Invasive pneumococcal disease: the protection of infants through early vaccination

The protection of infants against invasive pneumococcal disease (IPD), including meningitis, pneumonia and bacteremia, responsible for hundreds of deaths and serious sequelae each year in France, necessarily through their early vaccination at the age two months.
According to the immunization schedule developed by the Minister of Health, the vaccination scheme against invasive pneumococcal disease involves the injection of three doses of vaccine at two, three and four months, followed by a booster between twelve and fifteen months, against 24 months previously, said Dr. Antoine Bourrillon, chief of pediatrics at the Robert Debré (Paris, nineteenth district, AP-HP) hospital, during a press briefing.

The vaccine contains the seven serotypes most frequently implicated in invasive pneumococcal disease in infants. One of these serotypes requires three injections, the pediatrician said, citing cases of IPD occurred while only two injections were made.

Besides being the prevention of IPD in infants, the conjugate vaccine decreases the incidence of such infections in over 65 unvaccinated. In the United States, where vaccination of newborns was widespread in 2000, the incidence of IPD in children under two years has dropped by more than 80% and about one-third in 65 years.

This effect is related to the efficacy of the vaccine on the natural port of pneumococci, the infant no longer transmitting bacterial strains grandparents, explained Dr. Joel Gaudelus, head of department of pediatrics at the Jean Verdier Hospital ( Bondy, Seine-Saint-Denis, AP-HP). The action on the bacterial strains carrying however mainly related to the recall, which is why the age of it has been argued in the new recommendations to twelve to fifteen months before against two years ago, he added .

The vaccine is also involved in the decline of antibiotic resistance. Vaccinated children who did not receive antibiotics during the last three months experience and four times less likely to be resistant than those who were not vaccinated but were treated with antibiotics pneumococci, a U.S. study shows.

The objective in terms of coverage is at least 80% of the population in less than two years. 64% of children in this age group received at least one dose of vaccine, said pediatricians.

The adverse effects of pneumococcal vaccine are similar to those of all vaccines, namely redness and mild pain at the injection site, fever, irritability ... It was not found any serious side effects, said Dr. Gaudelus, ensuring no causal link between the vaccine and the risk of sudden infant death syndrome. Only a "temporal correlation" may possibly be observed since the age of vaccination is that to which the risk of sudden infant death syndrome is the largest (between two and four months), he added.

The pneumococcus is the leading cause of bacterial meningitis, the leading cause of pneumococcal pneumonia and the leading cause of bacteremia. One in ten children suffering from pneumococcal meningitis died. Others can keep lifelong consequences, despite antibiotic treatment, including cognitive impairment or deafness. The peak onset of meningitis is between the ages of four and six months, hence the importance of early vaccination, insisted Professor Bourrillon.