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Impact of Conjugate Pneumococcal Vaccines

Pneumococcal capsular polysaccharide has been available for decades but does not induce protective immune responses in infants and toddlers who are at highest risk for disease. In February 2000, a protein-polysaccharide conjugate vaccine (Prevnar; Wyeth Pharmaceuticals, Philadelphia, PA), including serotypes 4, 6B, 9V, 14, 18C, 19F and 23F, was licensed for use in infants and young children and recommended as part of the routine U.S. childhood immunization schedule. The pivotal efficacy trial for licensure of this vaccine, conducted in Northern California, demonstrated efficacy of 97.4% against invasive pneumococcal disease caused by serotypes contained in the vaccine. Other efficacy trials conducted with this vaccine and other pneumococcal conjugate vaccine (PCV) products have shown significant efficacy against a variety of microbiologic and clinical outcomes including invasive pneumococcal disease, nasopharyngeal colonization, otitis media, pneumonia and antimicrobial resistance. Data are now available on the impact of vaccine on colonization and disease with routine use.