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

	Brand name	Approval for children	Introduction to childhood routine immunization	Approval for adults	Introduction to adult routine immunization	Note
PPSV23	ニューモバックスNP Pneumovax NP	1988（昭和63年） ≥ 2 y/o	N/A†	1988（昭和63年）	2014（平成26年） only for all 65 y/o or 60-64 with specific conditions†
PCV7	プレベナー Prevenar	2009（平成21年）	2010（平成22年）	N/A	N/A	Sales terminated and switched to PCV13 in 2013
PCV13	プレベナー13 Prevenar 13	2013（平成25年）	2013（平成25年）	2014（平成26年）≥ 65 y/o 2020（平成28年） people at high risk of IPD irrespective of age	N/A
PCV15	バクニュバンス Vaxneuvance	2023（令和5年）	N/A as of 2023	2022（令和4年） people at high risk of IPD irrespective of age	N/A
PCV20		Under review as of 2023

†covered by Public Health Insurance for asplenia

*Table updated on 24th Aug 2023

Year	PPSV23 Pneumovax NP	PCV7 Prevenar	PCV13 Prevenar13	PCV15 Vaxneuvance	PCV20
1988 昭和63	Approved 2yr≤ Covered for asplenia by Public Health Insurance
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 or 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 or adults at risk of IPD
2023 令和5				Approved 2mo≤

*Table updated on 25th Aug 2023

Efficacy of pneumococcal vaccines

Effectiveness of pneumococcal vaccines