Evaluation of pentavalent conjugated pneumococcal vaccine in toddlers

ArticleinThe Pediatric Infectious Disease Journal 16(1):72-4 · February 1997with5 Reads
DOI: 10.1097/00006454-199701000-00016 · Source: PubMed
    • "In 3 studies the immunogenicity of PnPS was studied with the effects of diseases such as asthma [21], recurrent infections [23], and HIV [26]. In 4 studies a comparison was made with conjugate vaccines [5,15,19,21]. In some studies PnPS was used to boost children who had been primed with a conjugate vaccine [2,5,13,17,18] or PnPS vaccine [5,6,8,10111214,22,24]. "
    [Show abstract] [Hide abstract] ABSTRACT: The immunogenicity of plain (not conjugated) pneumococcal polysaccharides in children and infants was reviewed using a systematic literature search. Immunogenicity was defined as the fold-increase in serotype specific antibody concentration after a single dose of plain polysaccharide vaccine in unprimed subjects. Meta-regression was used to calculate the influence of study treatments including subject age, sampling time, dosage, immunization route, vaccine composition and study location. Immunogenicity increased with age for all serotypes, and the increase was more rapid in the first 11 months of life. Study location was the next most significant study variable, with higher responses in countries with lower GDP. A flat dose-response curve was observed over a range from 5 to 50 μg polysaccharide. Serotypes 6A, 6B, 14, 19F and 23F were significantly less immunogenic than serotypes 2, 3, 4, 7F, 8, 9N, 9V and 18C in 11 month old children, but continued to increase in immunogenicity with age until reaching similar levels at 6 years. Some proposed T-independent immune mechanisms could explain the differences in serotype immunogenicity.
    Full-text · Article · Aug 2011
    • "The first studies performed used monovalent vaccines (serotypes 6A/6B, 12F) (Fattom et al., 1990; Lue et al., 1990; Sarnaik et al., 1990; Schneerson et al., 1986; Sigurdardottir et al., 1997; Vidarsson et al., 1998). In the early 1990s bivalent (serotypes 6A, 12F) (O'Brien et al., 1996; Steinhoff et al., 1994), tetravalent (serotypes 6B, 14, 19F, 23F) (Ahman et al., 1998; Arguedas et al., 2001; Dagan et al., 1997a; Ka¨yhtyKa¨yhty et al., 1995; Kroon et al., 2000; Nieminen et al., 1998 Nieminen et al., , 1999) and pentavalent conjugate vaccines (Ahman et al., 1996; Ahmed et al., 1996; Daum et al., 1997; King et al., 1996; Obaro et al., 1997; Pichichero et al., 1997; Powers et al., 1996; Shelly et al., 1997) were studied. Further clinical studies have been performed with two heptavalent (serotypes 4, 6B, 9 V, 14, 18C, 19F, 23F) vaccine formulations using OMPC as carrier protein (Anderson et al., 1996; Blum et al., 2000; Chan et al., 1996; Miernyk et al., 2000; Molrine et al., 1995; Storek et al., 1997) or CRM 197 (Barnett et al., 1999; Black et al., 2000 Black et al., , 2001 Black et al., , 2002 Choo et al., 2000; Nurkka et al., 2001; O'Brien et al., 2000; Rennels et al., 1998; Shinefield et al., 1999; Vernacchio et al., 1998; Zielen et al., 2000). "
    [Show abstract] [Hide abstract] ABSTRACT: Streptococcus pneumoniae is a leading cause of bacterial pneumonia, meningitis, and acute otitis media in children and adults worldwide. In the age group of < 2 years the incidence of invasive pneumococcal disease ranges from approximately 14 cases per 100,000 in Germany and the Netherlands and more than 90 per 100,000 children in Spain. The vulnerability of children to S. pneumoniae can also be demonstrated by the high rate of sequelae (> 20% in Germany) and the high mortality (7.5%) in pneumococcal meningitis. Furthermore, antibiotic resistance of S. pneumoniae is increasing in Europe, particularly in France, Spain, and Eastern European countries, whereas Germany and Northern Europe are only marginally affected. A 7-valent pneumococcal conjugate vaccine (7vPCV) that was shown to be highly efficacious in preventing invasive pneumococcal disease in infants in the USA was licensed in Europe in 2001. It is expected that broad usage of the vaccine would reduce the incidence of invasive pneumococcal disease and the levels of pneumococcal resistance significantly. Important questions have been raised regarding the effectiveness of this vaccine in high-risk populations, serotype replacement, the efficacy of this vaccine in otitis media, and the co-administration of the new vaccine with other standard childhood vaccines used in various European countries. France and Spain currently have the most-wide ranging guidelines recommending pneumococcal vaccination for children. Overall, the development of pneumococcal conjugate vaccines is a significant step in the control of pneumococcal disease in children in Europe. Further progress in pneumococcal vaccine development can be expected from conjugate vaccines including more than seven serotypes (9-valent, 11-valent).
    Article · Oct 2004
    • "Thirty to 50% of all patients with otitis media and a substantial percentage of cases of sinusitis and pneumonia are caused by pneumococci. Risk groups for serious pneumococcal disease include children under the age of 2 years, elderly and patients with immunodeficiencies [2] . Nasopharyngeal colonization by S. pneumoniae is common: probably all humans are colonized with this organism at least once early in life. "
    [Show abstract] [Hide abstract] ABSTRACT: Streptococcus pneumoniae is a major cause of morbidity and mortality in infants, children and the elderly. Despite the availability of excellent antimicrobial therapy and adequate health care systems, respiratory diseases and invasive infections caused by pneumococci still comprise a major health problem. The emerging resistance to penicillin and other commonly used antibiotics underscores the importance of the development of novel vaccine strategies to combat pneumococcal disease. Although the 23-valent polysaccharide (PS) vaccine is immunogenic and protective in most adults and children over 5 years of age, they fail to protect children under 2 years of age. Fortunately, the recent conjugate vaccines have shown to be highly efficacious in preventing invasive diseases in this risk group. Moreover, promising results regarding prevention of pneumonia and acute otitis media have been published. Unfortunately, protection is raised against a limited number of pneumococcal serotypes, and serotype replacement and subsequent vaccine failure have become a serious concern. Currently, several pneumococcal surface proteins are considered as alternative vaccine candidates because of their serotype-independence. Thus far, pneumococcal surface adhesin A (PsaA) has proven to be highly protective against colonization in animal models. Moreover, pneumococcal surface protein A (PspA) and pneumolysin have shown to elicit protection against invasive diseases. Future research will elucidate their true potential in protecting humans. In this paper we discuss the present knowledge on pneumococcal vaccines and the current status of novel vaccine strategies.
    Full-text · Article · Jul 2004
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