首页> 外文期刊>Chest: The Journal of Circulation, Respiration and Related Systems >Determining the optimal pneumococcal vaccination strategy for adults: is there a role for the pneumococcal conjugate vaccine?
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Determining the optimal pneumococcal vaccination strategy for adults: is there a role for the pneumococcal conjugate vaccine?

机译:确定成年人的最佳肺炎球菌疫苗接种策略:肺炎球菌结合疫苗是否有作用?

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摘要

On February 24, 2010, the US Food and Drug Administration approved a 13-valent pneumococcal protein conjugate vaccine (PCV13) for use in children. Currently, the only pneumococcal vaccine approved for use in adults in the United States is the 23-valent pneumococcal polysaccharide vaccine (PPV23). Although PPV23 provides partial protection against invasive pneumococcal disease, it does not appear to impact the risk of pneumonia in elderly patients or younger adults with comorbidities. Experience with PCV7 in children and studies of the immunogenicity of PCV7 in high-risk adults suggest that PCV13 may be effective in adults. However, prior receipt of PPV23 may blunt the antibody response to protein conjugate vaccination; thus, receipt of PPV23 could potentially diminish the benefit of subsequent pneumococcal conjugate vaccination. The approval of PCV13 for children has created a unique dilemma for physicians seeking to provide optimum protection for their high-risk adult patients. Potential options could include use of the PCV13 "off-label," perhaps followed by PPV23; withholding pneumococcal vaccination of adults while awaiting approval of PCV13; or continuing to use the PPV23. Although there are limited data on PCVs in adults, the availability of PCV13 for children will likely cause uncertainty for some physicians until there is updated official guidance regarding the optimum strategies for prevention of pneumococcal infection in adults.
机译:2010年2月24日,美国食品药品监督管理局批准了一种13价肺炎球菌蛋白结合疫苗(PCV13)用于儿童。目前,美国唯一批准用于成人的肺炎球菌疫苗是23价肺炎球菌多糖疫苗(PPV23)。尽管PPV23提供了针对浸润性肺炎球菌疾病的部分保护,但它似乎并未影响老年患者或合并症的年轻人的肺炎风险。儿童PCV7的经验以及对高危成年人PCV7免疫原性的研究表明,PCV13在成年人中可能有效。但是,事先收到PPV23可能会使抗体对蛋白质结合物疫苗的反应变钝;因此,接受PPV23可能会减少随后的肺炎球菌结合疫苗接种的益处。儿童PCV13的批准为寻求为其高危成年患者提供最佳保护的医生创造了一个独特的难题。可能的选择可能包括使用PCV13“标签外”,或者使用PPV23;在等待PCV13批准的同时停止成年人的肺炎球菌疫苗接种;或继续使用PPV23。尽管成人PCV的数据有限,但儿童的PCV13的可用性可能会引起一些医生的不确定性,直到有关预防成人肺炎球菌感染的最佳策略的最新官方指南发布为止。

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