Polyvalent pneumococcal vaccines: a review.

The development, pharmacology, effectiveness, adverse reactions and clinical use of polyvalent pneumococcal vaccines are reviewed. Patients with sickle cell anemia, asplenic and elderly patients, infants and closed populations are particularly susceptible to Streptococcus pneumoniae infections. Polyvalent pneumococcal vaccine induces a satisfactory antibody response wihin about two weeks which declines with time but generally remains elevated for at least 20 months after infection. The vaccine has been reported to reduce the incidence of pneumococcal disease by 76 to 100% and to reduce the carrier rate of pneumococci covered by the vaccine; however, infants younger than two years of age repond inconsistently. Local reactions to the vaccine (soreness at injection site, erythema, induration and tenderness) occur in 86% of adults and nearly all children. The incidence of adverse reactions increases on revaccination. The recommendations of the U.S. Public Health Service and Center for Disease Control on use of the vaccine are presented. Mass immunization with the vaccine is not recommended, but the vaccine may be of benefit in sickle cell, asplenic and elderly patients, and in closed populations.