University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), Churchill Hospital, Department of Paediatrics, Oxford Vaccine Group , Old Road, Headington, Oxford, OX3 7LE , UK +44 0 1865 857420 ; +44 0 1865 857420 ;
Expert Opin Biol Ther. 2013 Oct;13(10):1451-65. doi: 10.1517/14712598.2013.824419. Epub 2013 Jul 29.
The introduction of pneumococcal conjugate vaccines into infant immunization schedules has successfully reduced the incidence of pneumococcal disease caused by vaccine serotypes. Disease incidence is low in healthy 6 - 17-year-old children and young people; however, there are a number of clinical conditions that put individuals in this age group at increased risk. Expansion of the license of a 13-valent pneumococcal conjugate vaccine , PCV-13, to include the 6 - 17 age group has recently been approved by European and American regulatory bodies.
Studies assessing the safety, immunogenicity, and efficacy of pneumococcal conjugate vaccines in both healthy and high-risk 6 - 17-year-old children and adolescents are covered and the potential impact of PCV-13 in these populations is discussed. The use of the 23-valent pneumococcal polysaccharide vaccine, PPV-23, in high-risk children and adolescents is also considered.
Expanding the use of PCV-13 to include high-risk children and adolescents aged 6 - 17 has the potential to prevent additional cases of disease; however, vaccination of this population may no longer be necessary when herd immunity to PCV-13 serotypes becomes fully established. Despite the broader serotype coverage of PPV-23, the benefits of this vaccine in high-risk populations are uncertain.
肺炎球菌结合疫苗被纳入婴幼儿免疫计划后，疫苗血清型引起的肺炎球菌病发病率已成功降低。在健康的 6-17 岁儿童和年轻人中，疾病发病率较低；然而，有一些临床情况使该年龄段的个体面临更高的风险。最近，包括欧洲和美国监管机构在内的监管机构已批准将 13 价肺炎球菌结合疫苗（PCV-13）的许可证扩大到包括 6-17 岁年龄组。
本文涵盖了评估肺炎球菌结合疫苗在健康和高风险 6-17 岁儿童和青少年中的安全性、免疫原性和疗效的研究，并讨论了 PCV-13 在这些人群中的潜在影响。还考虑了在高风险儿童和青少年中使用 23 价肺炎球菌多糖疫苗（PPV-23）的问题。
将 PCV-13 的使用扩大到包括 6-17 岁的高风险儿童和青少年，有可能预防更多的疾病病例；然而，当 PCV-13 血清型的群体免疫力完全建立时，该人群的疫苗接种可能不再必要。尽管 PPV-23 的血清型覆盖面更广，但该疫苗在高危人群中的益处尚不确定。
