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Pneumococcal vaccine in aboriginal children--a randomized controlled trial involving 60 children.

Sixty aboriginal children aged 6 months to 5 years in central Australia participated in a double-blind, randomized controlled trial of a 14-valent pneumococcal vaccine. The study was run in parallel with a similar trial involving 1273 Adelaide caucasian children. The aboriginal children, by comparison, had lower baseline levels of pneumococcal antibodies, a lesser antibody response to vaccination and more commonly carried potentially invasive pneumococci. Whereas the Adelaide children had derived no measurable benefit from use of the vaccine, the available data in the limited aboriginal study suggest that vaccine recipients experienced some reduction in carriage of vaccine type pneumococci and, during an 18-month period of follow up, experienced less respiratory infections than those who had received placebo. Although the numbers were small and randomization problematic, the consistency of the clinical and bacteriological findings and the seriousness of the problem of respiratory infections in aboriginal children, justify further efforts to investigate a possible role for routine pneumococcal immunization in aboriginal children.