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Pneumococcal vaccine in the prevention of community-acquired pneumonia: a skeptical view of cost-effectiveness.
Semin Respir Infect. 1993 Dec; 8(4):294-9.SR

Abstract

Streptococcus pneumoniae (pneumococcus) is an important pathogen that causes pneumonia, bacteremia, and meningitis in adults. In recent years, pneumococcal isolates resistant to penicillin have become increasingly prevalent in the U.S. For these reasons, wide use of the pneumococcal vaccine has been advocated. Pneumococcal vaccines have been proven to be effective in preventing the invasive complications of S pneumoniae infection. The efficacy of pneumococcal vaccines in preventing non-bacteremic pneumonia in high-risk subjects, however, has not been proven. The current pneumococcal vaccine is limited because it includes the antigens of the serotypes known to be associated with invasive infection, and it elicits a thymus-independent, B-cell response that evokes no memory and a poor immunologic response in many of the patients at greatest risk for pneumococcal infection. In the absence of data concerning efficacy of the pneumococcal vaccine against pneumonia, it is difficult to argue that it is cost-effective for this purpose. I concur with the recommendations for use of pneumococcal vaccine to prevent bacteremia, but I am skeptical about the vaccine's efficacy against pneumonia. More data and an improved vaccine are necessary.

Authors+Show Affiliations

Infectious Disease Section, New York Department of Veterans Affairs Medical Center, NY 10010.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

7938926

Citation

Simberkoff, M S.. "Pneumococcal Vaccine in the Prevention of Community-acquired Pneumonia: a Skeptical View of Cost-effectiveness." Seminars in Respiratory Infections, vol. 8, no. 4, 1993, pp. 294-9.
Simberkoff MS. Pneumococcal vaccine in the prevention of community-acquired pneumonia: a skeptical view of cost-effectiveness. Semin Respir Infect. 1993;8(4):294-9.
Simberkoff, M. S. (1993). Pneumococcal vaccine in the prevention of community-acquired pneumonia: a skeptical view of cost-effectiveness. Seminars in Respiratory Infections, 8(4), 294-9.
Simberkoff MS. Pneumococcal Vaccine in the Prevention of Community-acquired Pneumonia: a Skeptical View of Cost-effectiveness. Semin Respir Infect. 1993;8(4):294-9. PubMed PMID: 7938926.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pneumococcal vaccine in the prevention of community-acquired pneumonia: a skeptical view of cost-effectiveness. A1 - Simberkoff,M S, PY - 1993/12/1/pubmed PY - 1993/12/1/medline PY - 1993/12/1/entrez SP - 294 EP - 9 JF - Seminars in respiratory infections JO - Semin Respir Infect VL - 8 IS - 4 N2 - Streptococcus pneumoniae (pneumococcus) is an important pathogen that causes pneumonia, bacteremia, and meningitis in adults. In recent years, pneumococcal isolates resistant to penicillin have become increasingly prevalent in the U.S. For these reasons, wide use of the pneumococcal vaccine has been advocated. Pneumococcal vaccines have been proven to be effective in preventing the invasive complications of S pneumoniae infection. The efficacy of pneumococcal vaccines in preventing non-bacteremic pneumonia in high-risk subjects, however, has not been proven. The current pneumococcal vaccine is limited because it includes the antigens of the serotypes known to be associated with invasive infection, and it elicits a thymus-independent, B-cell response that evokes no memory and a poor immunologic response in many of the patients at greatest risk for pneumococcal infection. In the absence of data concerning efficacy of the pneumococcal vaccine against pneumonia, it is difficult to argue that it is cost-effective for this purpose. I concur with the recommendations for use of pneumococcal vaccine to prevent bacteremia, but I am skeptical about the vaccine's efficacy against pneumonia. More data and an improved vaccine are necessary. SN - 0882-0546 UR - https://www.unboundmedicine.com/medline/citation/7938926/Pneumococcal_vaccine_in_the_prevention_of_community_acquired_pneumonia:_a_skeptical_view_of_cost_effectiveness_ L2 - https://medlineplus.gov/vaccines.html DB - PRIME DP - Unbound Medicine ER -