Department of Pulmonology, Kameda Medical Center, Kamogawa, Japan.
Department of Public Health, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2328963. doi: 10.1080/21645515.2024.2328963. Epub 2024 Mar 22.
Pneumonia, predominantly caused by , remains a leading cause of global mortality. The 23-valent Pneumococcal polysaccharide vaccine (PPSV23) and conjugate vaccines (PCVs) are vital measures to fight against it. This paper discussed the changes in pneumococcal vaccination strategies, particularly for older adults, as vaccine effectiveness and epidemiological patterns shift. While PPSV23 maintains effectiveness against invasive pneumococcal disease (IPD), its effectiveness against pneumococcal pneumonia is declining. Conversely, PCV13 consistently demonstrates effectiveness against both IPD and pneumonia. Consequently, the US Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends using PCVs, notably PCV20 and PCV15, over PPSV23. Japanese studies indicate a change in the efficacy/effectiveness of PPSV23 following PCV introduction in children, likely owing to serotype replacement and herd immunity. Additionally, recent data reveals a plateau in the reduction of PCV13 and PPSV23-covered serotypes, posing a challenge to current strategies. This paper indicates a paradigm shift in pneumonia management, acknowledging its chronic nature and potential to exacerbate other diseases. The future of pneumococcal vaccination lies in broader serotype coverage through PCVs, adapting to serotype changes driven by childhood vaccination programs. Furthermore, continuous research and vaccine development are crucial in this evolving field.
肺炎主要由 引起，仍然是导致全球死亡的主要原因。 23 价肺炎球菌多糖疫苗（PPSV23）和结合疫苗（PCV）是对抗它的重要措施。本文讨论了肺炎球菌疫苗接种策略的变化，特别是对于老年人，因为疫苗的有效性和流行病学模式发生了变化。虽然 PPSV23 对侵袭性肺炎球菌病（IPD）仍然有效，但对肺炎球菌性肺炎的有效性正在下降。相反，PCV13 对 IPD 和肺炎均持续有效。因此，美国疾病控制与预防中心免疫实践咨询委员会建议使用 PCV，特别是 PCV20 和 PCV15，而不是 PPSV23。日本的研究表明，在儿童中引入 PCV 后，PPSV23 的疗效/有效性发生了变化，这可能是由于血清型替代和群体免疫所致。此外，最近的数据显示，PCV13 和 PPSV23 覆盖的血清型减少趋于平稳，这对当前的策略构成了挑战。本文标志着肺炎管理模式的转变，认识到其慢性性质及其加剧其他疾病的潜力。肺炎球菌疫苗接种的未来在于通过 PCV 实现更广泛的血清型覆盖，适应由儿童疫苗接种计划驱动的血清型变化。此外，在这个不断发展的领域中，持续的研究和疫苗开发至关重要。
