1887

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Volume 55, Issue 8

Control of pneumococcal disease in the United Kingdom – the start of a new era Free

Abstract

In 2000, a multi-valent pneumococcal conjugate vaccine, known as Prevnar, was licensed for use in infants and young children in the USA. The subsequent introduction of the vaccine into the childhood immunization schedule in that country led to a significant decrease in pneumococcal disease. The vaccine is effective against invasive and non-invasive pneumococcal infection, can be used in young children as well as adults and, like all conjugate vaccines, provides long-lasting immunity. Moreover, it reduces the incidence of antibiotic resistance because a number of resistant serotypes are targeted by the vaccine. Prevnar, also known as Prevenar, has since been licensed in numerous countries, including the UK. On 8 February 2006, the Departments of Health in England, Scotland and Wales announced the inclusion of Prevenar in the childhood immunization schedule. This announcement has important implications for pneumococcal infection, disease surveillance and immunization policy in the UK.

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2006-08-01
2024-04-25
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References

  1. Ament A., Baltussen R., Duru G. & 11 other authors; 2000; Cost-effectiveness of pneumococcal vaccination of older people: a study in 5 western European countries. Clin Infect Dis 31:444–450 [CrossRef]
     [Google Scholar]
  2. Anonymous 2006; Study Evaluating Pneumococcal Vaccine in Healthy Infants . http://www.clinicaltrials.gov
  3. Artz A. S., Ershler W. B., Longo D. L. 2003; Pneumococcal vaccination and revaccination of older adults. Clin Microbiol Rev 16:308–318 [CrossRef]
     [Google Scholar]
  4. Beall B., McEllistrem M. C., Gertz R. E. Jr & 9 other authors; 2006; Pre- and postvaccination clonal compositions of invasive pneumococcal serotypes for isolates collected in the United States in 1999, 2001, and 2002. J Clin Microbiol 44:999–1017 [CrossRef]
     [Google Scholar]
  5. Black S. B., Shinefield H. R., Hansen J., Elvin L., Laufer D., Malinoski F. 2001; Postlicensure evaluation of the effectiveness of seven valent pneumococcal conjugate vaccine. Pediatr Infect Dis J 20:1105–1107 [CrossRef]
     [Google Scholar]
  6. Black S. B., Shinefield H. R., Ling S. & 8 other authors; 2002; Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia. Pediatr Infect Dis J 21:810–815 [CrossRef]
     [Google Scholar]
  7. Breuer T. 2005; Streptorix – Going Beyond Prevnar . http://www.gsk.com/financial/presentations/vaccines2005/Streptorix.pdf
  8. Brouwer C. N., Maillé A. R., Rovers M. M., Veenhoven R. H., Grobbee D. E., Sanders E. A. M., Schilder A. G. M. 2005; Effect of pneumococcal vaccination on quality of life in children with recurrent acute otitis media: a randomized, controlled trial. Pediatrics 115:273–279 [CrossRef]
     [Google Scholar]
  9. Byington C. L., Spencer L. Y., Johnson T. A. & 8 other authors; 2002; An epidemiological investigation of a sustained high rate of pediatric parapneumonic empyema: risk factors and microbiological associations. Clin Infect Dis 34:434–440 [CrossRef]
     [Google Scholar]
  10. Byington C. L., Samore M. H., Stoddard G. J. & 9 other authors; 2005; Temporal trends of invasive disease due to Streptococcus pneumoniae among children in the intermountain west: emergence of nonvaccine serogroups. Clin Infect Dis 41:21–29 [CrossRef]
     [Google Scholar]
  11. Centers for Disease Control and Prevention; 2000; Preventing pneumococcal disease among infants and young children. Recommendations of the Advisory Committee on Immunization Practices (ACIP. Morb Mortal Wkly Rep 49:1–35
     [Google Scholar]
  12. Centers for Disease Control and Prevention; 2005; Direct and indirect effects of routine vaccination of children with 7-valent pneumococcal conjugate vaccine on incidence of invasive pneumococcal disease - United States, 1998-2003. Morb Mortal Wkly Rep 54:893–897
     [Google Scholar]
  13. Chaves F., Campelo C., Sanz F., Otero J. R. 2003; Meningitis due to mixed infection with penicillin-resistant and penicillin-susceptible strains of Streptococcus pneumoniae . J Clin Microbiol 41:512–513 [CrossRef]
     [Google Scholar]
  14. Clarke S. C., Scott K. J., McChlery S. M. 2004a; Erythromycin resistance in invasive serotype 14 pneumococci is highly related to clonal type. J Med Microbiol 53:1101–1103 [CrossRef]
     [Google Scholar]
  15. Clarke S. C., Scott K. J., McChlery S. M. 2004b; Serotypes and sequence types of pneumococci causing invasive disease in Scotland prior to the introduction of pneumococcal conjugate polysaccharide vaccines. J Clin Microbiol 42:4449–4452 [CrossRef]
     [Google Scholar]
  16. Clarke S. C., Reid J. A., Thom L., Diggle M. A., McChlery S., Scott K., Edwards G. F. 2005; Erythromycin resistance among invasive pneumococci in Scotland, 1994–2003. Br J Biomed Sci 62:28–30
     [Google Scholar]
  17. Clarke S. C., Jefferies J. M., Smith A. J., McMenamin J., Mitchell T. J., Edwards G. F. 2006a; Potential impact of conjugate vaccine on the incidence of invasive pneumococcal disease among children in Scotland. J Clin Microbiol 44:1224–1228 [CrossRef]
     [Google Scholar]
  18. Clarke S. C., Jefferies J. M. C., Smith A. J., McMenamin J., Mitchell T. J., Edwards G. F. S. 2006b; Pneumococci causing invasive disease in children prior to the introduction of pneumococcal conjugate vaccine in Scotland. J Med Microbiol 55:1079–1084 [CrossRef]
     [Google Scholar]
  19. Coffey T. J., Enright M. C., Daniels M., Wilkinson P., Berron S., Fenoll A., Spratt B. G. 1998; Serotype 19A variants of the Spanish serotype 23F multiresistant clone of Streptococcus pneumoniae . Microb Drug Resist 4:51–55 [CrossRef]
     [Google Scholar]
  20. Coffey T. J., Daniels M., Enright M. C., Spratt B. G. 1999; Serotype 14 variants of the Spanish penicillin-resistant serotype 9V clone of Streptococcus pneumoniae arose by large recombinational replacements of the cpsA–pbp1a region. Microbiology 145:2023–2031 [CrossRef]
     [Google Scholar]
  21. Cordeiro S. M., Bajaksouzian S., Windau A., Palavecino E. L., Jacobs M. R. 2005; Clonality of serotypes of amoxicillin resistant isolates of Streptococcus pneumoniae from 1997 to 2003 in Cleveland. In Abstracts of the 105th General Meeting of the American Society for Microbiology 2005 , abstract C-121 Washington, DC: American Society for Microbiology;
     [Google Scholar]
  22. Crook D. W. 2006; Capsular type and the pneumococcal human host-parasite relationship. Clin Infect Dis 42:460–462 [CrossRef]
     [Google Scholar]
  23. Dear K. B. G., Andrews R. R., Holden J., Tatham D. P. 2003; Vaccines for preventing pneumococcal infection in adults. Cochrane Database Syst Rev Issue 4, Art. No.: CD000422. doi: 10.1002/14651858.CD000422
  24. De Graeve D., Beutels P. 2004; Economic aspects of pneumococcal pneumonia: a review of the literature. Pharmacoeconomics 22:719–740 [CrossRef]
     [Google Scholar]
  25. Department of Health 2002 Extending meningitis C vaccine to 20–24 year olds; pneumococcal vaccine for at-risk 2 year olds , PL/CMO/2002/1 London: Department of Health;
     [Google Scholar]
  26. Department of Health 2003 Adult immunisation update. Introduction of a pneumococcal immunisation programme for those aged 80 years and over , PL/CMO/2003/6 London: Department of Health;
     [Google Scholar]
  27. Department of Health 2005 The pneumococcal immunisation programme for older people and risk groups , PL/CMO/2005/1 London: Department of Health;
     [Google Scholar]
  28. Dhooge I., Van Damme D., Vaneechoutte M., Claeys G., Verschraegen G., Van Cauwenberge P. 1999; Role of nasopharyngeal bacterial flora in the evaluation of recurrent middle ear infections in children. Clin Microbiol Infect 5:530–534 [CrossRef]
     [Google Scholar]
  29. Eskola J., Kilpi T., Palmu A. & 9 other authors; 2001; Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 344:403–409 [CrossRef]
     [Google Scholar]
  30. Fireman B., Black S. B., Shinefield H. R., Lee J., Lewis E., Ray P. 2003; Impact of the pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J 22:10–16 [CrossRef]
     [Google Scholar]
  31. George A. C., Melegaro A. 2001; Invasive pneumococcal infection England and Wales 1999. CDR Weekly 11: issue 21
     [Google Scholar]
  32. George R. C., Johnson A. P., Speller D. C., Efstratiou A., Broughton K., Patel B. C. 1997; Serogroups/types and antibiotic resistance of referred isolates of Streptococcus pneumoniae : 1993 to 1995. Commun Dis Rep CDR Rev 7:R159–164
     [Google Scholar]
  33. Gertz R. E. Jr, McEllistrem M. C., Boxrud D. J. & 8 other authors; 2003; Clonal distribution of invasive pneumococcal isolates from children and selected adults in the United States prior to 7-valent conjugate vaccine introduction. J Clin Microbiol 41:4194–4216 [CrossRef]
     [Google Scholar]
  34. Hausdorff W. P., Siber G., Paradiso P. R. 2001; Geographical differences in invasive pneumococcal disease rates and serotype frequency in young children. Lancet 357:950–952 [CrossRef]
     [Google Scholar]
  35. Heath P. T., McVernon J. 2002; The UK Hib vaccine experience. Arch Dis Child 86:396–399 [CrossRef]
     [Google Scholar]
  36. Henrichsen J. 1995; Six newly recognized types of Streptococcus pneumoniae . J Clin Microbiol 33:2759–2762
     [Google Scholar]
  37. Jefferies J. M. C., Smith A., Clarke S. C., Dowson C., Mitchell T. J. 2004; Genetic analysis of diverse disease-causing pneumococci indicates high levels of diversity within serotypes and capsule switching. J Clin Microbiol 42:5681–5688 [CrossRef]
     [Google Scholar]
  38. Joint Committee on Vaccination and Immunisation 2004 Minutes of the meeting held on Friday 1 October 2004 http://www.advisorybodies.doh.gov.uk/jcvi/mins011004.htm
  39. Kyaw M. H., Clarke S., Edwards G. F., Jones I. G., Campbell H. 2000; Serotypes/groups distribution and antimicrobial resistance of invasive pneumococcal isolates: implications for vaccine strategies. Epidemiol Infect 125:561–572 [CrossRef]
     [Google Scholar]
  40. Kyaw M. H., Clarke S., Jones I. G., Campbell H. 2002; Incidence of invasive pneumococcal disease in Scotland, 1988-99. Epidemiol Infect 128:139–147
     [Google Scholar]
  41. Kyaw M. H., Christie P., Clarke S. C., Mooney J. D., Ahmed S., Jones I. G., Campbell H. 2003; Invasive pneumococcal disease in Scotland, 1999-2001: use of record linkage to explore associations between patients and disease in relation to future vaccination policy. Clin Infect Dis 37:1283–1291 [CrossRef]
     [Google Scholar]
  42. Kyaw M. H., Rose C. E. Jr, Fry A. M., Singleton J. A., Moore Z., Zell E. R., Whitney C. G. 2005; The influence of chronic illnesses on the incidence of invasive pneumococcal disease in adults. J Infect Dis 192:377–386 [CrossRef]
     [Google Scholar]
  43. Ledwith M. 2001; Pneumococcal conjugate vaccine. Curr Opin Pediatr 13:70–74 [CrossRef]
     [Google Scholar]
  44. Lexau C. A., Lynfield R., Danila R. & 10 other authors; 2005; Changing epidemiology of invasive pneumococcal disease among older adults in the era of pediatric pneumococcal conjugate vaccine. JAMA (J Am Med Assoc) 294:2043–2051 [CrossRef]
     [Google Scholar]
  45. Lieu T. A., Ray G. T., Black S. B., Butler J. C., Klein J. O., Breiman R. F., Miller M. A., Shinefield H. R. 2000; Projected cost-effectiveness of pneumococcal conjugate vaccination of healthy infants and young children. JAMA (J Am Med Assoc) 283: , 1460–1468 [CrossRef]
     [Google Scholar]
  46. Long S. S. 2005; Capsules, clones, and curious events: pneumococcus under fire from polysaccharide conjugate vaccine. Clin Infect Dis 41:30–34 [CrossRef]
     [Google Scholar]
  47. Maiden M. C., Stuart J. M. 2002; Carriage of serogroup C meningococci 1 year after meningococcal C conjugate polysaccharide vaccination. Lancet 359:1829–1831 [CrossRef]
     [Google Scholar]
  48. Marchisio P., Claut L., Rognoni A. & 8 other authors; 2003; Differences in nasopharyngeal bacterial flora in children with nonsevere recurrent acute otitis media and chronic otitis media with effusion: implications for management. Pediatr Infect Dis J 22:262–268
     [Google Scholar]
  49. McCaig L. F., Besser R. E., Hughes J. M. 2002; Trends in antimicrobial prescribing rates for children and adolescents. JAMA (J Am Med Assoc) 287:3096–3102 [CrossRef]
     [Google Scholar]
  50. McChlery S. M., Scott K. J., Clarke S. C. 2005; Clonal analysis of invasive pneumococcal isolates in Scotland and coverage of serotypes by the licensed conjugate polysaccharide pneumococcal vaccine: possible implications for UK vaccine policy. Eur J Clin Microbiol Infect Dis 24:262–267 [CrossRef]
     [Google Scholar]
  51. McEllistrem M. C., Adams J. M., Shutt K., Sanza L. T., Facklam R. R., Whitney C. G., Jorgensen J. H., Harrison L. H. 2005; Erythromycin-nonsusceptible Streptococcus pneumoniae in children, 1999-2001. Emerg Infect Dis 11:969–972 [CrossRef]
     [Google Scholar]
  52. McIntosh E. D. 2004; Cost-effectiveness studies of pneumococcal conjugate vaccines. Expert Rev Vaccines 3:433–442 [CrossRef]
     [Google Scholar]
  53. Meats E., Brueggemann A. B., Enright M. C., Sleeman K., Griffiths D. T., Crook D. W., Spratt B. G. 2003; Stability of serotypes during nasopharyngeal carriage of Streptococcus pneumoniae . J Clin Microbiol 41:386–392 [CrossRef]
     [Google Scholar]
  54. Melegaro A., Edmunds W. J. 2004a; Cost-effectiveness analysis of pneumococcal conjugate vaccination in England and Wales. Vaccine 22:4203–4214 [CrossRef]
     [Google Scholar]
  55. Melegaro A., Edmunds W. J. 2004b; The 23-valent pneumococcal polysaccharide vaccine. Part I. Efficacy of PPV in the elderly: a comparison of meta-analyses. Eur J Epidemiol 19:353–363
     [Google Scholar]
  56. Miller E., Waight P., Efstratiou A., Brisson M., Johnson A., George R. 2000; Epidemiology of invasive and other pneumococcal disease in children in England and Wales 1996-1998. Acta Paediatr Suppl 89:11–16 [CrossRef]
     [Google Scholar]
  57. Nesin M., Ramirez M., Tomasz A. 1998; Capsular transformation of a multidrug-resistant Streptococcus pneumoniae in vivo. J Infect Dis 177:707–713 [CrossRef]
     [Google Scholar]
  58. O'Brien K. L., Dagan R. 2003; The potential indirect effect of conjugate pneumococcal vaccines. Vaccine 21:1815–1825 [CrossRef]
     [Google Scholar]
  59. Pai R., Gertz R. E., Whitney C. G., Beall B. 2005; Clonal association between Streptococcus pneumoniae serotype 23A, circulating within the United States, and an internationally dispersed clone of serotype 23F. J Clin Microbiol 43:5440–5444 [CrossRef]
     [Google Scholar]
  60. Ray G. T. 2002; Pneumococcal conjugate vaccine: economic issues of the introduction of a new childhood vaccine. Expert Rev Vaccines 1:65–74 [CrossRef]
     [Google Scholar]
  61. Sleeman K., Knox K., George R. & 8 other authors; 2001; Invasive pneumococcal disease in England and Wales: vaccination implications. J Infect Dis 183:239–246 [CrossRef]
     [Google Scholar]
  62. Spratt B. G., Greenwood B. M. 2000; Prevention of pneumococcal disease by vaccination: does serotype replacement matter?. Lancet 356:1210–1211 [CrossRef]
     [Google Scholar]
  63. Stefanelli P., Fazio C., Neri A., Sofia T., Mastrantonio P. 2003; First report of capsule replacement among electrophoretic type 37 Neisseria meningitidis strains in Italy. J Clin Microbiol 41:5783–5786 [CrossRef]
     [Google Scholar]
  64. Stephens D. S., Zughaier S. M., Whitney C. G. & 8 other authors; 2005; Incidence of macrolide resistance in Streptococcus pneumoniae after introduction of the pneumococcal conjugate vaccine: population-based assessment. Lancet 365:855–863 [CrossRef]
     [Google Scholar]
  65. Swartley J. S., Marfin A. A., Edupuganti S., Liu L.-J., Cieslak P., Perkins B., Wenger J. D., Stephens D. S. 1997; Capsule switching of Neisseria meningitidis . Proc Natl Acad Sci U S A 94:271–276 [CrossRef]
     [Google Scholar]
  66. Syrjanen R. K., Kilpi T. M., Kaijalainen T. H., Herva E. E., Takala A. K. 2001; Nasopharyngeal carriage of Streptococcus pneumoniae in Finnish children younger than 2 years old. J Infect Dis 184:451–459 [CrossRef]
     [Google Scholar]
  67. Whitney C. G., Farley M. M., Hadler J. & 10 other authors; 2003; Decline in invasive pneumococcal disease after the introduction of protein–polysaccharide conjugate vaccine. N Engl J Med 348:1737–1746 [CrossRef]
     [Google Scholar]
  68. Zimmerman R. K. 2005; If pneumonia is the “old man's friend”, should it be prevented by vaccination? An ethical analysis. Vaccine 23:3843–3849 [CrossRef]
     [Google Scholar]
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Control of pneumococcal disease in the United Kingdom – the start of a new era
J. Med. Microbiol. 55, 975 (2006); https://doi.org/10.1099/jmm.0.46579-0
/content/journal/jmm/10.1099/jmm.0.46579-0
/content/journal/jmm/10.1099/jmm.0.46579-0
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