Pneumococcus

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epidemiology

• 1.19mi. deaths in 2016
• 197.05 mil. episodes in 2016
• the leading cause of lower respiratory infections followed by H. influenzae, influenza /B and RS virus
• 50% of pneumococcal deaths in India, Nigeria, DRC and Pakistan

serotype

• all serotypes known more than 90 are pathogenic for human
• differentiation of serotypes is important for epidemiology

antimicrobial resitance

• first reported in late 1960s

Vaccine

• PPSV does not induce T-cell dependent immunity
• PCV induces T-cell dependent immunity
• new product "Pneumosil" from India
  • 10-valent
  • serotypes 1, 5, 6A, 6B, 7F, 9V, 14, 19A, 19F, 23F
• the reason why PCV13 for older population failed to show persistent efficacy against IPD in the U.S. may be contributed by spread of PCV13 for children which has caused serotype substitutions in community

History of Pneumococcal vaccines in Japan

Year	PPSV23	PCV7	PCV13	PCV15	PCV20
	Pneumovax NP	Prevenar	Prevenar13	Vaxneuvance
1988 昭和63	Approved - 2yr≤ Covered by Public Health Insurance - Asplenia
2009 平成21		Approved - 2mo≤ ≤9yr
2010 平成22		Routinized - 2mo≤ ≤60mo (<5yr)
2013 平成25		Terminated and switched to PCV13	Approved - 2mo≤ <6yr Routinized - 2mo≤ ≤60mo (<5yr)
2014 平成26	Routinized - at 65yr - 60-64yr with specific chronic conditions		Approved - 65yr≤ at risk of IPD
2020 令和2			Approved - 6yr≤ at risk of IPD
2022 令和4				Approved - elderly - adults at risk of IPD
2023 令和5				Approved - 2mo≤	Submitted for approval
	PPSV23	PCV7	PCV13	PCV15	PCV20

Table updated on 25th Aug 2023