Faculty

Ron Dagan

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Public health impact of pneumococcal conjugate vaccine: Assessment of pneumococcal disease burden and serotype distribution

During the last two decades, several pneumococcal conjugate vaccines (PCVs) have been introduced to most populations in the world and contain from 7 to 13 serotypes. Further development is about to occur with 15- and 20-valent PCVs. The impact of PCVs on the various disease outcomes is diverse, and depends much on vaccine uptake, but also on vaccine serotype content and the effect on nasopharyngeal carriage in the recipient (usually infants and toddlers), accounting for both direct and indirect (herd) protection. We have learned that what seems to be only a small difference in serotype distribution of the PCV content, could result in significant differences in impact on disease, although all PCVs have an important impact on invasive diseases, pneumonia, and otitis media. The serotype replacement phenomenon is a necessary result of PCV widespread administration. All currently used
vaccines show significant replacement, depending on the serotypes absent from the vaccine, and virulence and prevalence of the remaining serotypes. Thus, the new generation vaccines can improve the already dramatic impact, by further reducing disease caused by some of the remaining

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