Controlling invasive pneumococcal disease: is vaccination of at-risk groups sufficient?
Controlling invasive pneumococcal disease: is vaccination of at-risk groups sufficient?
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DOI：
10.1111/j.1368-5031.2006.00858.x
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发表时间：
2006-04
影响因子：
2.6
通讯作者：
Malinoski, F J
中科院分区：
文献类型：
--
作者：
Fletcher, M A;Laufer, D S;McIntosh, E D G;Cimino, C;Malinoski, F J
侵袭性肺炎球菌病（IPD）的风险因素包括年轻和年老、合并症（如脾功能障碍、免疫缺陷、慢性肾脏疾病、慢性心脏或肺部疾病或脑脊液漏）、拥挤的环境或不良的社会经济条件。婴儿和幼儿普遍使用7价肺炎球菌结合物（7vPncCRM）疫苗，导致接种疫苗人群的IPD显着下降（直接保护），未接种疫苗人群的IPD发生率也有所下降（间接免疫;群体保护）。虽然7vPncCRM疫苗在美国普遍用于儿童，但许多欧盟国家选择针对患有合并症的儿童。本综述旨在突出IPD的个体风险因素，描述评估高危人群中肺炎球菌结合疫苗的研究，并以英国为例，估计自7vPncCRM疫苗推出以来，欧盟可能接种疫苗的高危儿童比例。虽然仅针对患有合并症的儿童进行免疫接种可能会对少数人取得令人满意的结果，但许多仅仅因为年龄而处于风险中的健康儿童将被忽视，并且可能无法建立群体保护。
Risk factors for invasive pneumococcal disease (IPD) include young and old age, comorbidities (such as splenic dysfunction, immunodeficiencies, chronic renal disease, chronic heart or lung disease or cerebral spinal fluid leak), crowded environments or poor socioeconomic conditions. Universal use of the 7-valent pneumococcal conjugate (7vPncCRM) vaccine for infants and young children has led to significant decreases in IPD in the vaccinated population (direct protection), and there has also been a decrease in the incidence of IPD among the nonvaccinated population (indirect immunity; herd protection). While 7vPncCRM vaccine is administered universally to children in USA, many countries of the European Union have chosen to target children with comorbidities. This review aims to highlight individual risk factors for IPD, describe studies that evaluated pneumococcal conjugate vaccines in at-risk groups and estimate the proportion of at-risk children who may have been vaccinated in the European Union since the 7vPncCRM vaccine was introduced, using UK as an example. Although immunisation targeting only children with comorbidities may achieve satisfactory results for a few, many otherwise healthy children at risk simply because of their age will be neglected, and herd protection might not be established.