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Pneumococcal polysaccharide vaccine

Pneumococcal polysaccharide vaccine
Vaccine description
Target disease 23 serotypes of Streptococcus pneumoniae
Type ?
Clinical data
AHFS/Drugs.com Multum Consumer Information
MedlinePlus a607021
Pregnancy
category
  • US: C (Risk not ruled out)
Routes of
administration
IM
ATC code
Legal status
Legal status
Identifiers
ChemSpider
  • none
 NYesY (what is this?)  

Pneumococcal polysaccharide vaccine (PPSV)—the latest version is known as Pneumovax 23 (PPV-23)—is the first pneumococcal vaccine derived from a capsular polysaccharide, and an important landmark in medical history. The polysaccharide antigens were used to induce type-specific antibodies that enhanced opsonization, phagocytosis, and killing of (pneumococcal) bacteria by phagocytic immune cells. The pneumococcal polysaccharide vaccine is widely used in high-risk adults. As a result, there have been important reductions in the incidence, morbidity, and mortality from invasive pneumococcal disease.

First used in 1945, the tetravalent vaccine was not widely distributed, since its deployment coincided with the discovery of penicillin. In the 1970s, Robert Austrian championed the manufacture and distribution of a 14-valent PPSV. This evolved in 1983 to a 23-valent formulation (PPSV23). A significant breakthrough affecting the burden of pneumococcal disease was the licensing of a protein conjugate heptavalent vaccine (PCV7) beginning in February 2000.

In the United States, PPSV is recommended for adults 65 years of age or older, adults with serious long-term health problems, smokers, children older than two years with serious long-term health problems, giving the protection of 5 years or more. The World Health Organization recommendations are similar. The WHO does not recommend use of PPV in routine childhood immunization programs. Pneumococcal vaccine is beneficial to control exacerbations of chronic obstructive pulmonary disease (COPD) and asthma.

In March 2011, The Joint Committee on Vaccination and Immunisation (JCVI) of the United Kingdom advised to stop using PPSV, for those aged 65 years and older. However, as of 2013, the Green Book, which is the United Kingdom's official government recommendations on immunizations, still carried the recommendation to give PPSV to those aged 65 and over. PPSV should be offered to those in clinical risk groups.

PPSV is important for those with HIV/AIDS. In Canadian HIV patients, the vaccine has been reported to decrease the incidence of invasive pneumococcal disease from 768/100,000 person-years to 244/100,000 patient-years. Current WHO guidelines recommend immunization with PPV-23 for HIV patients in clinical stage 1, while the CDC recommends immunization in those with a CD4 cell count greater than 200/μL.


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