Bacterial vaccines and serotype replacement: lessons from Haemophilus influenzae and prospects for Streptococcus pneumoniae

Emerg Infect Dis. May-Jun 1999;5(3):336-45. doi: 10.3201/eid0503.990304.

Abstract

Conjugate vaccines have reduced the incidence of invasive disease caused by Haemophilus influenzae, type b (Hib), in industrialized countries and may be highly effective against Streptococcus pneumoniae. However, the serotype specificity of these vaccines has led to concern that their use may increase carriage of and disease from serotypes not included in the vaccine. Replacement has not occurred with the use of Hib vaccines but has occurred in trials of pneumococcal vaccines. Mathematical models can be used to elucidate these contrasting outcomes, predict the conditions under which serotype replacement is likely, interpret the results of conjugate vaccine trials, design trials that will better detect serotype replacement (if it occurs), and suggest factors to consider in choosing the serotype composition of vaccines.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Bacterial Vaccines*
  • Haemophilus Infections / prevention & control
  • Haemophilus Vaccines / immunology
  • Haemophilus influenzae / classification*
  • Haemophilus influenzae / immunology
  • Humans
  • Models, Biological
  • Pneumococcal Infections / prevention & control
  • Serotyping*
  • Streptococcus pneumoniae / classification*
  • Streptococcus pneumoniae / immunology
  • Vaccines, Conjugate*

Substances

  • Bacterial Vaccines
  • Haemophilus Vaccines
  • Vaccines, Conjugate