Photo from the CDC website, showing the swift decline in cases of severe pneumococcal disease in young children since the Prevnar/conjugated vaccine has been introduced:

Pneumonia vaccine for babies: An underrerported success story

One of the biggest Medical stories of the year has been largely ignored: The large decrease in deaths and disease from the pneumonia vaccine for kids

The adult vaccine is simple, but children didn’t produce an immune response below age 2, so they “conjugated” it by combining it to another disease antigen…and voila, antibodies…
LINK explains the problem of making vaccines for antibodies to attack the polysaccharide coating of the invasive pneumococcus:

by activation of B cells in a T-independent manner, producing predominantly IgM and little memory B cells.1 Protein-polysaccharide conjugate vaccines (such as Prevnar/PCV7 which uses 7 prevalent polysaccharides to bind to non-toxic variant of diphtheria toxin, CRM197) allow the protein to present antigen on B cells and CD40/CD40L interaction, while T cells allow antibody class switching from IgM to IgG producing memory cells and longer response.

In English, this means the germ in a normal vaccine only produces IGM antibodies that are the “Quick response” antibodies, but don’t last long.

By combining the germ’s antigen (coat of the germ) with another antigen (In this case, a form of Diphtheria toxin that has been deactivated) it fools the body into producing IgG antibodies, the longer acting and stronger antibody that can destroy germs.
Prevnar seems to be working, as the graph shows.

Bad news: It may not work for kids with HIV or who have no spleeen…so kids with sickle cell anemia, which can destroy the spleen’s immune response, have to be given it early, before they lose this immunity.

And of course here comes the paranoia: Worries it will cause an epidemic of diabetes..or resistant diseases…or that other vaccines given at the same time won’t work as well…

Although the germ is the pneumococcus (i.e. pneumonia causing germ), the real danger is that invasive pneumococcus caused severe ear infections that sometimes sperad to the brain, causing meningitis.

With kids getting the Prevnar and the HIB vaccines, we docs rarely see meningitis any more. I haven’ t done a spinal tap for years. Oh, we still have viral meningitis and the terrible meningococcal type (there is a vaccine for that one, mainly for older kids) but the emergency spinal tap done because you had a very very sick kid wit a “red ear” (Ear infection) but who was irritable and lethargic (or worse, convulsing) is now a much less common problem in our emergency rooms.
And that is the best news for moms everywhere.


Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket, and she writes medical essays at HeyDoc Xanga Blog

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