The remarkable history of pneumococcal vaccination: an ongoing challenge

Abstract

Although it varies with age and geographical distribution, the global burden of infection with Streptococcus pneumoniae (pneumococcus) remains considerable. The elderly, and younger adults with comorbid conditions, are at particularly high risk of pneumococcal infection, and this risk will increase as the population ages. Vaccination should be the backbone of our current strategies to deal with this infection.Main body: This manuscript reviews the history of the development of pneumococcal vaccines, and the impact of different vaccines and vaccination strategies over the past 111 years. It documents the early years of vaccine development in the gold mines of South Africa, when vaccination with killed pneumococci was shown to be effective, even before the recognition that different pneumococci were antigenically distinct. The development of type-specific vaccines, still with whole killed pneumococci, showed a high degree of efficacy. The identification of the importance of the pneumococcal capsule heralded the era of vaccination with capsular polysaccharides, although with the advent of penicillin, interest in pneumococcal vaccine development waned. The efforts of Austrian and his colleagues, who documented that despite penicillin therapy, patients still died from pneumococcal infection in the first 96 h, ultimately led to the licensing first of a 14-valent pneumococcal polysaccharide in 1977 followed by the 23-valent pneumococcal polysaccharide in 1983. The principal problem with these, as with other polysaccharide vaccines, was that that they failed to immunize infants and toddlers, who were at highest risk for pneumococcal disease. This was overcome by chemical linking or conjugation of the polysaccharide molecules to an immunogenic carrier protein. Thus began the era of pneumococcal conjugate vaccine (PCV), starting with PCV7, progressing to PCV10 and PCV13, and, most recently, PCV15 and PCV20. However, these vaccines remain serotype specific, posing the challenge of new serotypes replacing vaccine types. Current research addresses serotype-independent vaccines which, so far, has been a challenging and elusive endeavor.Conclusion: While there has been enormous progress in the development of pneumococcal vaccines during the past century, attempts to develop a vaccine that will retain its efficacy for most pneumococcal serotypes are ongoing.

Characterization of the innate immune response to Streptococcus pneumoniae infection in zebrafish

“…Six of the zebrafish C3 variants (coded by c3a. [1][2][3][4][5][6] exhibit significant homology to human C3, and have been shown to respond to bacterial stimulus, while the other two (coded by c3a.7, and c3a.8) are more distinct, both in sequence, and in expression pattern [139]. The most responsive C3 genes in our infection model were c3a.1-3 and c3a.6, supporting the previous study and further suggesting their important role in host defense during bacterial infection.…”

“…Due to the high incidence of pneumococcal infections, this pathogen is a major cause of morbidity especially in children and the elderly, and accounted for over a million deaths globally in 2016 [3]. While the global use of pneumococcal conjugate vaccines has reduced the colonization, pneumonia, acute otitis media, and invasive disease caused by the vaccine serotypes, the increased prevalence of nonvaccine serotypes and the high incidence of antibiotic resistant isolates of S. pneumoniae retain this pathogen as a major health burden worldwide [4][5][6].…”

Ambulant erworbene Pneumonie

“…eine Wiederholungsimpfung mit PPSV23 im Abstand von mindestens 6 Jahren nach individueller Indikationsstellung [3]. Neben dem Polysaccharid-Impfstoff sind konjugierte Pneumokokkenimpfstoffe verfügbar, die eine bessere Immunogenität besitzen [4]. Bislang wurden diese unter anderem deshalb nicht empfohlen, da die Serotypenabdeckung geringer war als bei PPSV23.…”

Was gibt es Neues bei der Meningokokken- und Pneumokokken-Impfung?

“…anatomisch asplenen Patienten (147,7) gefolgt von Kindern mit chronischen Lebererkrankungen (134,1). IPD treten besonders in den Wintermonaten und im Kindesalter bei Säuglingen und Kleinkindern 58 auf ( Abb. 1 und Abb.…”