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Response to Dawson et al: Letter to the Editor on ‘‘A review of current data to support decision making for introduction of next generation higher valency pneumococcal conjugate vaccination of immunocompetent older adults in the UK’’

We thank Dr Dawson et al. for their comments [1]. The objective of our review was to focus particularly on the substantial published adult pneumococcal data that have been generated within the UK; these will be especially important for informed decision-making in the UK for the new higher valency adult pneumococcal conjugate vaccines that are expected to shortly become available. These local data include considerable data that specifically give valuable insight into the protection the 23-valent pneumococcal polysaccharide vaccine (PPV23) has afforded older UK adults against pneumococcal disease, and our conclusions were based on careful consideration of these [2–5]. The data clearly show that PPV23 provides older UK adults with only limited short-term protection against invasive pneumococcal disease (IPD) [2,3] and has achieved no impact on IPD at the population level [2] with various PPV23 serotypes now comprising an increasing proportion of IPD serotypes amongst older UK adults [2,5]. Local UK data are also unable to provide any compelling evidence to suggest that PPV23 provides older UK adults with meaningful protection against pneumococcal pneumonia [4]. Our conclusions are consistent with those of the UK’s Joint Committee on Vaccination and Immunization (JCVI) [6] and other leading internationally recognized pneumococcal experts from the UK [7,8]. This suggests that an alternative vaccine to PPV23 is needed to better protect older UK adults against pneumococcal disease with higher valency pneumococcal conjugate vaccines offering an attractive option. This reflects the clear body of evidence demonstrating the ability of pneumococcal conjugate vaccines to protect adults against pneumococcal disease [9] and the subsequent wider industry effort to develop new higher valency pneumococcal conjugate vaccines specifically for use in adult populations. Funding