Because children have a relatively low immune function and the drug resistance rate of Streptococcus pneumonia is increasing year by year, once children are infected with Streptococcus pneumonia infection, it is easy to cause severe pneumonia and meningitis, and sometimes even fa

Author: Sun Yixian Memorial Hospital of Sun Yat-sen University Zhang Guangde

Review: Sun Yixian Memorial Hospital of Sun Yat-sen University Chen Chuxiong

There is a bacteria called Streptococcus pneumoniae, which can cause lobular pneumonia, meningitis, bronchitis and other diseases. Because children have a relatively low immune function and the drug resistance rate of Streptococcus pneumonia is increasing year by year, once children are infected with Streptococcus pneumonia infection, it is easy to cause severe pneumonia and meningitis, and sometimes even fatal. Even if they can survive, it may lead to sequelae such as deafness, paralysis, and mental retardation.

In view of the serious threat to children's health, the World Health Organization WHO has listed global vaccination for preventing pneumococcal disease as a priority. Therefore, in our country, it is particularly necessary and urgent to use pneumococcal vaccination for children to prevent pneumococcal infection.

There are currently two types of pneumococcal vaccines that are on the market: 13-valent pneumococcal polysaccharide binding vaccine (PCV13); 23-valent pneumococcal polysaccharide vaccine (PPV23). This type of vaccine is a Class II vaccine that requires everyone to receive voluntarily and at their own expense, and is not a Class I vaccine free of charge by the state.

I believe many mothers and dads are worried about vaccination with PPV23 and PCV13. What is the difference between them? Which one should I get? Should I get both? Or one of them? Below, the pharmacist Yixian will help you solve the doubts.

PPV23 and PCV13 are as follows:

1. Different prevention ranges

13-valent pneumococcal polysaccharide binding vaccine can prevent 13 pneumococcal infections, while 23-valent pneumococcal polysaccharide vaccine can prevent 23 pneumococcal infections. Therefore, the prevention range of 23-valent pneumococcal polysaccharide vaccine is wider.

2. The duration of immunity is different

13Valent pneumococcal polysaccharide binding vaccine (PCV13)

Response type is Humoral/cell immune . antigen binds bacterial capsular polysaccharides to protein carriers, and after binding, it becomes a T-cell-dependent antigen (full antigen). After vaccination, it can form an immune memory and generate a re-immune response. immunity lasts for a long time , and its use is not restricted by age, and it can especially have a very good protective effect on infants and young children under 2 years old.

23Valent pneumococcal polysaccharide vaccine (PPV23)

Response type is Humoral Immunization . The antigen is a bacterial capsular polysaccharide, which is a non-T-cell-dependent antigen (hapten), and cannot produce immune memory. The immune duration of is short-lasting . It is not effective in protecting children of younger age, especially infants under 2 years old.

3. The applicable population is different:

13 Valentine pneumococcal polysaccharide binding vaccine: suitable for infants and young children at 6 weeks of age to 15 months of age;

23 Valentine pneumococcal polysaccharide vaccine: not recommended for young children under 2 years old; this vaccine is mainly suitable for people over 2 years old who are at an increased risk of pneumococcal infection. focuses on the following groups:

1, the elderly;

2. People with normal immune function but suffering from chronic diseases (such as heart blood). duct diseases, lung disease, diabetes, alcoholism, cirrhosis);

3. Immunely dysfunction: splenectomy or spleen insufficiency, sickle cell disease, Hojekin's disease, lymphoma, multiple myeloma , chronic renal failure , nephrotic syndrome and organ transplants;

4, asymptomatic and symptomatic HIV infection;

5, cerebrospinal fluid leakage patients;

6. Special population: dense residents or staff in high-risk environments where pneumococcal infection or its complications occur (such as elderly people who have been hospitalized for a long time, welfare institution personnel, etc.).

4. Different vaccination methods

13-valent pneumococcal polysaccharide binding vaccine Recommended routine immunization procedures: basal immunization is given one dose at 2, 4 and 6 months of age, and strengthen immunization is given one dose at 12 to 15 months of age. The first dose of basic immunization can be vaccinated at the earliest at 6 weeks, and the doses will be separated by 4 to 8 weeks.

23Valent pneumococcal polysaccharide vaccine Recommended routine immunization procedures: initial vaccination: one dose (0.5ml); re-vaccination: one dose (0.5ml); systemic re-vaccination is not recommended for those who have been vaccinated with pneumococcal vaccine. Re-vaccination is recommended for people with high-risk pneumococcal infection (such as splenectomy) who have been vaccinated with pneumococcal polysaccharide vaccine for more than 5 years, or who have significantly decreased antibody titers in the body (such as nephrotic syndrome, renal failure or organ transplants).

So, can you inoculate both?

Generally, children are injected with 13-valent pneumococcal polysaccharide-bound vaccine without the need for another 23-valent pneumococcal polysaccharide vaccine; special conditions such as high-risk people can receive two types of vaccines, which depends on the situation, but please note that the two must be separated by a certain period of time at least.

summary

Invasive pneumococcal disease is a disease that seriously endangers life and health. The consensus of experts on immune prevention of pneumococcal diseases in my country (2017 edition) mentioned that vaccination with pneumococcal vaccine is the best choice for children with to prevent pneumococcal disease . Yixian Pharmacist here to remind all dads and moms that should be vaccinated as long as conditions are available.

Generally speaking, 13-valent pneumococcal polysaccharide binding vaccine is recommended for children aged 6 weeks to 15 months of age to prevent pneumonia in young children; Therefore, in our country, children who decide to get pneumonia vaccine, must pay attention to grasp the time. As long as is over , infants and young children aged 15 months of age , our community generally will not vaccinate 13-valent pneumococcal polysaccharide binding vaccine, except for special circumstances.

Generally speaking, 23-valent pneumococcal polysaccharide vaccine is mainly aimed at people over 72 years old who are at an increased risk of pneumococcal infection and adults with decreased immunity, such as people with poor physical fitness such as those over 65 years old or patients with chronic diseases who have splenectomy.

References:

[1] JAMA Clinical Guidelines Summary: 2014 Application of ACIP Pneumococcal Vaccine in Adults American Advisory Committee

[2] Miwako Kobayashi, MD1,2; Nancy M Bennett, MD3,4; Ryan Gierke, MPH1 et al , Intervals Between PCV13 and PPSV23 Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

[3]Almea Matanock, MD1; Grace Lee, MD2; Ryan Gierke, MPH et al, Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Updated Recommendations of the Advisory Committee on Immunization Practices