It worked pretty well for South African miners who were vulnerable to the bug. But then nothing was done with this discovery until the 's, when a vaccine against pneumococcal pneumonia was developed at the Rockefeller University in NYC. Several years later an even more effective version was developed and now anyone over 65 is recommended for the vaccineMany parents know only too well preschoolers get excruciatingly painful middle ear infections.
Often they're caused by this same dangerous microbe. So for over a decade scientists worked to develop a third generation of pneumococcal vaccine, this time with an eye to protecting the very young and the very old.
But it wasn't easy. The quest was complicated and involved several large-scale clinical trials of the vaccine. Then in the year a successful vaccine, Prevnar was developed. PCV7 is a conjugate vaccine see our article, Different Types of Vaccines , for more on how these vaccines are made ; it was expanded to include protection against 13 strains in , and renamed PCV13 brand name Prevnar 13, manufactured by Pfizer. PCV13 protects against the bacterial strains responsible for the most severe childhood pneumococcal infections.
PCV7 was added to the recommended childhood vaccination schedule in PCV13 replaced it on the schedule in Pneumococcal vaccination via PCV13 is included on the U.
Additional protection via the polysaccharide vaccine PPSV23 is recommended for children with certain underlying medical conditions. The PPSV23 vaccine is also recommended for adults with certain risk factors for pneumococcal disease up to age 65, including asthma and cigarette smoking. In , the Advisory Committee on Immunization Practices recommended that adults age 65 and older also receive pneumococcal conjugate vaccine PCV. Therefore, at age 65, adults who have never received pneumococcal vaccine should receive a single dose of PCV13 followed months later by a dose of PPSV Centers for Disease Control and Prevention.
Pneumococcal Disease. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson, W. Pneumococcal vaccination: What everyone should know. Morbidity and Mortality Weekly Report. Muller, M. Pediatric bacterial meningitis.
Merck licensed a polysaccharide vaccine protecting against 14 types of pneumococcal bacteria in In , Merck expanded on this work by producing a vaccine against 23 types of pneumococcal bacteria.
One challenge in producing a pneumococcal vaccine involved determining which of the more than 90 types of pneumococcal bacteria produced the most disease. Once that work was complete, Robert Austrian, MD, at the University of Pennsylvania isolated the types most appropriate for the vaccine and provided this information to Hilleman at Merck. Merck researchers then developed the vaccine from the polysaccharide outer coatings of the bacteria.
True or false? Many people have Streptococcus pneumoniae in their noses and throats without becoming ill. Article Menu [ ]. Vaccine Science [ ]. Biological Weapons, Bioterrorism, and Vaccines. Cancer Vaccines and Immunotherapy. Careers in Vaccine Research.
S and 1, of those cases occurred in children under 5. WHO estimates S. As with pneumococcal disease in the U. IMPORTANT NOTE: NVIC encourages you to become fully informed about Pneumococcal and the Pneumococcal vaccine by reading all sections in the Table of Contents , which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child.
This information is for educational purposes only and is not intended as medical advice. A brief history of the pneumococcus in biomedical research: a panoply of scientific discovery. Clin Infect Dis. A century of pneumococcal vaccination research in humans.
Clin Microbiol Infect. Leading Causes of Death, Accessed online Oct. Pneumonia History. News Medical Lifesciences Oct 11, Thorax ; 53 3 Geographical differences in invasive pneumococcal disease rates and serotype frequency in young children. March 24, : Clin Microbiol Rev. PloS Genetics May 1, Pneumococcal infections are more common during the winter and in early spring when respiratory diseases are more prevalent.
The period of communicability for pneumococcal disease is unknown, but presumably transmission can occur as long as the organism appears in respiratory secretions.
Estimates of the incidence of pneumococcal disease have been made from a variety of population-based studies. More than 31, cases and more than 3, deaths from invasive pneumococcal disease bacteremia and meningitis are estimated to have occurred in the United States in More than half of these cases occurred in adults who had an indication for pneumococcal polysaccharide vaccine. Before routine use of pneumococcal conjugate vaccine in , the burden of pneumococcal disease among children younger than age 5 years was significant.
An estimated 17, cases of invasive disease occurred each year, of which 13, were bacteremia without a known site of infection and about were meningitis. An estimated children died every year as a result of invasive pneumococcal disease.
Although not considered invasive disease, an estimated 5 million cases of acute otitis media occurred each year among children younger than 5 years of age. The widespread use of pneumococcal conjugate vaccines in children has resulted in a decrease in transmission of vaccine-type strains, thereby preventing pneumococcal disease among unvaccinated children and adults.
ABCs data suggest that the use of pneumococcal conjugate vaccine has had a major impact on the incidence of invasive disease among young children.
The decreases were offset partially by increases in invasive disease caused by serotypes not included in PCV7, in particular 19A. Declines have been sustained and have not been offset by increases in non-vaccine type disease. Among children born during —, In , Vaccination coverage levels in were In addition, persons who frequently visit physicians and who have chronic conditions are more likely to be at increased risk of pneumococcal infection than those who require infrequent visits.
Screening and subsequent immunization of hospitalized persons found to be at increased risk could have a significant impact on reducing complications and death associated with pneumococcal disease. The first pneumococcal polysaccharide vaccine was licensed for use in the United States in It contained purified capsular polysaccharide antigen from 14 different types of pneumococci. In , a valent polysaccharide vaccine PPSV23, Pneumovax 23 was licensed and replaced the valent vaccine, which is no longer produced.
It included purified capsular polysaccharide of seven serotypes of S. It contains the same 7 serotypes of S. PPSV23 is composed of purified preparations of pneumococcal capsular polysaccharide from 23 types of pneumococci.
PPSV23 is administered by either intramuscular or subcutaneous injection. Each dose of PPSV23 contains phenol as a preservative. It contains no adjuvant or antibiotic. PCV13 contains 13 serotypes of S.
PCV13 is administered by intramuscular injection. Each dose of PCV13 contains aluminum phosphate as an adjuvant. It contains no antibiotic or preservative. PPSV23 is not recommended for children younger than age 2 years.
Children should routinely receive a 3-dose primary series of PCV13 at age 2, 4, and 6 months, and dose 4 booster at age 12 through 15 months. Dose 1 can be administered as early as 6 weeks.
For doses given before the 1 st birthday, the minimum interval between doses is 4 weeks; doses given at age 12 months or older should be separated by at least 8 weeks. PCV13 can be administered at the same time as other routine immunizations. Unvaccinated children age 7 months or older do not require a full series of four doses. If the vaccination series is initiated at age 7 through 11 months, and the next dose is administered after the 1 st birthday, another dose should be administered 8 weeks later.
Healthy children age 24 through 59 months should receive 1 dose of PCV13 if child is unvaccinated or received any incomplete schedule. Routine use of PCV13 is not recommended for healthy children age 5 years or older. Children with any incomplete schedule of 3 doses should receive 1 dose of PCV13 at least 8 weeks after the most recent dose. Some children and adolescents in this age group with certain conditions should only receive one dose of PPSV23, if they have not already.
A second dose of PPSV23 is recommended 5 years after the first PPSV23 dose for adults with anatomic or functional asplenia, or other immunocompromising conditions. A single dose of PPSV23 is recommended for all adults age 65 years or older, regardless of previous pneumococcal vaccination history.
If PPSV23 was administered at age 65 years or later, no additional doses are needed. Find additional information on the timing of pneumococcal vaccination for adults and children. The minimum interval between PCV13 and PPSV23 is 8 weeks for adults with immunocompromising conditions and 1 year for immunocompetent adults. However, in adults, if they are administered simultaneously or at an interval less than 8 weeks, neither dose needs to be repeated.
In children, if they are administered simultaneously, PCV13 should be repeated at least 8 weeks later. The target groups for pneumococcal vaccines and influenza vaccines overlap.
Either pneumococcal vaccine may be given at the same time as influenza vaccine, if indicated, but at different anatomical sites. Most healthy adults age 65 years or older need only a single lifetime dose of PPSV23 and may be administered PCV13 on or after the 65 th birthday based on shared clinical decision making.
While for most other vaccines health care providers should only accept written, dated records as evidence of vaccination, self-reported doses of adult PPSV23 but not PCV13 are acceptable. Persons with uncertain or unknown vaccination status should be vaccinated.
When elective splenectomy, immunocompromising therapy, or cochlear implant placement is being planned, providers should choose the vaccines appropriate to the level of risk for invasive pneumococcal disease which would exist after the surgery or treatment.
For example, a person who will undergo splenectomy should be considered asplenic when applying these vaccine recommendations. The choice of vaccine also depends on past history of pneumococcal vaccination.
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