title: Theory and strategy for Pneumococcal vaccines in the elderly.
abstract: Pneumonia is the fourth-leading cause of death globally, and Streptococcus pneumoniae is the most important causative pathogen. Because the incidence of pneumococcal diseases is likely to increase with the aging society, we should determine an optimal strategy for pneumococcal vaccination. While consensus indicates that 23-valent pneumococcal polysaccharide vaccine prevents invasive pneumococcal diseases (IPD), its effects on community-acquired pneumonia (CAP) remain controversial. Recently, a 13-valent pneumococcal conjugate vaccine (PCV13) was released. The latest clinical study (CAPiTA study) showed that PCV13 reduced vaccine-type CAP and IPD. Based on these results, the Advisory Committee on Immunization Practices recommended initial vaccination with PCV13 for the elderly. Scientific evidence regarding immunosenescence is needed to determine a more ideal vaccination strategy for the elderly with impaired innate and adaptive immunity. Continuing research on the cost effectiveness of new vaccine strategies considering constantly changing epidemiology is also warranted.
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Ho
authors.initials: H
authors.lastname: Namkoong
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishii
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Funatsu
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kimizuka
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Yagi
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asami
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Asakura
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Testuro
authors.initials: T
authors.lastname: Kamo
authors.affiliation: b Center for Infectious Diseases and Infection Control; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Sadatomo
authors.initials: S
authors.lastname: Tasaka
authors.affiliation: a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Betsuyaku
authors.affiliation: b Center for Infectious Diseases and Infection Control; Keio University School of Medicine ; Tokyo , Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hasegawa
mesh_terms: D026683:Advisory Committees; D000375:Aging; D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology; D002487:Centers for Disease Control and Prevention, U.S.; D017714:Community-Acquired Infections / Q000382:microbiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D006801:Humans; D000068884:Immunosenescence / Q000276:immunology*; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D013296:Streptococcus pneumoniae / Q000145:classification / Q000276:immunology; D014481:United States; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000276:immunology*
chemical_list: C538862:13-valent pneumococcal vaccine; C414006:23-valent pneumococcal capsular polysaccharide vaccine; D000907:Antibodies, Bacterial; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: aging; elderly; pneumococcal conjugate vaccine; pneumococcal diseases; pneumococcal polysaccharide vaccine; pneumococcal vaccines; senescence