Effect of Community‐Wide Conjugate Pneumococcal Vaccine Use in Infancy on Nasopharyngeal Carriage through 3 Years of Age: A Cross‐Sectional Study in a High‐Risk Population

Abstract

Community-wide PnCRM7 vaccination in infancy reduces the prevalence of vaccine-type carriage and increases the prevalence of nonvaccine-type carriage through at least 3 years of age.

Reduced antibiotic prescribing for acute respiratory infections in adults and children

“…The decline in antibacterial use was faster for both older and younger children than for adults, although use in younger adults declined faster than for older adults. Possible reasons for these differences include: the influence of the pneumococcal conjugate vaccine on the perceived risk of child bacterial illness [43][44][45] and on parents' health through herd effects; 45,46 a potentially initially wider pool of unneeded antibacterial use in younger individuals; and a possible differential effect of demonstrated in this study, from 71% in 1990 to 59% in 2004, is similar to these US reports. Similarly, Steinman et al reported declining antibacterial use for child ARIs, from 41% in 1991 to 21% in 1999.…”

Vaccination with the pneumococcal 7-valent conjugate: a successful experiment but the species is adapting

“…Although PCV7 has demonstrated a dramatic positive impact, a small, incremental, yearly increase of replacement invasive disease caused by certain NVTs not included in PCV7 has been observed [12]. This observation coincides with reports of increased colonization and otitis media caused by NVTs [3,16,17,18]. Although there are reports that PCV7 has successfully decreased nasopharyngeal carriage of antibiotic-resistant strains [19], a more recent carriage study reported increases in previously recognized penicillin-nonsusceptible clones of NVTs 19A, 15A and 35B [17].…”

“…This vaccine targeted the serotypes that cause more than 80% of IPD in children and the serotypes accounting for 83% of IPD caused by penicillin-nonsusceptible pneumococci in children under 5 years of age. This 7-valent conjugate vaccine (PCV7) has demonstrated spectacular success, not only in reducing IPD in children [1,2], but also in reducing colonization in this target population with resultant decreased IPD in older-age groups [1,3].…”

Effect of Swab Composition and Use of Swabs versus Swab-Containing Skim Milk-Tryptone-Glucose-Glycerol (STGG) on Culture- or PCR-Based Detection of Streptococcus pneumoniae in Simulated and Clinical Respiratory Specimens in STGG Transport Medium

“…The latter fact has resulted in a decrease in invasive disease in adults (21) and in infants too young to have been directly protected by vaccination (13) via herd type immunity. This has been accompanied by an apparent increase in the prevalence of colonization with nonvaccine serotypes (7,10,12). Some of these nonvaccine serotypes may have been present prior to the use of PCV7 but were unrecognized due to limitations in the sensitivity of culture and the difficulty in detecting more than one serotype in a nasopharyngeal specimen.…”