Evolving Role of 13-valent Pneumococcal Conjugate Vaccine in Clinical Practice

Abstract

Since the introduction of 7-valent pneumococcal conjugate vaccine (PCV7), PCVs with extended coverage have become available, and there is emerging global evidence that these vaccines, in particular PCV13, have further reduced rates of invasive pneumococcal disease compared with PCV7. The present article aims to address emerging topics related to PCV13 use in routine clinical practice; specifically: (1) the potential role of high-valent PCVs in reducing pneumococcal disease burden; (2) the impact of PCVs on nasopharyngeal carriage and how this may contribute to reductions in otitis media and pneumonia, as well as the prevalence of resistant pneumococcal strains; (3) new PCV13 indications and (4) importance of schedule adherence for PCV in the prevention of cases of vaccine serotype-specific invasive pneumococcal disease. The beneficial effects of PCVs in protecting individuals from a wide spectrum of pneumococcal diseases can be increased by improving the vaccine coverage and adhering to the recommended vaccination schedules. There is increasing evidence that PCV13 has reduced much of the post-PCV7 burden of pneumococcal diseases in the pediatric community, including reducing pneumococcal colonization and the incidence of invasive pneumococcal disease and mucosal diseases. This has also led to a reduction in antibiotic-resistant pneumococcal diseases. The role of PCV13 in clinical practice is evolving, with PCV13 now available for children and adolescents between the ages of 6 weeks and 17 years, thus ensuring that children in all age groups can be protected against vaccine-serotype pneumococcal diseases. Continued surveillance is warranted to monitor the impact of PCV13 on disease burden.

A 13-year survey of pneumococcal nasopharyngeal carriage in children with acute otitis media following PCV7 and PCV13 implementation

“…Before PCV implementation, the serotypes successful in colonizing the nasopharynx that were potentially subjected to prolonged or multiple exposure to antibiotic drugs, which can lead to antibiotic resistance, were ST 6A, 6B, 9V, 14, 19A, 19F and 23F [34][35][36]. The reduction of these serotypes was dually influenced by the PCV7 and by the antibiotic selective pressure [13].…”

The effect of immunization with pneumococcal conjugated vaccines on Streptococcus pneumoniae resistance patterns in acute otitis media

“…To prevent invasive pneumococcal diseases, pneumococcal conjugate vaccines (PCVs) have been introduced worldwide. To some extent, these vaccines have also been shown to reduce AOM burden (2). The decrease in AOM incidence after PCV7 introduction was blunted by the emergence of non-vaccine serotypes of Sp, which eventually led to the introduction of the broader spectrum 13-valent vaccine.…”

Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

“…8,[26][27][28] Evidently, PCV impact on pneumococcal disease and carriage rates depends also on the individually established vaccine efficacy, vaccine uptake, adherence to plans. 29 and potentially vaccine dosing regimens. 9,30 PCV7 was licensed in Israel in mid-2007, and was used sporadically until 2009.…”