Triptych of the Hermit Saints: pneumococcal polysaccharide vaccines for the elderly

Abstract

Ger T Rijkers,1,2 Laura IE Yousif,1 Simone MC Spoorenberg,3 Frans J van Overveld1 1Department of Science, University College Roosevelt, Middelburg, the Netherlands; 2Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, the Netherlands; 3Department of Internal Medicine, St Antonius Hospital, Nieuwegein, the Netherlands Abstract: Pneumococcal pneumonia is a serious disease with considerable morbidity and mortality in the elderly. Despite adequate antibiotic treatment, the long-term mortality of pneumococcal pneumonia remains high. Preventive measures in the form of vaccination, therefore, are warranted. Twenty-three-valent polysaccharide vaccines have a broad coverage but limited efficacy. Pneumococcal conjugate vaccines have been shown in children to be able to prevent invasive and mucosal pneumococcal diseases. It should be realized that the serotype composition of current pneumococcal conjugate vaccines is not tailored for the elderly, and that replacement disease can occur. Yet, the current 13-valent conjugate vaccine has been shown to protect against infections with vaccine serotypes. Long-term mortality of pneumococcal pneumonia should be included in policy making about the introduction of these vaccines for the elderly. Keywords: pneumonia, Streptococcus pneumoniae, vaccination, elderly, conjugate vaccines, cost-effectiveness

Keywords

• pneumonia
• Streptococcus pneumoniae
• vaccination
• elderly
• conjugate vaccines
• cost-effectiveness