Pneumococcal polysaccharide vaccination for adults: new perspectives for Europe

Abstract

Vaccination is the only public-health measure likely to reduce the burden of pneumococcal diseases. In 2010, a group of European experts reviewed evidence on the burden of pneumococcal disease and the immunogenicity, clinical effectiveness and cost–effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23). They also considered issues affecting the future use of PPV23 and pneumococcal conjugate vaccines in the elderly and adults at high risk of pneumococcal disease. PPV23 covers 80–90% of the serotypes responsible for invasive pneumococcal disease in Europe. Primary vaccination and revaccination with PPV23 are well tolerated, induce robust, long-lasting immune responses in elderly adults and are cost effective. Ensuring protection against pneumococcal disease requires monitoring of the changing epidemiology of pneumococcal serotypes causing invasive pneumococcal disease and improving vaccine coverage. In the future, it will be critically important for pneumococcal vaccination recommendations for elderly adults to be based on comparative evaluations of PPV23 and newer pneumococcal conjugate vaccines with regard to their long-term immunogenicity, clinical effectiveness and cost–effectiveness.

Keywords::

• adults
• cost–effectiveness
• effectiveness
• elderly
• immunogenicity
• invasive pneumococcal diseases
• pneumococcal conjugate vaccines
• pneumococcal infections
• pneumococcal polysaccharide vaccines
• pneumonia
• vaccination

Acknowledgements

The authors thank Sanofi Pasteur MSD, Lyon, France, for supporting the meeting that led to this report and for providing unpublished data on PPV23 distribution in European countries.

The authors also thank Florence Baron-Papillon (Sanofi Pasteur MSD) and Suzanne Soum (Sanofi Pasteur MSD) for their assistance in preparing the manuscript. The authors take sole responsibility for its content.

Financial & competing interests disclosure

All authors attended the expert meeting sponsored by Sanofi Pasteur MSD November 2010.

David S Fedson received compensation for attending the initial expert meeting and for writing and reviewing the several drafts of this manuscript. Within the past year, DSF has lectured on pneumococcal vaccination at two scientific meetings and received travel compensation and modest honoraria. DSF has no other competing interests; he is retired and receives no salary or consultation fees for his activities. DSF contributed to data collection, analysis and interpretation, critical review and final validation of the manuscript.

Mark van der Linden has received research funding from Wyeth/Pfizer, GSK, is a member of advisory boards of Wyeth/Pfizer and GSK and is a consultant for Wyeth/Pfizer, GSK and Sanofi Pasteur MSD. MvL contributed to data collection, analysis and interpretation, critical review and final validation of the manuscript.

Agostinho Marques and Peter Klemets contributed to the critical review and final validation of the manuscript.

Luis Salleras has received travel expenses and honoraria for lectures and round-tables from Sanofi Pasteur, GSK, Pfizer, Novartis and Crucell. LS contributed to data analysis and critical review and final validation of the manuscript.

Laurence Nicolas-Spony and Sandrine I Samson are employed by Sanofi Pasteur MSD. LNS and SIS contributed to data collection and critical review of the manuscript.

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.

Funded writing assistance was utilized in the production of this manuscript from Communigen Ltd (Oxford, UK). No other writing assistance was utilized in the production of this manuscript.