Overseas, an additional weapon against pneumococcal infections may be available next June. In fact, the FDA’s evaluations of the first pneumococcal vaccine specifically developed for the adult population could be completed by the beginning of the summer. The new product, known experimentally as V116 and developed by MSD, covers more than 80% of the pneumococcal serotypes responsible for pneumococcal disease in adults.
Pneumococcal diseases
Pneumococcal (Streptococcus pneumoniae) there are many types. There are hundreds of serotypes known to date, responsible for approximately 14.5 million cases of severe diseases, such as bacteremic pneumonia, meningitis and sepsis, the so-called invasive forms of infections and the most dangerous ones. “But pneumococcal infections are never trivial, not even the most common ones that cause ear infections, sinusitis, bronchitis and pneumonia,” he recalled Francesco Vitalehead of the Oncology and Public Health Department of the AOU Policlinico Palermo, who spoke today in Rome during a conference where the latest results on the effectiveness of the V116 vaccine were presented.
What vaccines prevent pneumonia? December 27, 2023
In Italy it is not very clear how hard pneumococcus affects: every number, even relating to cases of more serious infections, is simply an underestimate, considering that many pneumococcal diseases are treated by general practitioners, and even when they require hospitalization the typing that allows us to trace the etiological agent does not always occur, experts explain. “By analyzing hospital discharge forms in the period from 2000 to 2019, we calculated that the number of pneumonias in these 10 years was 2.5 million: approximately 250 thousand per year”. Of these, Vitale continued, only for a small part was the responsible agent traced, and pneumococcus was the most frequent, representing over 20% of cases. But those 2.5 million could be many more, up to 10 times as much, Vitale explained, considering the undeclared workers treated by general practitioners. And we’re just talking about pneumonia. The latest data from the Higher Institute of Health on pneumococcal invasive bacterial diseases for the first six months of 2023 speak of 930 cases in different age groups: more common in children under five years of age and in the elderly. It is here, in fact, that the bacterium strikes, in these two different populations.
Pneumonia, how many vaccines against pneumococcus are there and for whom are they indicated by Anna Lisa Bonfranceschi 18 December 2023
Pneumococcus in children
In children, pneumococcus mainly strikes under the first year of age, often with ear infections, but also with pneumonia, meningitis and sepsis, he recalled Susanna Esposito, director of the pediatric clinic at Pietro Barilla Hospital in Parma. “Since the 2000s, however, we have had conjugated vaccines available and today the coverage can be considered quite good, even if we still observe some delays in administration, especially in the post-Covid era, and a slight gap with mandatory vaccinations such as the hexavalent one , with the exception of Emilia Romagna. It is necessary to work more to stress the importance of vaccination in the little ones”. Because the benefits are not only the reduction of diseases, but also the advantage gained for herd immunity, the expert recalled: vaccinating children also allows the circulation of the pathogen to be reduced, through the reduction of carriers ( the pneumococcus nests easily at the nasopharyngeal level).
Elderly, so we can increase vaccination coverage by Anna Lisa Bonfranceschi 26 January 2024
These benefits have indeed been observed in both children and adults, the experts recalled. But pneumococcus is a bacterium that ‘chases’ vaccines, as is known: “When pressure is put on some serotypes, including them in the vaccine to provide protection against them, new ones emerge – he recalled Pier Luigi Lopalco, professor of Hygiene at the University of Salento – and so the development of vaccines has tried to follow this phenomenon, always with the idea of increasing the number of serotypes covered: first 7, then 13, then 15, 20 and 23″. However, this approach cannot be the only guiding principle in the development of increasingly effective products. “We cannot just think of adding as many serotypes into a single vaccine, because we would not be able to guarantee the same immunogenicity for everyone and we would create an imbalance – he added Caterina Rizzofull professor of General and Applied Hygiene, Department of Translational Research and new technologies in Medicine and Surgery of the University of Pisa – It is more useful to include the strains prevalent in the target population, based on epidemiological evidence”.
A vaccine designed for adults
Proceeding according to this logic, and taking into account the epidemiological analyzes coming from the Northern hemisphere, the V116 vaccine was developed. A product designed to offer coverage against 21 pneumococcal serotypes, specifically chosen to counter the spread of adult strains, where vaccinations are further behind: “It is a product designed specifically for the ‘ecological’ niche of the elderly – he continues Lopalco – 13 strains are in common with pediatric vaccines, 8 are exclusive to the adult pathology. In this way we try to go beyond the logic of just increasing, also designing something specific for the population of interest. And effective, with a conjugated vaccine.” The data presented at the latest congress dedicated to pneumococcal diseases, last month in Cape Town, South Africa, demonstrate that the strategy is the right one: “The 21 strains of the vaccine do not interfere with each other, the vaccine manages to produce antibodies in quantity not inferior to previous products and it also works in patients with HIV – continues Lopalco – The exclusive strains of this vaccine are estimated to be responsible, alone, for a quarter of pathologies in the elderly”. And overall, based on some epidemiological data, the V116 vaccine could cover 84% of all serotypes present in adults.