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→Effectiveness of pneumococcal vaccines
*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===
{|class="wikitable"
|+''Table updated on 25th Aug 2023''
|-
!style="width:4em" rowspan="2"|Year
!style="width:12em"|PPSV23
!style="width:12em"|PCV7
!style="width:12em"|PCV13
!style="width:12em"|PCV15
!style="width:12em"|PCV20
|-
!Pneumovax NP||Prevenar||Prevenar13||Vaxneuvance||
|-
!1988<br>昭和63
|'''Approved'''<br>- 2yr≤<br>'''''Covered by Public Health Insurance'''''<br>- Asplenia|| || || || |
|-
!2009<br>平成21
| ||'''Approved'''<br>- 2mo≤ ≤9yr|| || ||
|-
!2010<br>平成22
| ||'''''Routinized'''''<br>- 2mo≤ ≤60mo (<5yr)|| || ||
|-
!2013<br>平成25
| ||'''Terminated''' and switched to PCV13||'''Approved'''<br>- 2mo≤ <6yr<br>'''''Routinized'''''<br>- 2mo≤ ≤60mo (<5yr)|| ||
|-
!2014<br>平成26
|'''''Routinized'''''<br>- at 65yr<br>- 60-64yr with specific chronic conditions|| ||'''Approved'''<br>- 65yr≤ at risk of IPD|| ||
|-
!2020<br>令和2
| || ||'''Approved'''<br>- 6yr≤ at risk of IPD|| ||
|-
!2022<br>令和4
| || || ||'''Approved'''<br>- elderly<br>- adults at risk of IPD||
|-
!2023<br>令和5
| || || ||'''Approved'''<br>- 2mo≤||''Submitted for approval''
|-
! !!PPSV23!!PCV7!!PCV13!!PCV15!!PCV20
|}
===Efficacy of pneumococcal vaccines===
===Effectiveness of pneumococcal vaccines===
===Effectiveness against colonization===
==Serotype replacement==
==Overwhelming Post-Splenectomy Infection (OPSI) and pnuemococcus==
