Official statements of the expert meeting on pneumococcal vaccination in adults in Russia

Abstract Background Pneumococcal infections are a major cause of morbidity and mortality in young children and immaturity of the immune system partly underlies poor vaccine responses seen in the young. Emerging evidence suggests a key role for epigenetics in the maturation and regulation of the immune system in health and disease. The study aimed to investigate epigenetic changes in early life and to understand the relationship between the epigenome and antigen-specific antibody responses to pneumococcal vaccination. Methods The epigenetic profiles from 24 healthy children were analyzed at 12 months prior to a booster dose of the 13-valent pneumococcal conjugate vaccine (PCV-13), and at 24 months of age, using the Illumina Methylation 450 K assay and assessed for differences over time and between high and low vaccine responders. Results Our analysis revealed 721 significantly differentially methylated positions between 12 and 24 months (FDR < 0.01), with significant enrichment in pathways involved in the regulation of cell–cell adhesion and T cell activation. Comparing high and low vaccine responders, we identified differentially methylated CpG sites (P value < 0.01) associated with HLA-DPB1 and IL6. Conclusion These data imply that epigenetic changes that occur during early childhood may be associated with antigen-specific antibody responses to pneumococcal vaccines.

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2700. Evaluation of 10- and 13-Valent Protein Conjugate Pneumococcal Vaccine Effectiveness for Children in Korea

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2377 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S949-S950

Author(s):

Sangho Sohn ◽

Kwan Hong ◽

Hari Hwang ◽

Byung Chul Chun

Keyword(s):

Pneumococcal Vaccine ◽

Cox Regression ◽

Acute Otitis Media ◽

Pneumococcal Vaccination ◽

Dose Schedule ◽

Vaccine Effectiveness ◽

Pneumococcal Infections ◽

National Health Insurance System ◽

National Immunization ◽

Control And Prevention

Abstract Background Pneumococcal vaccination for infants was introduced to the mandatory National Immunization Program (NIP) of Korea in May 2014. Both 10- and 13-valent protein conjugated vaccines (PCV) have been in use with 3 + 1 dose schedule. We assessed the vaccine effectiveness in protecting children from all-cause pneumonia (ACP), pneumococcal pneumonia (PP), invasive pneumococcal diseases (IPD), and acute otitis media (AOM). Methods The birth cohort of children born between 2013 and 2015 was identified from the national population registry for retrospective observation. Vaccination status was confirmed through NIP registry by Korean Centers for Disease Control and Prevention, and disease occurrence was detected through the National Health Insurance System. Children who finished at least 3-doses of PCV were classified vaccinated while who did not receive any type of pneumococcal vaccine until study end were classified unvaccinated. The outcome of interest was hospital admission from any of pneumococcal infections among ACP, PP, IPD or AOM. After adjusting for high risk and underlying conditions, the vaccine effectiveness (VE) was calculated with Cox regression. VE of different valent PCV was also compared within fully vaccinated (4-doses) children. Results A total of 1,243,432 children were included. Fifty-one percent of children were boys and median age was 30-months. Ninety-eight percent were vaccinated and 89% of them were fully vaccinated. The incidence (per 100,000 person-years) of ACP was 10,982 in vaccinated and 9,276 in unvaccinated, and that of IPD and AOM were 1.0 vs 1.5 and 45.7 vs 31.3, respectively. The vaccine had protective effect for ACP (VE 20.2% [95% CI 19.5–20.9]), PP (VE 25.5% [95% CI 21.1–29.6]), IPD meningitis (VE 93.6% [95% CI 27.1–99.4]) and AOM (VE 4.6% [95% CI 4.1–5.1]). When fully vaccinated with PCV10, compared with PCV13, it was statistically more protective against ACP (VE 22.7% vs. 19.6%, P = 0.033) and PP (VE 50.8% vs. 21.3%, P < 0.001) but not different against AOM (VE 4.2% vs. 6.0%, P = 0.53). Conclusion Four-doses of PCV strategy for children in current mandatory NIP is effective for protecting the vaccinated from ACP, PP, IPD, and AOM. Disclosures All authors: No reported disclosures.

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Antibody Response to Pneumococcal Polysaccharide Vaccination Predicts Pneumococcal Disease in Splenectomized Patients with Hematological Diseases.

Blood ◽

10.1182/blood.v104.11.1335.1335 ◽

2004 ◽

Vol 104 (11) ◽

pp. 1335-1335

Author(s):

Honar Cherif ◽

Magnus Bjorkholm ◽

Mats Kalin ◽

Helle B. Konradsen ◽

Ola Landgren

Keyword(s):

Antibody Response ◽

Pneumococcal Disease ◽

Pneumococcal Vaccination ◽

Immunological Response ◽

Poor Responders ◽

Pneumococcal Infections ◽

Hematological Diseases ◽

Prophylactic Measures ◽

Increased Risk ◽

Antibody Titers

Abstract Patients with hematological diseases undergoing diagnostic or therapeutic splenectomy are at increased risk of acquiring fulminant pneumococcal infections. Vaccination is a straightforward option in reducing these infections. Certain patient subgroups showing inadequate immunological response to pneumococcal vaccination may be candidates for alternative prophylactic measures. We prospectively studied the antibody response to vaccination with 23-valent pneumococcal capsular polysaccharide vaccine (Pneumovax N) in splenectomized patients with hematological disorders in relation to clinical characteristics and pneumococcal disease. A total of 76 splenectomized patients (Hodgkin s lymphoma 26, indolent lymphoma 10, aggressive lymphoma 8, immune hemolytic anemia 6, immune thrombocytopenic purpura 22, and others 4) with a median age of 52 years (range 18–82) were included. Antibody titers were determined using an enzyme-linked immunosorbent assay before and 12 months after vaccination. A weak immunological response was observed in 27 (35%) patients (poor responders) and an adequate response in 49 (65%) (good responders). During the follow-up period of 5–9 years after vaccination and despite repeated revaccination in many cases, a total of 5 episodes of microbiologically verified pneumococcal infections were reported in poor responders, while only one episode was noted among good responders (p=.01). Underlying malignant hematological diseases were more frequent among poor responders than among good responders (p=.002). The distribution of patients according to age, gender, immunoglobulin levels, time between splenectomy and vaccination (<1 year>), time between preceding chemotherapy/radiotherapy and vaccination (<6 months>) and/or previous radiotherapy did not differ between poor and good responders. In conclusion, a significant number of splenectomized patients with hematological diseases respond poorly to pneumococcal vaccination and have a significantly increased risk of post-splenectomy pneumococcal infections despite vaccination. In the absence of clinical parameters that can reliably predict a poor antibody response, measurement of antibody titers 12 months after vaccination seems to be the most adequate method for identification of patients in this subgroup. Poor responders may be offered other prophylactic measures such as antibiotic prophylaxis and/or immunization with pneumococcal conjugate vaccines. Studies to further elucidate the last alternative are ongoing.

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Cost of pneumococcal infections and cost-effectiveness analysis of pneumococcal vaccination at risk adults and elderly in Turkey

Human Vaccines ◽

10.4161/hv.7.4.14188 ◽

2011 ◽

Vol 7 (4) ◽

pp. 441-450 ◽

Cited By ~ 15

Author(s):

Levent Akin ◽

Mehmet Kaya ◽

Serdar Altinel ◽

Laure Durand

Keyword(s):

At Risk ◽

Cost Effectiveness ◽

Pneumococcal Vaccination ◽

Cost Effectiveness Analysis ◽

Pneumococcal Infections ◽

Effectiveness Analysis

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The Health Professional’s View on the Inclusion of Age in the Recommendations for Pneumococcal Vaccination: Results of a Cross-Sectional Survey in France

Geriatrics ◽

10.3390/geriatrics7010004 ◽

2021 ◽

Vol 7 (1) ◽

pp. 4

Author(s):

Gaëlle Farge ◽

Benoît de Wazières ◽

Jocelyn Raude ◽

Clémence Delavelle ◽

Fabienne Humbert ◽

...

Keyword(s):

Vaccination Coverage ◽

Healthcare Professionals ◽

Vaccination Campaign ◽

Pneumococcal Vaccination ◽

Attitudes And Beliefs ◽

Structured Interviews ◽

Pneumococcal Infections ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Vaccination Recommendations

Elderly people are at high risk for pneumococcal infections. However, older age is not an eligibility factor for pneumococcal vaccination in France. Adults with certain co-morbidities or immunocompromised states are eligible for vaccination, which leaves adults aged ≥65 years without comorbidities at-risk for pneumococcal infections. The objective of the study was to evaluate the acceptability to healthcare professionals (HCPs) of extending pneumococcal vaccination to all individuals ≥65 years. Based on themes identified in semi-structured interviews with 24 HCPs, a representative sample of 500 general practitioners and pharmacists were surveyed about their knowledge, attitudes and beliefs with respect to pneumococcal vaccination for individuals ≥65 years. Current recommendations for pneumococcal vaccination are poorly understood by participants (mean score: 5.8/10). Respondents were generally supportive of inclusion of age in vaccination recommendations (7.5/10), with 58% being very supportive. For 72% of HCPs, this would contribute to improved vaccination coverage. The strategy could be facilitated by associating pneumococcal vaccination with the influenza vaccination campaign (8.3/10). Pharmacists were favourable to participating in pneumococcal vaccination (8.5/10). In conclusion, extension of pneumococcal vaccination to all people aged ≥65 years would be welcomed by HCPs, simplifying identification of patients to be vaccinated and potentially improving vaccination coverage.

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CLINICAL AND EPIDEMIOLOGICAL ASSESSMENT OF THE EFFECTIVENESS OF VACCINATION OF CHILDREN AGAINST PNEUMOCOCCAL INFECTION IN THE AMUR REGION

Journal of microbiology epidemiology immunobiology ◽

10.36233/0372-9311-2016-3-57-63 ◽

2016 ◽

pp. 57-63 ◽

Cited By ~ 1

Author(s):

A. G. Chuchalin ◽

G. G. Onischenko ◽

V. P. Kolosov ◽

O. P. Kurganova ◽

N. L. Tezikov ◽

...

Keyword(s):

Hospital Admissions ◽

Pneumococcal Infection ◽

Acute Otitis Media ◽

Total Duration ◽

Monitoring Program ◽

Pneumococcal Vaccination ◽

Community Acquired Pneumonia ◽

Amur Region ◽

Pneumococcal Infections ◽

High Level

Aim. To study the effectiveness of anti-pneumococcal vaccination of children in the organization of anti-epidemic measures in the areas of the flood in the Amur region. Material and methods. The monitoring program included 4988 children aged 2 to 5 years who have risk factors for pneumococcal infection. Pneumococcal conjugate vaccine Prevenar-13 was used for immunization. Data on the incidence of child with acute respiratory infection, acute otitis media, pneumonia, meningitis during the post-vaccination period were taken into account. To evaluate the effectiveness of vaccination we used indicators and specific criteria (coefficient prophylactic vaccination and infection index). Results. The level of total morbidity of children in post-immunization period decreased by 13.6%; the number of cases of pneumonia in the population of observed children decreased by 2.3 times; the total duration of the illness in children decreased by 14.6%, the number of courses of antibiotic therapy was reduced by 21.3%, the number of hospital admissions of children- 38.4%, the number of days of temporary disability of parents - 11.1%. Direct dependence of the degree of effectiveness of vaccination against pneumococcal disease by the age of children is determined. Conclusion. The findings suggest that implementation of the program of clinical and epidemiological monitoring and prevention of community-acquired pneumonia with use of a vaccine against pneumococcal infections in the territory of the Amur Region has a high level of medical and socio-economic efficiency.

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Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

Cardiology ◽

10.1159/000493572 ◽

2018 ◽

Vol 141 (2) ◽

pp. 98-106 ◽

Cited By ~ 11

Author(s):

Katerina Fountoulaki ◽

Sotirios Tsiodras ◽

Eftychia Polyzogopoulou ◽

Christophoros Olympios ◽

John Parissis

Keyword(s):

Heart Failure ◽

Cardiovascular Events ◽

Respiratory Infections ◽

Pneumococcal Vaccination ◽

Cost Effective ◽

Optimal Dose ◽

Current Evidence ◽

Pneumococcal Infections ◽

Potential Cost ◽

Beneficial Effects

Influenza and pneumococcal infections have been suggested to be potential risk factors for causing adverse cardiovascular events, especially in high-risk patients. Vaccination against respiratory infections in patients with established cardiovascular disease (CVD) could serve as a potential cost-effective intervention to improve their clinical outcomes and cardiac societies have encouraged it. Previous studies have shown that influenza vaccination reduce mortality, acute coronary syndromes and hospitalization in patients with coronary heart disease (CHD) and/or heart failure (HF). However, there is a paucity of randomized prospective clinical trials in the field of the pneumococcal vaccination, and additional higher-quality evidence is needed. Furthermore, questions around the role of vaccination in the primary prevention of CVD, the optimal dose and timing are largely unanswered. The pathophysiologic mechanism in which vaccination provides cardiovascular protection may be related to the modification of the immune-inflammatory model of atherogenesis. The present review summarizes the current evidence and understanding for vaccination against influenza and streptococcus pneumoniae in CHD, HF and stroke and highlights its beneficial effect in the reduction of adverse cardiovascular events.

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A Streptococcus pneumoniae (pneumococcus) -infekciók ezer arca

Orvosi Hetilap ◽

10.1556/650.2015.30293 ◽

2015 ◽

Vol 156 (44) ◽

pp. 1769-1777

Author(s):

Bálint Gergely Szabó ◽

Katalin Szidónia Lénárt ◽

Béla Kádár ◽

Andrea Gombos ◽

Balázs Dezsényi ◽

...

Keyword(s):

Streptococcus Pneumoniae ◽

High Risk ◽

Pneumococcal Vaccination ◽

Invasive Disease ◽

Active Immunization ◽

Clinical Aspects ◽

Pneumococcal Infections ◽

High Risk Patients ◽

Incidence And Mortality ◽

Risk Patients

Incidence and mortality rates of infections caused by Streptococcus pneumoniae (pneumococcus) are high worldwide and in Hungary among paediatric as well as adult populations. Pneumococci account for 35–40% of community acquired adult pneumonias requiring hospitalization, while 25–30% of Streptococcus pneumoniae pneumonias are accompanied by bacteraemia. 5–7% of all infections are fatal but this rate is exponentially higher in high risk patients and elderly people. Mortality could reach 20% among patients with severe invasive pneumococcal infections. Complications may develop despite administration of adequate antibiotics. The authors summarize the epidemiology of pneumococcal infections, pathogenesis of non-invasive and invasive disease and present basic clinical aspects through demonstration of four cases. Early risk stratification, sampling of hemocultures, administration of antibiotics and wider application of active immunization could reduce the mortality of invasive disease. Anti-pneumococcal vaccination is advisable for adults of ≥50 years and high risk patients of ≥18 years who are susceptible to pneumococcal disease. Orv. Hetil., 2015, 156(44), 1769–1777.

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Improving Surveillance of the Impact of Influenza and Its Prevention in Canada

Canadian Journal of Infectious Diseases ◽

10.1155/1993/562460 ◽

1993 ◽

Vol 4 (5) ◽

pp. 257-262

Author(s):

David S Fedson

Keyword(s):

Health Care ◽

Influenza Vaccination ◽

Health Care Systems ◽

Pneumococcal Vaccination ◽

Clinical Effectiveness ◽

Administrative Databases ◽

Administrative Database ◽

Pneumococcal Infections ◽

Care Systems ◽

The Impact

The organization of Canada’s provincial health care systems and the administrative databases that sustain them provide physicians, epidemiologists and public health officials with unique opportunities to improve surveillance of influenza and its prevention. These databases can be used to measure the impact of influenza on excess mortality, hospitalization and costs to the health care system. They can also be used to study the epidemiology of influenza vaccination practices. Studies using the administrative database for the province of Manitoba have established the epidemiological rationale for hospital-based vaccination and have evaluated the clinical effectiveness of influenza vaccination. As pneumococcal vaccination becomes widespread in Canada, provincial databases should also prove useful in assessing the impact of the pneumococcal infections and their prevention with pneumococcal vaccine.

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Antiretroviral Therapy as Prevention of … Pneumococcal Infections?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw228 ◽

2016 ◽

Vol 3 (4) ◽

Cited By ~ 4

Author(s):

Anaïs Lesourd ◽

Jérémie Leporrier ◽

Valérie Delbos ◽

Guillemette Unal ◽

Patricia Honoré ◽

...

Keyword(s):

Risk Factors ◽

Human Immunodeficiency Virus ◽

Antiretroviral Therapy ◽

General Population ◽

Significant Risk ◽

Pneumococcal Vaccination ◽

Vaccination Strategy ◽

Pneumococcal Infections ◽

Hiv Patients ◽

Immunodeficiency Virus

Abstract Background Despite antiretroviral therapy, it is generally believed that the risk for pneumococcal infections (PnIs) is high among patients infected with human immunodeficiency virus (HIV). However, most studies in this field have been conducted before 2010, and the proportion of virologically suppressed patients has drastically increased in these latter years thanks to larger indications and more effective antiretroviral regimens. This study aimed to re-evaluate the current risk of PnI among adult patients infected with HIV. Methods The incidence of PnI was evaluated between 1996 and 2014 in 2 French regional hospitals. The 80 most recent cases of PnI (2000–2014) were retrospectively compared with 160 controls (HIV patients without PnI) to analyze the residual risk factors of PnI. Results Among a mean annual follow-up cohort of 1616 patients, 116 PnIs were observed over 18 years. The risk factors of PnI among patients infected with HIV were an uncontrolled HIV infection or “classic” risk factors of PnI shared by the general population such as addiction, renal or respiratory insufficiency, or hepatitis B or C coinfection. Pneumococcal vaccination coverage was low and poorly targeted, because only 5% of the cases had been previously vaccinated. The incidence of invasive PnIs among HIV patients with a nonvirologically suppressed infection or comorbidities was 12 times higher than that reported in the general population at the country level (107 vs 9/100000 patients), whereas the incidence among virologically suppressed HIV patients without comorbidities was lower (7.6/100000 patients). Conclusions Human immunodeficiency virus infection no longer per se seems to be a significant risk factor for PnI, suggesting a step-down from a systematic to an “at-risk patient” targeted pneumococcal vaccination strategy.

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