Maternal and neonatal pneumococcal vaccination - where are we now?

ABSTRACT

Pneumococcus is a significant pathogen in neonates and in early infancy, particularly as a cause of invasive disease in sub-Saharan Africa where nasopharyngeal carriage rates are also exceptionally high. The pneumococcal-conjugate vaccines have now been rolled out in many high income settings and an increasing number of low and middle income countries. They have been highly effective at preventing vaccine serotype disease in infants. However, a window of susceptibility remains prior to the first vaccination at around six weeks of age. This paper summarizes the data available on both maternal and neonatal vaccination to prevent disease in newborns and early infancy and considers the key challenges and next steps for research in the field.

KEYWORDS:

• Streptococcus pneumoniae
• pneumococcus
• maternal vaccination
• neonatal vaccination
• 23-valent pneumococcal polysaccharide vaccine
• pneumococcal conjugate vaccine
• safety
• immunogenicity
• nasopharyngeal carriage

Declaration of Interests

E Clarke is the principal investigator on a maternal and neonatal pneumococcal conjugate vaccine clinical trial funded by MRC (UK)/Wellcome/DFID and on a clinical trial of a 10-valent pneumococcal vaccine trial manufactured by the Serum Institute of India Pvt Ltd and sponsored and funded by PATH. He received no personal re-imbursement related to either of these trials. He additionally currently receives grant funding from the Meningitis Research Foundation and from The Bill & Melinda Gates Foundation. B Kampmann receives grant support from GSK, Pfizer, The Bill & Melinda Gates Foundation, The Medical Research Council (UK) and the Wellcome Trust for vaccine related studies at the MRC Unit in The Gambia and is funded by the UK NIHR to conduct studies of maternal immunization in the UK. She has also served on advisory boards for maternal immunization strategies for both industry and the Bill & Melinda Gates Foundation. D Goldblatt participates in occasional advisory boards for GSK, Sanofi Pasteur and Merck. His laboratory receives research contract support from GSK, Merck and Sanofi Pasteur. D Goldblatt is a NIHR Senior Investigator whose work is partly supported by the GOSH NIHR Biomedical Research. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.