneumococcal conjugate vaccines in at‐risk groups and estimate the proportion of at‐risk children who may have been vaccinated in the European Union since the 7vPncCRM vaccine was introduced, using UK as an example. Although immunisation targeting only children with comorbidities may achieve satisfactory results for a few, many otherwise healthy children at risk simply because of their age will be neglected, and herd protection might not be established.

Identification of new risk factors for pneumonia: population-based case-control study

“…3 While pneumonia can affect any age group, at most risk are adults aged ≥65 years, and infants and young children, who do not have a fully developed immune system. Patients at risk include those with splenic dysfunction, 4 cochlear implants or cerebrospinal fluid shunts, 3 chronic cardiovascular disease, chronic pulmonary disease, diabetes, 5 chronic liver disease, [6][7][8] and chronic renal failure, 5,9 as well as those with HIV and AIDS. 10,11 The 23-valent pneumococcal immunisation has been recommended since 1992 for individuals at high risk of invasive pneumococcal disease, and in 2003 the recommendation was extended to include all people aged ≥65 years.…”

Molecular characterization of non-vaccine Streptococcus pneumoniae serotypes 11A, 15 B/C and 23A recovered from invasive isolates in Colombia

“…NVT surveillance is an issue of concern given its relation with invasive diseases affecting less than two-year-old children, i.e., the most vulnerable population (28). Nevertheless, in this study 20.8% of isolates came from less than 2-year-old children, and 26.0% from more than 50-year-old adults.…”

Antibiotic Susceptibility and Prevalence of Adhesion Genes in Streptococcus pneumoniae Isolates Detected in Carrier Children in Tehran

“…This species is the main reason for mortality, especially in children, patients with chronic diseases, the elderly, and immune-compromised people of all ages worldwide (1). This pathogen causes economically significant diseases like sinusitis, septicemia, otitis, pneumonia, and even meningitis (2). Every year, S. pneumoniae takes the life of more than 1000000 children globally.…”