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Evolving Role of 13-valent Pneumococcal Conjugate Vaccine in Clinical Practice

Azzari, Chiara MD, PhD*; Martinón-Torres, Federico MD, PhD; Schmitt, Heinz-Josef MD, PhD; Dagan, Ron MD§

The Pediatric Infectious Disease Journal: August 2014 - Volume 33 - Issue 8 - p 858–864
doi: 10.1097/INF.0000000000000328
Vaccine Reports

Since the introduction of 7-valent pneumococcal conjugate vaccine (PCV7), PCVs with extended coverage have become available, and there is emerging global evidence that these vaccines, in particular PCV13, have further reduced rates of invasive pneumococcal disease compared with PCV7. The present article aims to address emerging topics related to PCV13 use in routine clinical practice; specifically: (1) the potential role of high-valent PCVs in reducing pneumococcal disease burden; (2) the impact of PCVs on nasopharyngeal carriage and how this may contribute to reductions in otitis media and pneumonia, as well as the prevalence of resistant pneumococcal strains; (3) new PCV13 indications and (4) importance of schedule adherence for PCV in the prevention of cases of vaccine serotype-specific invasive pneumococcal disease. The beneficial effects of PCVs in protecting individuals from a wide spectrum of pneumococcal diseases can be increased by improving the vaccine coverage and adhering to the recommended vaccination schedules. There is increasing evidence that PCV13 has reduced much of the post-PCV7 burden of pneumococcal diseases in the pediatric community, including reducing pneumococcal colonization and the incidence of invasive pneumococcal disease and mucosal diseases. This has also led to a reduction in antibiotic-resistant pneumococcal diseases. The role of PCV13 in clinical practice is evolving, with PCV13 now available for children and adolescents between the ages of 6 weeks and 17 years, thus ensuring that children in all age groups can be protected against vaccine-serotype pneumococcal diseases. Continued surveillance is warranted to monitor the impact of PCV13 on disease burden.

From the *Department of Paediatrics, University of Florence, Meyer Children’s University-Hospital, Viale Pieraccini 24, Firenze, Italy; Pediatric Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain, and Vaccine Research Unit, Healthcare Research Institute of Santiago, Spain; Medical Department Group and Scientific Affairs, Pfizer Vaccines, Paris, France; and §Pediatric Infectious Disease Unit, Soroka University Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Accepted for publication February 25, 2014.

This article is based on a symposium at the 31st Annual Meeting of the European Society for Paediatric Infectious Diseases, Milan Italy, May 28 to June 1, 2013, which was sponsored by Pfizer.

C.A. has received research grants and/or honoraria as a consultant/advisor and/or speaker, and conducted vaccine trials from GlaxoSmithKline, Sanofi Pasteur MSD, Pfizer Inc/Wyeth and Novartis. F.M.T. has received research grants and/or honoraria as a consultant/advisor and/or speaker and conducted vaccine trials from GlaxoSmithKline, Sanofi Pasteur MSD, Pfizer Inc/Wyeth, Novartis, Merck and MedImmune. During the production of this manuscript, F.M.T. received funding from the European Union’s seventh Framework program under EC-GA nº.279185 (EUCLIDS), from Instituto Carlos III (Intensificación de la actividad investigadora) and Fondo de Investigación Sanitaria (FIS; PI070069/PI1000540) del plan nacional deI+D+I and “fondos FEDER”. H.J.S. is an employee of Pfizer. R.D. has received grants/research support from Pfizer, Berna/Crucell and MSD; he has been a scientific consultant for Pfizer, Berna/Crucell, GlaxoSmithKline, Novartis, MSD and a speaker for Pfizer, Berna/Crucell and GlaxoSmithKline.

The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Ron Dagan, MD, Pediatric Infectious Disease Unit, Soroka University Medical Center, PO Box 151, Beer-Sheva 84101, Israel. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.