Timeline Of Human Vaccines
This is a timeline of the development of prophylactic human vaccines. Early vaccines may be listed by the first year of development or testing, but later entries usually show the year the vaccine finished trials and became available on the market. Although vaccines exist for the diseases listed below, only smallpox has been eliminated worldwide. The other vaccine-preventable illnesses continue to cause millions of deaths each year. Currently, polio and measles are the targets of active worldwide eradication campaigns.
How Is The Pneumococcal Vaccine Made
Like the Hib vaccine, the pneumococcal vaccine is made from the sugar coating of the bacteria. Antibodies directed against the pneumococcal polysaccharide protect the child without having to take the risk that their first encounter with natural pneumococcus will result in permanent disabilities or death.
Unfortunately, children less than 2 years old don’t develop very good immune responses to this polysaccharide alone. So the pneumococcal vaccine was made in a manner similar to the Hib vaccine . The pneumococcal polysaccharide is linked to a harmless protein. This version of the vaccine is referred to as the pneumococcal conjugate vaccine. Once linked, young children are able to make an immune response to the polysaccharide. The big difference between the pneumococcal vaccine and the Hib vaccine is the number of different types of polysaccharides that need to be included in the vaccine. Whereas, there is really only one strain of Hib that causes disease in children, there are about 90 different strains of pneumococcus. Fortunately, most of the serious disease in young children is caused by the 13 strains of pneumococcus contained in the vaccine.
The pneumococcal vaccine was found to be highly effective in preventing severe pneumococcal infection in a large trial of children injected with the vaccine. About 40,000 children were included in the initial trial of the vaccine. Since its licensure, the pneumococcal vaccine has been given to millions of children safely.
Adults Age 65 Years Or Older Without Immunocompromising Conditions Cerebrospinal Fluid Leak Or Cochlear Implant
A single dose of PPSV23 is recommended for all adults age 65 years or older, regardless of previous pneumococcal vaccination history. If any PPSV23 dose were given before age 65 years, a single, final dose of PPSV23 should be given at age 65 or at least 5 years after the last PPSV23 dose. If PPSV23 was administered at age 65 years or later, no additional doses are needed.
Adults age 65 years or older without immunocompromising conditions may discuss with their clinician and decide whether to receive PCV13 if a dose was not received before . If a decision is made to receive PCV13, a dose of PCV13 should be given first, followed by a dose of PPSV23 at least one year later.
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Persons With Chronic Diseases
Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional information about vaccination of people with chronic diseases.
Asplenia or hyposplenia
Hyposplenic or asplenic individuals should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine, followed by a booster dose of Pneu-P-23 vaccine. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Chronic kidney disease and patients on dialysis
Individuals with chronic kidney disease should receive age appropriate pneumococcal vaccines. Children less than 18 years of age with chronic kidney failure or nephrotic syndrome, should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine. Adults with chronic kidney failure should receive Pneu-P-23 vaccine. Adults with nephrotic syndrome should receive Pneu-C-13 and Pneu-P-23 vaccine. Due to the decreased immunogenicity and efficacy of Pneu-P-23 vaccine in children and adults with chronic kidney failure, 1 booster dose of Pneu-P-23 vaccine is recommended. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Chronic lung disease, including asthma
Chronic heart disease
Chronic liver disease
Endocrine and metabolic diseases
Non-malignant hematologic disorders
Side Effects Of The Pneumococcal Vaccine
Like most vaccines, the childhood and adult versions of the pneumococcal vaccine can sometimes cause mild side effects.
- redness where the injection was given
- hardness or swelling where the injection was given
There are no serious side effects listed for either the childhood or adult versions of the vaccine, apart from an extremely rare risk of a severe allergic reaction .
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Patients In Health Care Institutions
Residents of long-term care facilities should receive Pneu-P-23 vaccine. Refer to Recommendations for Use for information about pneumococcal vaccination of individuals at increased risk of IPD. Refer to Immunization of Patients in Health Care Institutions in Part 3 for additional information about vaccination of patients in health care institutions.
Medical Conditions Resulting In High Risk Of Ipd
Table 1: Medical Conditions Resulting in High risk of IPD
IPD is more common in the winter and spring in temperate climates.
Spectrum of clinical illness
Although asymptomatic upper respiratory tract colonization is common, infection with S. pneumoniae may result in severe disease. IPD is a severe form of infection that occurs when S. pneumoniae invades normally sterile sites, such as the bloodstream or central nervous system. Bacteremia and meningitis are the most common manifestations of IPD in children 2 years of age and younger. Bacteremic pneumococcal pneumonia is the most common presentation among adults and is a common complication following influenza. The case fatality rate of bacteremic pneumococcal pneumonia is 5% to 7% and is higher among elderly persons. Bacterial spread within the respiratory tract may result in AOM, sinusitis or recurrent bronchitis.
Worldwide, pneumococcal disease is a major cause of morbidity and mortality. The World Health Organization estimates that almost 500,000 deaths among children aged less than 5 years are attributable to pneumococcal disease each year. In Canada, IPD is most common among the very young and adults over 65 years of age.
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Prevention And Control Measures For Pneumococcal Disease
Childhood immunisation against S. pneumoniae is the most effective public health measure for preventing IPD both among vaccine recipients , and among unimmunised populations .
There are two principal types of pneumococcal vaccines currently in use: pneumococcal polysaccharide vaccine and pneumococcal conjugate vaccines :
PPV-23 contains purified capsular polysaccharide from the 23 serotypes that most commonly cause IPD. It is poorly immunogenic in children younger than two years of age and does not reduce pneumococcal carriage. The vaccine induces a T-cell independent response and there is no booster effect from repeated immunisations.
PCV-7 contains capsule polysaccharide conjugated to a protein that stimulates the immune response. PCV 7 is effective for infants, induces immunologic memory and reduces pneumococcal carriage rates.
PCV 7 is the pneumococcal vaccine currently used in most European immunisation programmes.
New pneumococcal conjugate vaccines are being introduced. In 2009 for example, the European Medicines Agency approved 10-valent and 13-valent vaccines that protect against a wider range of the most pathogenic serotypes.
PCV 7 was first licensed in Europe in 2001 and more than half of the European countries reporting to the European surveillance network for vaccine-preventable diseases have since introduced PCV 7 to their routine childhood immunisation programs. Current national immunisation schedules can be accessed here.
Whats The Difference Between Pcv13 And Ppsv23
|helps protect you against 13 different strains of pneumococcal bacteria||helps protect you against 23 different strains of pneumococcal bacteria|
|usually given four separate times to children under two||generally given once to anyone over 64|
|generally given only once to adults older than 64 or adults older than 19 if they have an immune condition||given to anyone over 19 who regularly smokes nicotine products like cigarettes or cigars|
- Both vaccines help prevent pneumococcal complications like bacteremia and meningitis.
- Youll need more than one pneumonia shot during your lifetime. A 2016 study found that, if youre over 64, receiving both the PCV13 shot and the PPSV23 shot provide the best protection against all the strains of bacteria that cause pneumonia.
- Dont get the shots too close together. Youll need to wait about a year in between each shot.
- Check with your doctor to make sure youre not allergic to any of the ingredients used to make these vaccines before getting either shot.
- a vaccine made with diphtheria toxoid
- another version of the shot called PCV7
- any previous injections of a pneumonia shot
- are allergic to any ingredients in the shot
- have had severe allergies to a PPSV23 shot in the past
- are very sick
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Indias First Indigenous Pneumonia Vaccine Developed By Sii Launched
1 min read.Staff Writer
- Pneumosil was found to be safe and effective in preventing Pneumonia disease during the clinical trials
- Harsh Vardhan said that Pneumonia is the single-largest infectious cause of death among children under five years, worldwide
Harsh Vardhan, Union health minister, today launched Pneumosil, India’s first Pneumococcal Conjugate Vaccine , developed by Serum Institute of India in collaboration with the Bill and Melinda Gates Foundation.
Speaking at the event, Harsh Vardhan said vaccines from Serum Institute are used in 170 countries and emphasised that the company has developed this vaccine during the Coronavirus pandemic and also got the government’s approval. He also said this vaccine development falls in line with Aatmanirbhar Bharat, the prime minister’s vision.
Karnataka govt extends holidays for degree, diploma col …
He also acknowledged the efforts made by the Ministry of Health and Family Welfare in this development making India self-reliant in PCV. “Pneumosil has been extensively evaluated in 5 randomized controlled clinical trials and has demonstrated comparable safety and immunogenicity against licensed pneumococcal vaccines across diverse populations of India and Africa,” Harsh Vardhan said.
Pneumococcal Conjugate Vaccines And Community Acquired Pneumonia
The burden of CAP in children
Childhood community acquired pneumonia has significant morbidity and mortality. The burden of CAP in developed countries is 1015 cases/1000 children per year with an annual hospital admission rate of 14/1000 . The incidence is higher in children less than 5years of age 6-40/1000 compared to 716/1000 in children from 515years of age . Most deaths occur in children younger than 4years of age . Influenza, respiratory syncitial virus and parainfluenza 1, 2 and 3 are frequent viruses causing CAP S. pneumoniae is the most common bacterial cause .
Aetiology of childhood CAP
An extended discussion of methodologies used to identify causative agents of CAP is beyond the scope of this article, but it is interesting to look briefly at some studies that have compared blood culture, PCR and serology for estimating the proportion of CAP cases that are attributable to S. pneumoniae. Blood culture has some well-known limitations. It is not routinely carried out in either general practice or hospitals and has a low sensitivity of 10-30% in childhood CAP, which decreases with prior antibiotic use.
In another study, serology indicated a pneumococcal aetiology in 18 of 101 children with CAP , but blood culture was positive in only one of them . In yet another study of 99 children with CAP, a pneumococcal aetiology was established in 46% by serology, in 22% by PCR and 1% by culture .
Impact of PCV7 on CAP
Empyema: complicated CAP
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The Impact Of Pneumococcal Vaccination In Australia
In January 2005, Australia implemented universal vaccination of all young children with the 7-valent conjugate vaccine, and of adults aged 65 years and over with the 23-valent polysaccharide vaccine. Before then, there were publicly-funded pneumococcal vaccination programs for Australians with increased risks of pneumococcal disease3 .
Following universal vaccination, the overall incidence rate of invasive pneumococcal disease decreased by 75% among non-indigenous children under two from 78 per 100 000 in 200204 to 19.5 per 100 000 in 2007. Invasive disease caused by the seven vaccine serotypes declined by 97%, from 60.9 per 100 000 to 2.1 per 100 000.3,9 Rates of hospitalisation due to pneumonia have decreased by 38% in children under two years.10 Substantial reductions in invasive disease were also observed in older children and adults, the age groups who did not receive the vaccine. The decline was mostly due to a decrease in invasive disease caused by the seven vaccine serotypes . 3,4 This suggests a strong benefit of herd immunity, additional to any direct effect arising from the adult 23-valent vaccine program.
Effectiveness Of The Pneumococcal Vaccine
Children respond very well to the pneumococcal vaccine.
The introduction of this vaccine into the NHS childhood vaccination schedule has resulted in a large reduction in pneumococcal disease.
The pneumococcal vaccine given to older children and adults is thought to be around 50 to 70% effective at preventing pneumococcal disease.
Both types of pneumococcal vaccine are inactivated or “killed” vaccines and do not contain any live organisms. They cannot cause the infections they protect against.
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Summary Of Information Contained In This Naci Statement
The following highlights key information for immunization providers. Please refer to the remainder of the Statement for details.
Streptococcus pneumoniae is a bacterium that can cause many types of diseases including invasive pneumococcal disease , and community-acquired pneumonia .
For the prevention of diseases caused by S. pneumoniae in adults, two types of vaccines are available in Canada: pneumococcal 23-valent polysaccharide vaccine containing 23 pneumococcal serotypes and pneumococcal 13-valent conjugate vaccine containing 13 pneumococcal serotypes.
NACI has been tasked with providing a recommendation from a public health perspective on the use of pneumococcal vaccines in adults who are 65 years of age and older, following the implementation of routine childhood pneumococcal vaccine programs in Canada.
Information in this statement is intended for provinces and territories making decisions for publicly funded, routine, immunization programs for adults who are 65 years of age and older without risk factors increasing their risk of IPD. These recommendations supplement the recent NACI recommendations on this topic that were issued for individual-level decision making in 2016.
Pneumococci Pneumococcal Disease And Disease Epidemiology
Streptococcus pneumoniae is a Gram-positive diplococcus that is part of the normal flora of the nasopharynx in humans. Pneumococcal colonization is usually asymptomatic, and transmission more often occurs from persons who are colonized than from those with disease. Infants start acquiring pneumococci in the first weeks to months of life, and duration of carriage with a particular strain can range from weeks to months . In low-income settings, pneumococcal colonization can be detected within the first month of life. People who develop pneumococcal disease generally do so after new acquisition of a new pneumococcal strain .
Incidence of invasive pneumococcal disease in the United States by age group and year, from the Centers for Disease Control and Preventions Active Bacterial Core surveillance. The first-generation pneumococcal conjugate vaccine became part of the routine US infant immunization program in 2000 and was replaced with a second-generation vaccine in 2010.
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Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. Review of pneumococcal vaccination status is particularly important for persons from areas of the world where sickle cell disease is present, as persons with sickle cell disease are at risk of serious pneumococcal infections. In many countries outside of Canada, pneumococcal conjugate vaccine is in limited use. Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada.
What If It Is Not Clear What A Person’s Vaccination History Is
When indicated, vaccines should be administered to patients with unknown vaccination status. All residents of nursing homes and other long-term care facilities should have their vaccination status assessed and documented.
How long must a person wait to receive other vaccinations?
Inactivated influenza vaccine and tetanusvaccines may be given at the same time as or at any time before or after a dose of pneumococcus vaccine. There are no requirements to wait between the doses of these or any other inactivated vaccines.
Vaccination of children recommended
In July 2000, the American Academy of Pediatrics and the CDC jointly recommended childhood pneumococcal immunization, since pneumococcal infections are the most common invasive bacterial infections in children in the United States.
“The pneumococcal conjugate vaccine, PCV13 or Prevnar 13, is currently recommended for all children younger than 5 years of age, all adults 65 years or older, and persons 6 through 64 years of age with certain medical conditions,” according to the 2014 AAP/CDC guidelines. “Pneumovax is a 23-valent pneumococcal polysaccharide vaccine that is currently recommended for use in all adults 65 years of age or older and for persons who are 2 years and older and at high risk for pneumococcal disease . PPSV23 is also recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have asthma.”
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Spectrum Of Clinical Illness
Transient pneumococcal colonization of the upper respiratory tract is common among healthy people colonization is estimated to occur in 20 to 60% of healthy children. Most typically, colonized individuals are asymptomatic carriers and show no observable symptoms.
In a small proportion of carriers, the bacterium invades a normally sterile site, such as the blood or meninges, leading to invasive pneumococcal disease . Symptoms can occur as soon as 1 to 3 days after infection. Pneumonia with secondary bacteremia, bacteremia, and meningitis are the most common forms of IPD.
Bacteremia is the most common manifestation of IPD among children 2 years of age and younger. Bacteremic pneumococcal pneumonia is the most common presentation among adults and is a common complication following influenza. The case fatality rate of bacteremic pneumococcal pneumonia is 5% to 7%, and is higher among elderly persons.