Pneumonia polysaccharide vaccines

Hilleman MR, Carlson AJ, McLean AA, Vella PP, Weibel RE, Woodhour AF. Streptococcus pneumoniae polysaccharide vaccine age and dose responses, safety, persistence of antibody, revaccination, and simultaneous administration of pneumococcal and influenza vaccines. Rev Infect Dis 1981 3(suppl) S31-S42. 

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. 

Pneumococcal vaccine, polyvalent [FDA former] Streptococcus pneumonia capsular polysaccharide vaccine [SY]... 

S. pneumoniae has more than 80 sero-types. The current polysaccharide vaccine consists of 23 serotypes and covers about 87% of all pneumococcal diseases in the United States. Current vaccine development is based on conjugate technology and concentrates on die most prevalent 7-9 serotypes. Three multivalent vaccine candidates are in clinical trials. All are based on conjugating the polysaccharide to a T-dependent protein carrier. The results of phase 1 and 11 trials in infants have demonstrated the safety and immnnogenicity of these vaccines. Phase. Ill trials to demonstrate efficacy are in progress and final approval of this vaccine for infant immunization will be by the year 2000. 

Wang, Q., Wang, M., Kong, F., Gilbert, G.L., Cao, B., Wang, L., Feng, L. Development of a DNA microarray to identify the Streptococcus pneumoniae serotypes contained in the 23-valent pneumococcal polysaccharide vaccine and closely related serotypes. J Microbiol Methods 68 (2007) 128-136. 

While most polysaccharide antigens act in a T-cell independent fashion, zwitterionic polysaccharides have been shown to induce T-cell mediated immunity [358]. Several bacteria produce zwitterionic CPS, which contain both free amine and free carboxyl groups in the repeating unit. These include CPS types 5 and 8 of Staphylococcus aureus, PSA from B. frag-ilis and the type 1 S. pneumoniae polysaccharide (O Fig. 28). Vaccination with zwitterionic polysaccharides have been shown to produce T-cell mediated immunity in mice [359], and vaccines based on zwitterionic CPS may be useful for combating several common bacterial pathogens. 

Polysaccharide vaccine Conjugate vaccine Meningitis Pneumonia Haemophilus influenzae typeb... 

Pneumococcal polysaccharide vaccine (Pneumovax 23 and Pnu-Immune 23) is a mixture of highly purified capsular polysaccharides from 23 of the most prevalent or invasive types of S. pneumoniae seen in the Umted States. Serotypes included are 1,2, 3, 4, 5, 6B, 7F, 8, 9N, 9V lOA, 12F, 14, 15B, 17F, 18C, 19A, 20, 22F, 23F, and 33F. These 23 types represent 85% to 90% of all blood isolates and 85% of pneumococcal isolates from other generally sterile sites seen in the United States. The vaccine is administered intramuscularly or subcutaneously as a single 0.5-mL dose. Each 0.5-mL dose of vaccine contains 25 meg of each polysaccharide type dissolved in isotonic saline solution (for a total of 575 meg polysaccharide) and 0.25% phenol as preservative. Significant cross-reactivity with other pneumococcal capsular antigens not represented in the vaccine does not... 

Because of the lack of immune responsiveness in children younger than 2 years of age when exposed to polysaccharide vaccines, manufacturers have been developing conjugate vaccines to offer children protection from certain strains of S. pneumoniae. Formation of serotype conjugates to ensure stability and immunogenicity of each strain is complex and difficult. Thus work has progressed slowly. 

Streptococcus pneumoniae CD4 count of >200 cells/mcL 23-valent polysaccharide vaccine, 0.5 mL intramuscularly... 

Libon, C., Haeuw, J.F., Crouzet, F., Mugnier, C., Bormefoy, J.Y., Beck, A. and Corvaia, N., 2002, Streptococcus pneumoniae polysaccharide conjugated to the outer membrane protein A from Klebsiella pneumoniae elicit protective antibodies. Vaccine 20 2174-2180. 

Pneumococcal capsular polysaccharide vaccine was shown to be effective at preventing pneumococcal pneumonia in young American military recruits (47) and in otherwise healthy South African gold miners (44,46). However, it is not clear whether data from these trials can be generalized to nonepidemic situations in the United States, where most pneumococcal disease in adults occurs in the elderly or in persons with chronic medical conditions. Vaccine... 

Vaccines can be roughly categorized into killed vaccines and Hve vaccines. A killed vaccine can be (/) an inactivated, whole microorganism such as pertussis, (2) an inactivated toxin, called toxoid, such as diphtheria toxoid, or (J) one or more components of the microorganism commonly referred to as subunit vaccines. The examples are capsular polysaccharide of Streptococcus pneumoniae and the surface antigen protein for Hepatitis B vims vaccine. 

Fractionation. The process by which components are extracted firm bacterial eells or from the medium in whieh the baeteria are grown and obtained in a purified form. The polysaccharide antigens of Neisseria meningitidis are separated from the bacterial cells by treatment with hexadecyltrimethylammonium bromide and those of Streptococcus pneumoniae with ethanol. The purity of an extracted material may be improved by resolubilization in a suitable solvent and precipitation. After purification, a component may be dried to a powder, stored indefinitely and, as required, incorporated into a vaccine in precisely weighed amounts at the blending stage. 

Pneumococcai poiysaccharidet Cultures of 23 serotypes of Strep, pneumoniae 1 Precipitation of polysaccharides with ethanoi 2 Blending into polyvalent vaccine Physico-chemical estimation of polysaccharides ... 

Pneumococcal vaccine is a mixture of capsular polysaccharides from 23 of the 83 most prevalent types of Streptococcus pneumoniae seen in the United States. 

Pneumococcal vaccines Mixture of purified surface polysaccharide antigens obtained from differing serotypes of Streptococcus pneumoniae Active immunization against Streptococcus pneumoniae... 

Vaccines Pneumococcal vaccine, polyvalent, 23 types of S. pneumoniae PNU-Immune- 23 0.5 ml dose contains 26 pg polysaccharide antigen purified from 23 serotypes of S. pneumoniae IM,SC NA NA NA Single 0.5 ml dose NA NA... 

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