Pnömokok aşıları Derleme

Abstract

Diseases caused by Streptococcus pneumoniae pneumococcus are major public health problems worldwide Serious diseases that are often caused by pneumococci include pneumonia meningitis and bacteraemia; otitis media and sinusitis are more common but less serious manifestations of infection 23 valent pneumococcal polysaccharide vaccine PPV23 is not effective in children younger than 2 years of age in whom 80 of childhood invasive pneumococcal diseases occur The 7 valent pneumococcal conjugate vaccine PCV7 contains 4 6B 9V 14 18C 19F and 23F serotypes Serotypes included in PCV7 and potentially cross reactive serotypes 6A 9A 9L 18B and 18F accounted for 86 of bacteremia 83 of meningitis and 65 of AOM among children aged lt;6 years PCV7 is administered intramusculary at ages of 2 4 6 and 12 15 months After three doses of PCV7 a preventing level of type specific antibody against the vaccine serotypes is achieved in approximately 90 of children Clinical studies suggest that PCV7 is safe and highly effective in preventing invasive pneumococcal disease in healthy children aged lt;2 years and has nbsp; a significant impact on pneumonia and acute otitis media Therefore it is recommended that all children aged lt;2 years should be vaccinated with PCV7 Heptavalent conjugate vaccine has advantages over PPV23 which include induction of immune system memory possibly resulting in longer duration of protection reduction in carriage probable higher efficacy against serotypes causing most invasive disease and probable effectiveness against noninvasive syndromes pneumonia and acute otitis media A 7 valent pneumococcal conjugate vaccine has been licensed since 2000 in USA The introduction of PCV7 in the US has resulted in substantial decline in IPD in the target population despite supply shortages including high risk children A herd effect in unvaccinated children and adults especially in the elderly has been observed A decline in antibiotic resistance has been observed since introduction of PCV7 Serotype replacement has been observed for carriage isolates of SP and for IPD nbsp; Serotypes 19A 15 22F 33F 35 are increasing in frequency in both children and in those agedabove 65 Today PCV7 is licensed in more than 70 countries and is used routinely in several developed countries Vaccines with 10 and 13 serotypes might be licensed between 2008 and 2010 Turk Arch Ped 2007; 42 Suppl: 43 50 Key words: nbsp; Invazive pneumococcal disease pneumococcal conjugate vaccine