Lévy J, Swennen B
Service de Pédiatrie, CHU Saint-Pierre, Bruxelles.
Rev Med Brux. 2004 Sep;25(4):A219-22.
Streptococcus pneumoniae is one of the major causes of severe invasive infections in young children. As purified polysaccharide are not immunogenic in infants, vaccines containing the bacterial polysaccharide conjugated to a carrier protein have been developed according to the model that has proved to be effective for Haemophilus influenzae b and group C meningococcus. A conjugate vaccine containing the 7 serotypes responsible for about 90% of the invasive infections occuring in children in the United States has been shown to have a 97% protective efficacy against infections caused by vaccine serotypes. Pneumococcal conjugate vaccines are also protective, although to a lesser extent, against otitis media caused by vaccine serotypes, but the global impact of these vaccines on the total number of otitis media remains limited. The large scale use of this vaccine has demonstrated its epidemiological impact on the burden of invasive pneumococcal disease in the age group targeted by vaccination as well as among the adult contacts of the vaccines. On the basis of these informations, the conjugate pneumococcal vaccine has been included in the recommended vaccination schedule in Belgium. However, repeated vaccine shortages as well as the high cost of the product make the implementation of this recommendation uncertain.
肺炎链球菌是幼儿严重侵袭性感染的主要病因之一。由于纯化的多糖对婴儿无免疫原性，已根据已证明对b型流感嗜血杆菌和C群脑膜炎球菌有效的模型，开发了含有与载体蛋白结合的细菌多糖的疫苗。一种含有在美国儿童中约90%侵袭性感染所涉及的7种血清型的结合疫苗，已显示出对疫苗血清型引起的感染具有97%的保护效力。肺炎球菌结合疫苗对疫苗血清型引起的中耳炎也有保护作用，尽管程度较小，但这些疫苗对中耳炎总数的全球影响仍然有限。这种疫苗的大规模使用已证明其对疫苗接种目标年龄组以及疫苗接种对象的成人接触者中侵袭性肺炎球菌疾病负担的流行病学影响。基于这些信息，结合肺炎球菌疫苗已被列入比利时推荐的疫苗接种计划。然而，疫苗反复短缺以及产品成本高昂使得该建议的实施具有不确定性。
