title: Adult pneumococcal vaccination: advances, impact, and unmet needs.
abstract: Preventing pneumonia in the elderly and individuals with comorbidities is an unmet clinical need. Streptococcus pneumoniae is the commonest bacterial cause of pneumonia, and we summarize recent findings regarding current S. pneumoniae vaccines, and debate their efficacy and cost-effectiveness in risk groups. We also discuss potential future vaccine strategies such as protein antigen vaccines.
  
  
  
  Current vaccination with pneumococcal polysaccharide vaccine does not prevent S. pneumoniae pneumonia. Vaccination with pneumococcal conjugated vaccine (PCV) prevents nasopharyngeal colonization, but although PCV13 has recently been shown to prevent S. pneumoniae pneumonia in adults, its overall efficacy was relatively low. The results of cost-effectiveness studies of PCV vaccination in adults are variable with some showing this is a cost-effective strategy, whereas others have not. The lack of cost-effectiveness is predominantly because of the current cost of the PCV vaccine and the existing herd immunity effect from childhood PCV vaccination on vaccine serotypes.
  
  
  
  S. pneumoniae pneumonia is a vaccine-preventable disease but remains a common cause of morbidity and mortality. Advances in vaccination using approaches that induce serotypes-independent immunity and are immunogenic in high-risk groups are required to reduce the burden of disease because of S. pneumoniae.
authors.affiliation: Centre for Inflammation and Tissue Repair, UCL Respiratory, London, UK.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: José
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Brown
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D006801:Humans; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000191:economics / Q000627:therapeutic use*; D013296:Streptococcus pneumoniae / Q000276:immunology; D014611:Vaccination
chemical_list: D022242:Pneumococcal Vaccines