Abstract
Pneumonia in childhood is endemic in large parts of the world and in particular, in developing countries, as well as in many indigenous communities within developed nations. Haemophilus influenzae type b and Streptococcus pneumoniae conjugate vaccines are currently available against the leading bacterial causes of pneumonia. The use of the vaccines in both industrialised and developing countries have shown a dramatic reduction in the burden of pneumonia and invasive disease in children. However, the greatest threat facing pneumococcal conjugate vaccine effectiveness is serotype replacement. The current vaccines provide serotype-specific, antibody-mediated protection against only a few of the 90+ capsule serotypes. Therefore, there has been a focus in recent years to rapidly advance technologies that will result in broader disease coverage and more affordable vaccines that can be used in developing countries. The next generation of pneumococcal vaccines have advanced to clinical trials.
Highlights
WŶĞƵŵŽŶŝĂ ŝŶ ĐŚŝůĚŚŽŽĚ ŝƐ ĞŶĚĞŵŝĐ ŝŶ ůĂƌŐĞ ƉĂƌƚƐ ŽĨ ƚŚĞ ǁŽƌůĚ ĂŶĚ ŝŶ ƉĂƌƟĐƵůĂƌŝŶ ĚĞǀĞůŽƉŝŶŐ ĐŽƵŶƚƌŝĞƐ ĂƐ ǁĞůů ĂƐ ŝŶ ŵĂŶLJ ŝŶĚŝŐĞŶŽƵƐ ĐŽŵŵƵŶŝƟĞƐ ǁŝƚŚŝŶ ĚĞǀĞůŽƉĞĚ ŶĂƟŽŶƐ,ĂĞŵŽƉŚŝůƵƐ ŝŶŇƵĞŶnjĂĞ type b and Streptococcus pneumoniae conjugate vaccines are currently available against the leading bacterial causes of pneumonia
Streptococcus pneumoniae and,ĂĞŵŽƉŚŝůƵƐ ŝŶŇƵĞŶnjĂĞ ƚLJƉĞ ď ;,ŝďͿ ĂƌĞ ƚŚĞ ĐĂƵƐĂƟǀĞ pathogens of serious childhood invasive disease, ŝŶĐůƵĚŝŶŐ ŵĞŶŝŶŐŝƟƐďĂĐƚĞƌĂĞŵŝĂ ĂŶĚ ƉŶĞƵŵŽŶŝĂ ŽƚŚ ƉŶĞƵŵŽĐŽĐĐƵƐ ĂŶĚ,ŝď ĐŽůŽŶŝƐĞ ƚŚĞ ŶĂƐŽƉŚĂƌLJŶdžƚŚĞ bacteria being transferred by respiratory droplets
ĐĂƵƐĞĚ ĂďŽƵƚ Θϭϯ ŵŝůůŝŽŶ ƐĞƌŝŽƵƐ ŝůůŶĞƐƐĞƐ Ϯ͘ īĞĐƟǀĞ vaccines are available to combat pneumonia, in poor countries accessibility to vaccines are limited by many ĨĂĐƚŽƌƐŝŶĐůƵĚŝŶŐ Ă ůĂĐŬ ŽĨ ƉŽůŝƟĐĂů ƐƵƉƉŽƌƚ ĞĐŽŶŽŵŝĐ Žƌ humanitarian crises, poor or non-existent health service ŝŶĨƌĂƐƚƌƵĐƚƵƌĞ ĂŶĚͬŽƌ ĞdžŝƐƟŶŐ ǀĂĐĐŝŶĞƐ ďĞŝŶŐ ĞŝƚŚĞƌ ƚŽŽ ĞdžƉĞŶƐŝǀĞ Žƌ ŶŽƚ ŽƉƟŵĂů ĨŽƌ ĚĞǀĞůŽƉŝŶŐ ĐŽƵŶƚƌLJ ƵƐĞ While other unimmunised children live in indigenous ĐŽŵŵƵŶŝƟĞƐ ŝŶ ĐŽƵŶƚƌŝĞƐ ƚŚĂƚ ĐĂŶ ĂīŽƌĚ ƚŽ ƉƌŽǀŝĚĞ ŝŵŵƵŶŝƐĂƟŽŶ ŚŽǁĞǀĞƌ ŚĂǀĞ ŶŽƚ ďĞĞŶ ŐŝǀĞŶ ƉƌŝŽƌŝƚLJ
Summary
The monovalent Hib conjugate vaccine has been available ƐŝŶĐĞ ƚŚĞ ůĂƚĞ ϭεΘϬƐ ĂŶĚ ǁĂƐ ĮƌƐƚ ůŝĐĞŶƐĞĚ ŝŶ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ;h^Ϳ ĨŽƌ ƵƐĞ ŝŶ ŝŶĨĂŶƚƐ ŝŶ ϭεεϬ ,ŝď ĐŽŶũƵŐĂƚĞ vaccines are composed of capsular polysaccharide, polyribosylribitol phosphate (PRP), conjugated to a protein ĐĂƌƌŝĞƌ ƐƵĐŚ ĂƐ ĚŝƉŚƚŚĞƌŝĂ ƚŽdžŝŶ ;͖ WZWͲͿ ŶŽŶͲƚŽdžŝĐ ĐƌŽƐƐͲ ƌĞĂĐƟǀĞ ŵĂƚĞƌŝĂů ŽĨ ĚŝƉŚƚŚĞƌŝĂ ƚŽdžŝŶϭεϳ ;ZDϭεϳ WZWͲ ZDϭεϳͿƚĞƚĂŶƵƐ ƚŽdžŽŝĚ ;dd WZWͲddͿ Žƌ ŵĞŶŝŶŐŽĐŽĐĐĂů ŽƵƚĞƌ ŵĞŵďƌĂŶĞ ƉƌŽƚĞŝŶ ;KDW WZWͲKDWͿdŚĞ ůĂƩĞƌ three Hib conjugate vaccines have consistently shown to be ĞīĞĐƟǀĞ ĂŐĂŝŶƐƚ ŝŶǀĂƐŝǀĞ ĚŝƐĞĂƐĞ ĂŶĚ ĂƌĞ ƵƐĞĚ ǁŽƌůĚǁŝĚĞ WZWͲKDW ĐŽŶĨĞƌƐ Ă ƉƌŽƚĞĐƟǀĞ ĂŶƟďŽĚLJ ƌĞƐƉŽŶƐĞ ĂŌĞƌ ƚŚĞ ĮƌƐƚ ĚŽƐĞƌĞƋƵŝƌĞƐ ŽŶůLJ Ϯ ĚŽƐĞƐ ƚŽ ĐŽŵƉůĞƚĞ ƚŚĞ ƉƌŝŵĂƌLJ ĐŽƵƌƐĞ ς ĂŶĚ ŝƐ ƚŚĞ ǀĂĐĐŝŶĞ ŽĨ ĐŚŽŝĐĞ ŝŶ ƉŽƉƵůĂƟŽŶƐ ǁŝƚŚ a high incidence of early onset disease. ƉƌŽǀŝĚĞ εκй ƉƌŽƚĞĐƟŽŶ ;ερй /͕ ςϳ ƚŽ ϭϬϬйͿ ǁŝƚŚ ŵŽƐƚ Gambian children receiving their second dose too late to ďĞ ƉƌŽƚĞĐƚĞĚ ĚŝƌĞĐƚůLJ WƌĞƐƵŵĂďůLJŝŶĚŝƌĞĐƚ ĞīĞĐƚƐ ŽĨ ƚŚĞ ǀĂĐĐŝŶĞ ŚĂĚ Ă ƐŝŐŶŝĮĐĂŶƚ ŝŵƉĂĐƚ ŽŶ ,ŝď ĚŝƐĞĂƐĞƚŚŽƵŐŚ ƐŝŶĐĞ ƚŚĂƚ ƟŵĞ ƚŚĞƌĞ ŚĂƐ ďĞĞŶ Ă ƌĞͲĂƉƉĞĂƌĂŶĐĞ ŽĨ ,ŝď ƉŶĞƵŵŽŶŝĂ ĂŶĚ ŵĞŶŝŶŐŝƟƐ ϭϮ͘ dŚĞ ĐĂƵƐĞ ŽĨ ƚŚĞ ƌĞͲ emergence is unclear in the absence of formal surveillance. /Ŷ ƚŚĞ h^͕ εϳй ŽĨ ƚŚĞ EĂǀĂũŽ ƉŽƉƵůĂƟŽŶ ;ερй /͕ ϳϮ ƚŽ εεйͿ ƌĞĐĞŝǀŝŶŐ Ăƚ ůĞĂƐƚ ϭ ĚŽƐĞ ŽĨ WZWͲKDW ǁĞƌĞ ƉƌŽƚĞĐƚĞĚ ĂŐĂŝŶƐƚ ŝŶǀĂƐŝǀĞ ,ŝď ĚŝƐĞĂƐĞ ϭϯ͘ dŚŝƐ ŚĞƌĚ ĞīĞĐƚ ŝƐ Ă ƌĞƐƵůƚ ŽĨ ƌĞĚƵĐĞĚ ŶĂƐŽƉŚĂƌLJŶŐĞĂů ĐŽůŽŶŝƐĂƟŽŶ ǁŝƚŚ ƚŚĞ organism in vaccinated infants leading to transmission ĚŝƐƌƵƉƟŽŶ ϭϭϭκ͘
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
