Otitis, rhinosinusitis, pneumonia. Every year, in addition to the frequent infections that affect the nose, throat and ear, pneumococcus also causes hundreds of serious illnesses, with the bacterium reaching the bloodstream, lungs and nervous system. When this happens, bacteremia, bacterial pneumonia, sepsis and meningitis appear, what experts call invasive pneumococcal infections, the most dangerous.
The fight against pneumococcal infections is still being fought today with antibiotics once the infections have appeared – with the ever-present spectrum of antibiotic resistance – but it is possible to anticipate, by adhering to the anti-pneumococcal vaccination, which today for infants and children is expanding, thanks to the arrival of a new 15-valent conjugate vaccine. A leap forward compared to the vaccines available so far for the little ones, which covered against 13 pneumococcal serotypes.
A group of paediatricians and experts from hygiene during an event dedicated to Rome.
Pneumonia, the super-powered vaccine arrives
A broader spectrum vaccine for the little ones
Lo pneumococcus, they recalled, is a bacterium (Streptoccocus pneumoniae) that exists in the form of about 100 serotypes, some of which are more dangerous than others, precisely because of their ability to give rise to invasive infections. Having a vaccine that covers several serotypes also for the youngest, among the populations most affected by infections together with the elderly, means extending protection.
“The 15-valent vaccine had already been on the market for a few months starting from the age of 18, now it is also indicated for newborns and the evolutionary range – he says Michael ConversanoDirector of the Prevention Department, ASL Taranto and past president of Siti, the Italian Hygiene Society – and this is very important considering how pneumococcal disease affects it, with a U-shaped epidemiological curve: with peaks for very early childhood and the elderly, populations for which pneumococcal vaccines are recommended”.
Pneumococcal pneumonia
The vaccine provides for three doses and, continues Conversano, is offered at the same time as the hexavalent. It is done starting from the third month of life. And the arrival of a broader spectrum formulation for the little ones is particularly important, also considering how S.pneumoniae infections behave: “With pneumococcus we observe the phenomenon of replacement: when we cover with some serotypes others find room for develop. And science and technology find themselves chasing it, gradually trying to vaccinate the population with ever more complete vaccines. For adults, we have already gone from 13 to twenty, with the arrival of a 20-valent conjugate vaccine, now for children we go from 13 to a 15-valent”.
Block the transmission of the pathogen
Looking back, in fact, remember susanna espositoDirector of the Pediatric Clinic of the Pietro Barilla AOU Hospital of Parma and Full Professor of Pediatrics, University of Parma, after the arrival of the 13-valent, and the reduction of infections caused by some of the serotypes of this vaccine, those caused by the serotypes 22F and 33F, the new ones included in the 15-valent vaccine.
“The enlargement with two new serotypes might seem like a small thing – he added Giancarlo Icardi, UOC Director of Hygiene, IRCCS San Martino Polyclinic Hospital of Genoa – DISSAL University of Genoa – but at an epidemic level it could have important implications. In fact, the addition of the two new ones could prevent between 8 and 10% of invasive bacterial diseases”. To which are added, the expert continues, also ear infections and pneumonia, but not only: “This vaccine is able to also block the colonization of the upper respiratory tract, which occurs in the so-called healthy carrier, the person without symptoms. This allows the transmission mechanism of the pathogen to be interrupted, offering, alongside the possibility of individual protection, also that at a social level, reducing its circulation”.
Vaccines, for adults are as useful as those for children
by Simone Valesini
Considering vaccination coverage for children – over 90% – the benefit would be significant. “Once all the regions have concluded with the bureaucratic and administrative obligations, the 15-valent vaccine will be available to everyone”, continues Conversano. Even with the possibility of shifting from one vaccine to another: that is, the new vaccine can also be administered to complete cycles started with 13-valent formulations.
Conjugate and polysaccharide vaccines
The offer of pneumococcal vaccines is vast and includes vaccines reserved for the so-called primary vaccination, such as the 15-valent and 20-valent conjugate, and the polysaccharide. “Pneumococcal conjugate vaccines are recommended above all for the pediatric group and adults over 65 years of age, but they are also recommended for all patients, of any age, who are more sensitive to these diseases due to pathology”, such as asplenics, people with chronic pathologies such as diabetes, heart disease, rheumatological diseases or those being treated with immunosuppressive drugs, Conversano points out: “For those over 65 and for those at risk over 18, sequential vaccination is recommended, with the polysaccharide 23 -valent, after a few months up to a year after the 20-valent to further broaden the protection”.
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