Pneumococcal Vaccines and Serotype Replacement

Meningitis vaccinations may possibly be the only vaccinations that this author would consider administering to her own children, knowing how frightening and dangerous meningitis is. Unfortunately, like HiB, this Prevnar (pneumococcal) vaccine has simply resulted in serotype replacement with equally virulent NVS's (non vaccine serotypes). It's amazing to me that doctors want us to risk Asthma, Pneumonia, Congestive Heart Failure, Sepsis, and even Death (see http://www.wyeth.com/content/showlabeling.asp?id=134 for product insert admiting causation to these severe adverse reactions) when the only thing you're getting in return is a switcheroo for an equally terrible disease.

References of Pneumococcal Serotype Replacement Documentation:

"While the rates of all resistant diseases caused by the vaccines serotype fell 87 precent, the rates of serotype 19A disease, a deadly type in the very young, rose by 315 percent between 1999 and 2004."

-Kyaw MH, "Effect of the introduction of the pneumococcal conjugate vaccine on drug resistant streptopoccus pneuomniae"; New England Journal of Medicine, April 2006

"During the post licensure period, there were significant decreases in the incidence of pneumococcal bacteremia caused by vaccine serotypes; however, rate of penicillin resistance and bacteremia due to non-vaccine related serotypes increased."

-Steenhoof AD, Shann SS, Emergence of vaccine related pneomococcal serotypes as a cause of bacteremia, The Childrens Hospital of Philadelphia, Clinical Infectious Diseases, April 2006

-Farrell DJ; "Increased antimicrobial resistance among non vaccine serotypes of Streptococcus pneumoniae in the pediatric population after the introduction of 7 valent pneumococcal vaccine in the United States"; Pediatr Infect Dis J. 2007 Feb;26(2):123-8

CONCLUSIONS: In Dallas , heptavalent pneumococcal conjugate vaccine reduced the incidence of IPD from 1999 to 2005 by reducing the incidence of vaccine-type disease. NVT serotypes, particularly 19A, were prevalent and more resistant to antimicrobials in 2004 and 2005

-Messina AF, "Impact of the pneumococcal conjugate vaccine on serotype distribution and antimicrobial resistance of invasive streptococcus pneumoniae isolates in Dallas, TX children from 1999 through 2005."; Pediatr Infect Dis J. 2007 June;26(6)461-7

CONCLUSIONS: Three years after the introduction of pneumococcal conjugate vaccine for universal administration to children less than 2 in Massachusetts, a significant increase in invasive disease due to serotype 19A was observed. Although MLST 199 remains the most frequent sequence type among invasive isolates (of 19A), a multidrug-resistant sequence type, not previously identified in Massachusetts , has become an important cause of invasive disease. Further surveillance of the changing ecology of S. pneumoniae is necessary as a 4-year time period is not sufficient to fully evaluate the impact of PCV of pneumococcal infections.

-Pelton SI; "Emergence of 19A as virulent and multi-drug resistant Pneumococcus in Massachusetts following universal immunization with pneumoccocal conjugate vaccine."; Pediatr Infect Dis. 2007 June;26(6)468-72

BACKGROUND: The introduction of the 7-valent conjugate pneumococcal vaccine (PCV7) in children may result in serotype replacement.

CONCLUSION: Serotype 19A is, at present, the most important cause of IPD by replacement serotypes, and it is increasingly drug resistant. CC199 is the predominant CC among type 19A serotypes in children <5 years old. Our data suggest that some of the increase in rates of infection with serotype 19A may be due to serotype switching within certain vaccine type strains.

-Pai R; "Postvaccine genetic structure of Streptococcus pneumoniae serotype 19A from children in the United States." J Infect Dis. 2005 Dec 1;192(11):1988-95