Pneumococcal Polysaccharide Vaccination for Adults
Vaccination is the only public-health measure likely to reduce the burden of pneumococcal diseases. In 2010, a group of European experts reviewed evidence on the burden of pneumococcal disease and the immunogenicity, clinical effectiveness and cost–effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23). They also considered issues affecting the future use of PPV23 and pneumococcal conjugate vaccines in the elderly and adults at high risk of pneumococcal disease. PPV23 covers 80–90% of the serotypes responsible for invasive pneumococcal disease in Europe. Primary vaccination and revaccination with PPV23 are well tolerated, induce robust, long-lasting immune responses in elderly adults and are cost effective. Ensuring protection against pneumococcal disease requires monitoring of the changing epidemiology of pneumococcal serotypes causing invasive pneumococcal disease and improving vaccine coverage. In the future, it will be critically important for pneumococcal vaccination recommendations for elderly adults to be based on comparative evaluations of PPV23 and newer pneumococcal conjugate vaccines with regard to their long-term immunogenicity, clinical effectiveness and cost–effectiveness.
Pneumococcal diseases continue to be an important public health problem throughout the world. Although >90 different capsular polysaccharide serotypes of Streptococcus pneumoniae have been identified, approximately 20 are responsible for >70% of cases of invasive pneumococcal disease (IPD) occurring in all age groups. Vaccination is the only public health measure likely to reduce the burden of pneumococcal diseases.
Two types of pneumococcal vaccine are available. The 23-valent pneumococcal polysaccharide vaccine (PPV23) is used in adults and children >2 years of age. By contrast, pneumococcal conjugate vaccines (PCVs) are currently used only in children <5 years of age. Indications for using PCV in adults are under review by regulatory and public health officials.
The introduction of 7-valent PCV (PCV-7) vaccination programs for children has dramatically reduced the incidence of pneumococcal diseases in children, and the highest disease burden is now seen in elderly adults. Although policies for PPV23 vaccination of elderly and 'at-risk' adults have been introduced in almost all European countries, coverage rates among target populations remain low. Consequently, the morbidity and mortality associated with pneumococcal diseases in these groups remain high.
In November 2010, a group of experts met to examine the current status of pneumococcal vaccination of elderly and at-risk adults in Europe. The group reviewed recent evidence on the burden of pneumococcal disease, the immunogenicity, clinical effectiveness and cost–effectiveness of PPV23 vaccination and issues related to the future use of PPV23 and PCVs in these groups.
Abstract and Introduction
Abstract
Vaccination is the only public-health measure likely to reduce the burden of pneumococcal diseases. In 2010, a group of European experts reviewed evidence on the burden of pneumococcal disease and the immunogenicity, clinical effectiveness and cost–effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23). They also considered issues affecting the future use of PPV23 and pneumococcal conjugate vaccines in the elderly and adults at high risk of pneumococcal disease. PPV23 covers 80–90% of the serotypes responsible for invasive pneumococcal disease in Europe. Primary vaccination and revaccination with PPV23 are well tolerated, induce robust, long-lasting immune responses in elderly adults and are cost effective. Ensuring protection against pneumococcal disease requires monitoring of the changing epidemiology of pneumococcal serotypes causing invasive pneumococcal disease and improving vaccine coverage. In the future, it will be critically important for pneumococcal vaccination recommendations for elderly adults to be based on comparative evaluations of PPV23 and newer pneumococcal conjugate vaccines with regard to their long-term immunogenicity, clinical effectiveness and cost–effectiveness.
Introduction
Pneumococcal diseases continue to be an important public health problem throughout the world. Although >90 different capsular polysaccharide serotypes of Streptococcus pneumoniae have been identified, approximately 20 are responsible for >70% of cases of invasive pneumococcal disease (IPD) occurring in all age groups. Vaccination is the only public health measure likely to reduce the burden of pneumococcal diseases.
Two types of pneumococcal vaccine are available. The 23-valent pneumococcal polysaccharide vaccine (PPV23) is used in adults and children >2 years of age. By contrast, pneumococcal conjugate vaccines (PCVs) are currently used only in children <5 years of age. Indications for using PCV in adults are under review by regulatory and public health officials.
The introduction of 7-valent PCV (PCV-7) vaccination programs for children has dramatically reduced the incidence of pneumococcal diseases in children, and the highest disease burden is now seen in elderly adults. Although policies for PPV23 vaccination of elderly and 'at-risk' adults have been introduced in almost all European countries, coverage rates among target populations remain low. Consequently, the morbidity and mortality associated with pneumococcal diseases in these groups remain high.
In November 2010, a group of experts met to examine the current status of pneumococcal vaccination of elderly and at-risk adults in Europe. The group reviewed recent evidence on the burden of pneumococcal disease, the immunogenicity, clinical effectiveness and cost–effectiveness of PPV23 vaccination and issues related to the future use of PPV23 and PCVs in these groups.
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