A second-generation pneumococcal conjugate vaccine for prevention of pneumococcal diseases in children.
A second-generation pneumococcal conjugate vaccine for prevention of pneumococcal diseases in children.
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DOI：
10.1097/mop.0b013e328341d1f5
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发表时间：
2011-02
影响因子：
3.6
通讯作者：
Pelton SI
中科院分区：
文献类型：
--
作者：
Grijalva CG;Pelton SI
第二代13价肺炎球菌结合疫苗（PCV 13）于2010年获得许可，并被推荐用于5岁以下儿童的普遍免疫。它的引入旨在解决在引入PCV 7后持续十年的肺炎球菌疾病的残余负担。在美国，用PCV 7免疫接种导致疫苗血清型引起的肺炎球菌疾病在接种疫苗和未接种疫苗的人中大幅下降。然而，由于非疫苗血清型（包括脓胸）导致的疾病增加;出现多药（包括头孢曲松）耐药血清型19 A菌株;以及需要更广泛的血清型覆盖以解决全球疾病负担，为包括血清型1、3、5、6A、7 F和19 A的第二代结合疫苗提供了依据。本文回顾了从PCV 7十年的经验中吸取的教训，由于非疫苗血清型引起的疾病问题日益严重，以及PCV 13影响剩余疾病负担的可能性。我们对比了侵袭性肺炎球菌病（IPD）与非菌血症性肺炎和急性中耳炎预防的潜在差异。我们得出结论，目前对PCV 13的建议为5岁以下的免疫接种提供了理由，以在人群中建立直接和间接的保护。
A second generation 13 valent pneumococcal conjugate vaccine (PCV13) was licensed and recommended for universal immunization of children through age five years in 2010. Its introduction is intended to address the residual burden of pneumococcal diseases that persists a decade after the introduction of PCV7. Immunization with PCV7 has resulted in a substantial decline in pneumococcal diseases caused by vaccine serotypes in both vaccinated and unvaccinated persons in the US. However an increase in disease due to non vaccine serotypes, including empyema; the emergence of multidrug, including ceftriaxone, resistant serotype 19A strains; and the need for broader serotype coverage to address the global disease burden provides a rationale for a second generation conjugate vaccine that includes serotypes 1, 3, 5, 6A, 7F and 19A. This article reviews the lessons learned from a decade of experience with PCV7, the increasing problem of disease due to non-vaccine serotypes, and the likelihood of PCV13 to impact the residual disease burden. We contrast the potential differences in prevention of invasive pneumococcal disease (IPD) compared to nonbacteremic pneumonia and acute otitis media. We conclude with the current recommendations for PCV13 providing a rationale for immunization through age 5 years to create both direct and indirect protection in the population.