Fedson D S
Pasteur-Mérieux MSD, Lyon, France.
Drugs Aging. 1999;15 Suppl 1:21-30. doi: 10.2165/00002512-199915001-00003.
During the 20 years following its licensure, pneumococcal vaccine has not been widely used. Although the vaccine was shown to be efficacious in South African gold miners, clinical trials of 'pneumonia vaccine' in older adults that have attempted to demonstrate vaccine efficacy in preventing pneumonia have been inconclusive. Retrospective studies have convincingly demonstrated the effectiveness of vaccination in preventing invasive pneumococcal disease, but these findings have only gradually gained acceptance, largely because some observers reject the findings of observational studies or fail to appreciate the importance of invasive disease. In the 1980s, pneumococcal vaccine was used only in the US, but other countries began vaccination in the mid-1990s, in part due to a better understanding of the disease and the vaccine, but also because of concern about antimicrobial resistance. With greater understanding of the global importance of pneumococcal disease and the promise of conjugate and protein vaccines, during the next 20 years pneumococcal vaccines will become the most important vaccines for adults and children worldwide.
在获得许可后的20年里，肺炎球菌疫苗并未得到广泛使用。尽管该疫苗在南非金矿工人中显示出有效，但在老年人中进行的旨在证明“肺炎疫苗”预防肺炎有效性的临床试验结果并不确定。回顾性研究令人信服地证明了接种疫苗在预防侵袭性肺炎球菌疾病方面的有效性，但这些发现只是逐渐得到认可，很大程度上是因为一些观察者拒绝接受观察性研究的结果，或者没有认识到侵袭性疾病的重要性。20世纪80年代，肺炎球菌疫苗仅在美国使用，但其他国家在20世纪90年代中期开始接种疫苗，部分原因是对该疾病和疫苗有了更好的了解，也因为对抗菌素耐药性的担忧。随着对肺炎球菌疾病全球重要性以及结合疫苗和蛋白质疫苗前景的更深入了解，在未来20年里，肺炎球菌疫苗将成为全球成人和儿童最重要的疫苗。
