The Analysis of Scientific Data on the Efficacy of Pneumococcal Conjugated Vaccine in the Cohort of Children with Bronchial Asthma

This article refutes one popular-science review that has appeared on the MDedge news site in January 2020. It has stated that there was no effect of vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) against invasive forms of Streptococcus pneumoniae in children with bronchial asthma. The author of this publication refers to the article «Asthma and the Risk of Invasive Pneumococcal Disease: A Meta-analysis» that described episodes of invasive pneumococcal disease and pneumonia development in children with bronchial asthma and in healthy children who was vaccinated with pneumococcal conjugate vaccine. It was concluded that the PCV-7 provides limited protection against colonization only with vaccine pneumococcus serotypes (according to the obtained data), and, thus, there was high risk of carriage of non-included serotypes in children with bronchial asthma (BA). The analysis of the article mentioned above has revealed that the representativeness of the data is extremely low. For example, the study groups were selected incorrectly, the PCV-7 administration scheme was not analyzed, whereas its violation may cause ineffective immunity development and as result disease development. Another crucial aspect is the lack of any data on the BA severity and inhaled corticosteroid therapy in vaccinated children. Nowadays, there are numerous scientific studies on the clinical efficacy of PCV in the prevention of IPD including the children with BA. Most world-class experts support the necessity of PCV-7 usage in children with BA for the prevention of IPD and suggest their patients over 6 years old on inhaled corticosteroid therapy to perform additional administration of pneumococcal polysaccharide vaccine.

vaccination, pneumococcal conjugate vaccine, bronchial asthma, popular-science review, invasive pneumococcal disease, pneumococcal serotypes, pneumococcal polysaccharide vaccine

1. Sullivan MG. Despite PCV, pediatric asthma patients face pneumococcal risks. MDedge News. January 3, 2020. Available online: https://www.mdedge.com/chestphysician/article/214985/asthma/despite-pcv-pediatric-asthma-patients-face-pneumococcalrisks. Accessed on November 06, 2020.

2. Castro-Rodriguez JA, Abarca K, Forno E. Asthma and the Risk of Invasive Pneumococcal Disease: A Meta-analysis. Pediatrics. 2020;145(1):e20191200. doi: 10.1542/peds.2019-1200.

3. Tan TQ. Asthma and Invasive Pneumococcal Disease in the Age of Pneumococcal Conjugate Vaccines. Pediatrics. 2020;145(1):e20193360. doi: 10.1542/peds.2019-3360.

4. Pilishvili T, Zell ER, Farley MM, et al. Risk factors for invasive pneumococcal disease in children in the era of conjugate vaccine use. Pediatrics. 2010;126(1):e9–e17. doi: 10.1542/peds.2009-2150.

5. Kwak BO, Choung JT, Park YM. The association between asthma and invasive pneumococcal disease: a nationwide study in Korea. J Korean Med Sci. 2015;30(1):60–65. doi: 10.3346/jkms.2015.30.1.60.

6. Namazova-Baranova LS, Fedoseenko MV, Vishneva EA, et al. Theoretical Background and Real Results: A Data Review on Vaccine Prevention of Pneumococcal Infection in the World. Pediatricheskaya farmakologiya — Pediatric pharmacology. 2018;15(1):58–74. (In Russ). doi: 10.15690/pf.v15i1.1844.

7. Esposito S, Musio A, Principi N. Paediatric asthma and pneumococcal vaccination. Vaccine. 2013;31(44):5015–5019. doi: 10.1016/j.vaccine.2013.08.090.

8. Klemets P, Lyytikäinen O, Ruutu P, et al. Risk of invasive pneumococcal infections among working age adults with asthma. Thorax. 2010; 65(8): 698–702. doi: 10.1136/thx.2009.132670.

9. Zhang L, Prietsch SO, Mendes AP, et al. Inhaled corticosteroids increase the risk of oropharyngeal colonization by Streptococcus pneumoniae in children with asthma. Respirology. 2013;18(2):272–277. doi: 10.1111/j.1440-1843.2012.02280.x.

10. Jung JA, Kita H, Yawn BP, et al. Increased risk of serious pneumococcal disease in patients with atopic conditions other than asthma. J Allergy Clin Immunol. 2010;125(1):217–221. doi: 10.1016/j.jaci.2009.10.045.

11. Luo R, Mann B, Lewis WS, et al. Solution structure of choline binding protein A, the major adhesin of Streptococcus pneumoniae. EMBO J. 2005;24(1):34–43. doi: 10.1038/sj.emboj.7600490.

12. American Academy of Pediatrics Committee on Infectious Diseases. Recommendations for the prevention of Streptococcus pneumoniae infections in infants and children: use of 13-valent pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23) Pediatrics. 2010;126(1):186–190. doi: 10.1542/peds.2010-1280.

13. Nuorti JP, Whitney CG. Prevention of pneumococcal disease among infants and children — use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine — recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010;59:1–18.

14. Choi EH, Kim KH, Kim YJ, et al. Recommendation for use of the newly introduced pneumococcal protein conjugate vaccines in Korea. Korean J Pediatr. 2011;54(4):146–151. doi: 10.3345/kjp.2011.54.4.146.

15. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommended immunization schedules for persons aged 0 through 18 years and adults aged 19 years and older — United States, 2013. MMWR Suppl. 2013;62(1):1.

16. Pelton SI, Weycker D, Farkouh RA, et al. Risk of pneumococcal disease in children with chronic medical conditions in the era of pneumococcal conjugate vaccine. Clin Infect Dis. 2014;59(5):615–623. doi: 10.1093/cid/ciu348.

17. Rose MA, Gruendler M, Schubert R, et al. Safety and immunogenicity of sequential pneumococcal immunization in preschool asthmatics. Vaccine. 2009;27(38):5259–5264. doi: 10.1016/j.vaccine.2009.06.054.

18. Quezada A, Maggi L, Norambuena X, et al. Response to pneumococcal polysaccharide vaccine in children with asthma, and children with recurrent respiratory infections, and healthy children. Allergol Immunopathol (Madr). 2016;44(4):376–381. doi: 10.1016/j.aller.2016.01.003.

19. Qian CJ, Coulombe J, Suissa S, Ernst P. Pneumonia risk in asthma patients using inhaled corticosteroids: a quasi-cohort study. Br J Clin Pharmacol. 2017;83(9):2077–2086. doi: 10.1111/bcp.13295.

20. Klinicheskie rekomendatsii po vaktsinoprofilaktike pnevmokokkovoi infektsii u detei. Moscow; 2018. (In Russ).

21. Protasov AV, Andreeva NP, Kostinovа AМ. Vaccination of patients with bronchial asthma against influenza and pneumococcal infection. (Žurnal mikrobiologii, èpidemiologii i immunobiologii = Journal of Microbiology, Epidemiology and Immunobiology. 2019;(4):90–98. (In Russ). doi: 10.36233/0372-9311-2019-4-90-98.