The fundamental link between pneumococcal carriage and disease.
Streptococcus pneumoniae (pneumococcus) is a major cause of worldwide mortality and morbidity, and to a large extent is vaccine-preventable. Nasopharyngeal carriage of pneumococcus precedes disease and is the source of pneumococcal spread between people. The use of vaccine effect on carriage as part of the vaccine licensure and post-vaccine introduction evaluation could facilitate and expand the licensure of new, life-saving pneumococcal vaccines and enable a comprehensive estimate of population effects after vaccine introduction. The authors provide a review of the evidence supporting pneumococcal carriage at the individual level as an immediate and necessary precursor to pneumococcal disease. Based on such a causal link between carriage and disease, the authors emphasize the role of information on pneumococcal carriage in vaccine trials and in public health decision-making.
Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland.
Birgit
B
Simell
Kari
K
Auranen
Helena
H
Käyhty
David
D
Goldblatt
Ron
R
Dagan
Katherine L
KL
O'Brien
D000818:Animals; D002353:Carrier State; D054884:Host-Pathogen Interactions; D006801:Humans; D032521:Immunity, Herd; D009305:Nasopharynx / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission; D022242:Pneumococcal Vaccines / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000254:growth & development / Q000276:immunology / Q000472:pathogenicity*
D022242:Pneumococcal Vaccines