Immunogenicity of pneumococcal conjugate vaccines.

BACKGROUND: Prevention of pneumococcal infections is a public health priority because of the high impact of the disease and because of the increasing problems due to antimicrobial resistance. Traditional vaccines, consisting of purified capsular polysaccharides (PSs) of Streptococcus pneumoniae, are not immunogenic in young children. In addition they confer only limited protection in patients with immunodeficiencies and hematologic malignancies. IMMUNOGENICITY OF PNEUMOCOCCAL CONJUGATE VACCINES: Immunogenicity of the PS vaccine has been enhanced by coupling pneumococcal PSs to proteins to produce a conjugate vaccine. Conjugate molecules are designed to possess T cell dependent properties, such as immunogenicity in early infancy, stimulation of high levels of IgG isotype antibodies and enhanced immunologic memory responses. In the clinical studies multivalent pneumococcal conjugate vaccines have been shown to induce an IgG-dominating serum antibody response against common pneumococcal serotypes causing infections in children. A booster dose later in life creates a robust and rapid antibody response, indicating the existence of immunologic memory in primed children. Antibodies induced by conjugate vaccines are functionally active, as demonstrated by their high avidity and opsonophagocytic activity.