Pneumococcal polysaccharides

Indications for Use. Pneumococcal polysaccharide vaccine maybe used for immuni2ation of persons two years of age or older who are at increased risk of pneumococcal disease. 

Pneumococcal vaccine. The heptavalent pneumococcal conjugate vaccine (PCV) is recommended for all children age 2-23 months. It is also recommended for certain children age 24-59 months. Pneumococcal polysaccharide vaccine (PPV) is recommended in addition to PCV for certain high-risk groups. See MMWR. 2000 49(RR-9) 1-35. 

Some antigens, such as type 3 pneumococcal polysaccharide, EPS and other polymeric substances such as dextrans (poly-D-glucose) and levan (poly-D-fructose) can induce antibody synthesis without the assistance of TH cells. These are known as T-independent (Ti) antigens. Only one class of immunoglobulin (IgM) is synthesized and there is a weak memory response. 

Type B vaccine, the Neisseria meningitidis Type A and C vaccine, the 23-valent pneumococcal polysaccharide vaccine and an acellular typhoid vaccine. 

Serious illness and death in COPD patients can be reduced by about 50% with annual influenza vaccination. The optimal time for vaccination is usually from early October through mid-November. All patients with COPD should also receive a one-time vaccination with the pneumococcal polysaccharide vaccine, even though sufficient data supporting its use in COPD patients are lacking.1,2 Patients over 65 years of age should be revacdnated if it has been more than 5 years since initial vaccination and they were less than 65 years of age at the time. 

PCV 7, 7-valent pneumococcal conjugated vaccine PPV 23, 23-valent pneumococcal polysaccharide vaccine. From Advisory Committee on Immunization Practices,18 Committee on Infectious Diseases,16 and Sickle Cell Disease Care Consortium.27... 

Pneumococcal polysaccharide PPV23 0.5 mL Intramuscular route preferred subcutaneous Children less than 2 years of age... 

The 23-valent pneumococcal polysaccharide vaccine contains 23 serotypes that are responsible for causing more than 80% of invasive S. pneumoniae infections in adults. The vaccine includes those serotypes that are associated with drug resistance. Use of the vaccine will not prevent the development of antibiotic-resistant S. pneumoniae, but is likely to prevent infection from drug-resistant strains. The 23-valent pneumococcal polysaccharide vaccine has demonstrated good immunogenicity in adults, but an individual will not develop immunity to all 23 serotypes following vaccination.10... 

The 23-valent pneumococcal polysaccharide vaccine is recommended for use in all adults 65 years of age or older and adults less than 65 years who have medical comorbidities that increase the risk for serious complications from S. pneumoniae infection, such as chronic pulmonary disorders, cardiovascular disease, diabetes mellitus, chronic liver disease, chronic renal failure, functional or anatomic asplenia, and immunosuppressive disorders. Alaskan natives and certain Native American populations are also at increased risk. Children over the age of 2 years may be vaccinated with the 23-valent pneumococcal polysaccharide vaccine if they are at increased risk for invasive S. pneumoniae infections, such as children with sickle cell anemia or those receiving cochlear implants. 

Revaccination with the 23-valent pneumococcal polysaccharide vaccine is recommended for adults over the age of 65 years if the first dose was administered when they were less than 65 years... 

Adults with HIV infection should be vaccinated with the 23-valent pneumococcal polysaccharide and hepatitis B vaccines as early in the course of the disease as possible. Inactivated influenza vaccine should be given yearly. Children should continue to receive vaccinations on the standard childhood immunization schedule. The individual may experience a transient elevation in HIV viral load following vaccination.17... 

The pneumococcal polysaccharides were treated in a previous Volume of this Series.1 The immunological properties of these polysaccharides have been well studied,2 thanks to extensive work by Heid-... 

The purification of a pneumococcal polysaccharide may be difficult, and the polysaccharide material is sometimes contaminated by a cell-wall component known as the C-substance. The methods for structural analysis of polysaccharides (which, like several of the pneumococcal polysaccharides, contain amino sugar and uronic acid... 

Pneumococcal vaccine. (Minimum age 6 weeks for pneumococcal conjugate vaccine [PCV 2 yeas for pneumococcal polysaccharide vaccine [PW])... 

Because children younger than 2 years of age do not respond adequately to the pneumococcal polysaccharide vaccine, a heptavalent pneumococcal conjugate vaccine was created that can be administered at 2, 4, and 6 months of age and between 12 and 15 months of age. 

NMR can also be used to elucidate the structural features of a repeating unit in a polysaccharide and to investigate the conformation and dynamics of polysaccharides.21 A unique polysaccharide structure results in a characteristic proton NMR spectrum. Therefore, NMR is a powerful tool for identifying polysaccharide structures. This remarkable specificity has led to the development of a routine NMR-based identity assay, recently reported by Abeygunawardana et al. for quality control testing of bacterial polysaccharide to be used in formulating a polyvalent pneumococcal polysaccharide vaccine.22... 

Prevenar is the pneumococcal polysaccharide-conjugate vaccine and contains polysaccharide, from seven capsular types of pneumococci, which is conjugated to diphtheria toxin (protein). Prevenar is recommended for individuals at increased risk of pneumococcal infection including those over 65 years, patients with chronic heart, renal, respiratory or liver disease, diabetics and immune deficiency. It is a component of the primary course of childhood immunisation. 

Preliminary hydrolysis with acetic acid may be helpful in avoiding N-deacetylation,53 and certain pneumococcal polysaccharides may be hydrolyzed with formic acid.54... 

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