Lagousi Theano, Papadatou Ioanna, Strempas Petros, Chatzikalil Elena, Spoulou Vana
Immunobiology Research Laboratory and Infectious Diseases Department "MAKKA", First Department of Paediatrics, "Aghia Sophia" Children's Hospital, Athens Medical School, 11527 Athens, Greece.
Athens Medical School, University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Vaccines (Basel). 2021 Nov 24;9(12):1390. doi: 10.3390/vaccines9121390.
Despite the significant reduction in pneumococcal disease due to pneumococcal vaccines, protection of vulnerable high-risk individuals, especially pediatric populations, remains a great challenge. In an effort to maximize the protection of high-risk children against pneumococcal disease, a combined schedule that includes both conjugate and polysaccharide vaccines is recommended by several countries in the developed world. On the other hand, middle- and low-income countries do not have in place established policies for pneumococcal immunization of children at risk. Pneumococcal conjugate vaccines, despite their benefits, have several limitations, mainly associated with serotype replacement and the wide range of serotype coverage worldwide. In addition, PPV23-impaired immunogenicity and the hyporesponsiveness effect among populations at risk have been well-documented. Therefore, the added value of continuing to include PPV23 in vaccination schedules for high-risk individuals in the years to come remains to be determined by monitoring whether the replacing/remaining serotypes causing IPD are covered by PPV23 to determine whether its benefits outweigh its limitations. In this review, we aim to describe serotype distribution and vaccine efficacy data on pneumococcal disease in the pre- and post-PCV implementation era among high-risk children in both developed and developing countries, assessing the optimization of current recommendations for their vaccination against pneumococcal disease.
尽管肺炎球菌疫苗使肺炎球菌疾病显著减少，但保护易受感染的高危个体，尤其是儿童群体，仍然是一项巨大挑战。为了最大程度地保护高危儿童免受肺炎球菌疾病侵害，发达国家的几个国家推荐了一种包括结合疫苗和多糖疫苗的联合接种程序。另一方面，中低收入国家尚未制定针对高危儿童肺炎球菌免疫接种的既定政策。肺炎球菌结合疫苗尽管有诸多益处，但也有一些局限性，主要与血清型替换以及全球血清型覆盖范围广泛有关。此外，23价肺炎球菌多糖疫苗（PPV23）免疫原性受损以及高危人群中的低反应性效应已有充分记录。因此，在未来几年继续将PPV23纳入高危个体的疫苗接种计划的附加价值，仍有待通过监测引起侵袭性肺炎球菌疾病（IPD）的替换/留存血清型是否被PPV23覆盖来确定，以判断其益处是否大于局限性。在本综述中，我们旨在描述发达国家和发展中国家高危儿童在肺炎球菌结合疫苗（PCV）实施前后时代肺炎球菌疾病的血清型分布和疫苗效力数据，评估针对其肺炎球菌疾病疫苗接种当前建议的优化情况。
