title: Paediatric asthma and pneumococcal vaccination.
abstract: Asthma is a clinical condition that has only recently been considered a risk factor for the development of pneumococcal infections. In the most recent guidelines concerning the use of pneumococcal vaccines, the Advisory Committee on Immunisation Practices recommends pneumococcal vaccination only when children with asthma aged <71 months are treated with high-dose corticosteroids, whereas the same Committee clearly indicates that asthma (without any definition of severity or treatment) is a reason for systematic pneumococcal vaccination in adults. It is also unclear which pneumococcal vaccine should be used and how to face the problem of booster doses. The main aim of this paper is to describe what is known about the real risk of pneumococcal infections in children with asthma, and discuss the unsolved problems regarding the paediatric use of pneumococcal vaccines. There are few published data regarding pneumococcal colonisation and the burden of pneumococcal disease in asthmatic children and adolescents, and none at all concerning the relationship between paediatric asthma and immune responses to pneumococcal vaccines. Further studies are therefore essential to assure that children and adolescents with asthma receive the best protection against pneumococcal diseases.
authors.affiliation: Pediatric High Intensity Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: susanna.esposito@unimi.it.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Alessandra
authors.initials: A
authors.lastname: Musio
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D026683:Advisory Committees; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D006801:Humans; D007115:Immunization Schedule; D010372:Pediatrics; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012307:Risk Factors; D014611:Vaccination / Q000379:methods*
chemical_list: D000305:Adrenal Cortex Hormones; D022242:Pneumococcal Vaccines
keywords: Adolescents; Asthma; Children; Pneumococcal conjugate vaccine; Pneumococcal vaccine; Streptococcus pneumoniae