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. 2016;12(2):336-43.
doi: 10.1080/21645515.2015.1075678.

Theory and Strategy for Pneumococcal Vaccines in the Elderly

Free PMC article

Theory and Strategy for Pneumococcal Vaccines in the Elderly

Ho Namkoong et al. Hum Vaccin Immunother. .
Free PMC article


Pneumonia is the fourth-leading cause of death globally, and Streptococcus pneumoniae is the most important causative pathogen. Because the incidence of pneumococcal diseases is likely to increase with the aging society, we should determine an optimal strategy for pneumococcal vaccination. While consensus indicates that 23-valent pneumococcal polysaccharide vaccine prevents invasive pneumococcal diseases (IPD), its effects on community-acquired pneumonia (CAP) remain controversial. Recently, a 13-valent pneumococcal conjugate vaccine (PCV13) was released. The latest clinical study (CAPiTA study) showed that PCV13 reduced vaccine-type CAP and IPD. Based on these results, the Advisory Committee on Immunization Practices recommended initial vaccination with PCV13 for the elderly. Scientific evidence regarding immunosenescence is needed to determine a more ideal vaccination strategy for the elderly with impaired innate and adaptive immunity. Continuing research on the cost effectiveness of new vaccine strategies considering constantly changing epidemiology is also warranted.

Keywords: aging; elderly; pneumococcal conjugate vaccine; pneumococcal diseases; pneumococcal polysaccharide vaccine; pneumococcal vaccines; senescence.


Figure 1.
Figure 1.
Schematic spectrum of pneumococcal disease Pneumococcal diseases consist of 2 groups: invasive pneumococcal disease (IPD) and non-IPD. IPD is a pneumococcal disease in which Streptococcus pneumoniae is detected in a sterile space. IPD consists of bacteraemic pneumonia, pleuritis, meningitis, arthritis, and bacteraemia, and non-IPD consists of non-bacteraemic pneumonia, otitis media, sinusitis, and bronchitis. Although bacteraemia occurs in only 10–30% of pneumococcal pneumonia cases, bacteraemic pneumonia is the most common IPD owing to the clinical frequency of pneumococcal pneumonia. In clinical settings, pleuritis usually occurrs with pneumonia.

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