title: Current issues regarding the use of pneumococcal conjugate and polysaccharide vaccines in Australian children.
abstract: OBJECTIVE
  To present the results of child pneumococcal vaccination studies in the setting of current Australian disease epidemiology and immunization policy, and issues that clinicians should consider in discussions with families.
  
  
  METHODS
  This paper includes a narrative review of randomized, controlled, double blind studies and systematic reviews which evaluated the efficacy of child pneumococcal vaccination.
  
  
  RESULTS
  7PCV is expected to prevent > 80% of childhood invasive pneumococcal disease (IPD, includes meningitis, septicaemia/bacteraemia) and the associated mortality. 7PCV may prevent 6% of all pneumonia, 18% of radiographically-defined pneumonia, 6% of all otitis media (OM) and 20%-40% of tympanostomy tube procedures. It may also reduce IPD due to antibiotic-resistant pneumococci, and prevent IPD in unvaccinated individuals. The impact of replacement disease caused by non-vaccine serotypes is not yet known. Pneumococcal polysaccharide vaccines given to 2-year-old children may prevent approximately 19% of all and 26% of recurrent OM.
  
  
  CONCLUSIONS
  The Australian Standard Vaccination Schedule recommends universal infant immunization with seven-valent pneumococcal conjugate vaccine (7PCV). Universal infant 7PCV will prevent pneumococcal diseases and deaths. The potential for its impact to be reduced in the long-term by serotype replacement must be closely monitored. Information concerning disease epidemiology, vaccine efficacy and safety, disease risk perception and national costs may prove useful in discussions with families.
authors.affiliation: Menzies School of Health Research, Tropical and Emerging Infectious Diseases Division, Ear Health and Education Unit, Darwin, Northern Territory, Australia. grantmac@menzies.edu.au
authors.forename: Grant A
authors.initials: GA
authors.lastname: Mackenzie
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Carapetis
authors.forename: Peter S
authors.initials: PS
authors.lastname: Morris
authors.forename: Amanda Jane
authors.initials: AJ
authors.lastname: Leach
mesh_terms: D001315:Australia / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D010033:Otitis Media / Q000453:epidemiology / Q000517:prevention & control; D011008:Pneumococcal Infections / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic
chemical_list: D022242:Pneumococcal Vaccines