title: Interim results of an ecological experiment - Conjugate vaccination against the pneumococcus and serotype replacement.
abstract: Streptococcus pneumoniae has more than 95 serotypes, each of which presumably can cause sepsis, meningitis, pneumonia, and acute otitis media. Pneumococcal conjugate vaccines (PCV) targeted against a limited number of serotypes have nonetheless revealed an impressive impact on each manifestation of pneumococcal disease. At the same time, growing evidence of significant non-vaccine type (NVT) replacement disease following implementation of infant PCV programs has raised questions about the long-term viability of PCV immunization strategies and how to optimize PCV formulations. We discuss here theoretical and practical considerations regarding serotype replacement, and provide a snapshot of the most important NVT types seen to date after implementation of the 2 higher-valent PCVs.
authors.affiliation: a GSK Vaccines ; Wavre , Belgium.
authors.forename: William P
authors.initials: WP
authors.lastname: Hausdorff
authors.affiliation: b Department of Epidemiology ; Center for Communicable Disease Dynamics; Harvard TH Chan School of Public Health ; Boston , MA , USA.
authors.forename: William P
authors.initials: WP
authors.lastname: Hanage
mesh_terms: D002353:Carrier State / Q000382:microbiology; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000276:immunology*; D006801:Humans; D007223:Infant; D009305:Nasopharynx / Q000382:microbiology; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology*; D065288:Serogroup; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000276:immunology*; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000276:immunology*
chemical_list: C538862:13-valent pneumococcal vaccine; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Acute Otitis Media; Invasive Pneumococcal Disease; Meningitis; Pneumococcal conjugate vaccines; Serotype replacement; Streptococcus pneumoniae