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Pneumococcal Vaccines: Current Status and Future Prospects

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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Vaccines Against Tropical and Other Infectious Diseases".

Deadline for manuscript submissions: closed (1 July 2025) | Viewed by 23343

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Dr. Vana Spoulou

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School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Interests: infectious diseases; vaccines; vaccine-induced immune response; immunological memory
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Dr. Ioanna Papadatou

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Dear Colleagues,

Streptococcus pneumonia, also known as Pneumococcus, is responsible for causing significant morbidity and mortality worldwide, especially among the very young and the elderly. Pneumococcal vaccines have effectively reduced the incidence of pneumococcal disease, particularly in these high-risk populations. However, maintaining high levels of protection against pneumococcal infections worldwide is challenging. The effectiveness of currently available vaccines is affected by multiple factors such as pneumococcal serotype replacement, vaccine formulation and vaccination schedule used in each setting, vaccination coverage, and prevalence of comorbidities.

In this Special Issue of Vaccines, we aim to gather an important collection of articles that explore the latest research and development efforts in Pneumococcal vaccines. We welcome Original Articles, Literature Reviews, and Viewpoints covering vaccination programs, the epidemiology of pneumococcal disease, and the challenges and opportunities for further vaccine development.

Dr. Vana Spoulou
Dr. Joanna Papadatou
Guest Editors

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Keywords

streptococcus pneumonia
pneumococcal disease
pneumococcal vaccines
epidemiology

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Published Papers (7 papers)

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Research

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18 pages, 2197 KB

Open AccessArticle

Long-Term Impact of Pneumococcal Conjugate Vaccines on the Burden of Pneumococcal Meningitis in Mozambique, 2013–2023

by Aquino Albino Nhantumbo, Goitom Weldegebriel, Linda de Gouveia, Reggis Katsande, Charlotte Elizabeth Comé, Alcides Moniz Munguambe, Vlademir Cantarelli, Cícero Dias, Rachid Muleia, Ezequias Fenias Sitoe, Eunice Veronica Zeca, Amir Seni, Ana Nicolau Tambo, Ana Cristina de Faria Neves Mussagi, Plácida Iliany Maholela, Ivano de Filippis and Eduardo Samo Gudo

Vaccines 2025, 13(12), 1246; https://doi.org/10.3390/vaccines13121246 - 15 Dec 2025

Viewed by 846

Abstract

Background: Mozambique introduced the 10-valent pneumococcal conjugate vaccine (PCV10) in 2013 using a three-dose primary series with no booster dose (3p+0) and later switched to the PCV13 using a schedule of two primary doses with one booster (2p+1). We aimed to describe the burden and serotype distribution of pneumococcal meningitis in children under 5 years of age in Mozambique over an eleven-year period starting with the year of PCV10 introduction, and assess the impact of the PCV vaccine and schedule changes. Methods: We analysed meningitis surveillance data in Mozambique from March 2013 through to December 2023. Cerebrospinal fluid (CSF) samples were collected from eligible children in three referral hospitals (Maputo Central Hospital [south], Beira Central Hospital [central], and Nampula Central Hospital [north]). Culture and polymerase chain reaction assay (qPCR) were performed on each sample. S. pneumoniae-positive samples were subsequently serotyped using multiplex assay. We estimated annual incidence rates for pneumococcal meningitis in children under 5 years old following the PCVs’ introduction (2013–2023). The impact of the product switch and schedule change from PCV10/3p+0 to PCV13/2p+1 on the burden and serotype distribution of pneumococcal meningitis was assessed. Results: Of the 4075 CSF samples tested, 7.4% (301/4075) were positive for S. pneumoniae, 2.5% (103/4075) for H. influenzae, and 1.0% (42/4075) for N. meningitidis. Pneumococcal meningitis incidence in children under five reduced from 44.7 cases per 100,000 in 2013 to 4.6 cases per 100,000 in 2023, an 89.7% reduction. In the PCV13/2p+1 period (2020–2023), pneumococcal meningitis incidence was 51.2% lower than the PCV10/3p+0 period (2013–2017) (IRR 0.49, 95% CI 0.4–0.6; p < 0.001). PCV10-serotype pneumococcal meningitis incidence among children under five decreased by 65.6% in the PCV13/2p+1 period (IRR 0.34, 95% CI 0.2–0.6; p < 0.001). We detected zero cases of pneumococcal meningitis due to the PCV13-serotype in 2020–2023, whereas non-PCV10/13-serotypes increased by 76% (IRR 1.76, 95% CI 1.2–2.6; p = 0.004). The case–fatality proportion decreased by 71.9% (95% CI 62.9–84.8%) in the PCV13/2p+1 period. Conclusions: Since the introduction of PCVs in Mozambique, the burden of pneumococcal meningitis and deaths in children under 5 years of age has substantially decreased, as well as the prevalence of PCV13-serotypes. Higher valency PCVs are needed due to the increased prevalence of non-PCV10/13-serotypes. Funding: Gavi, The Vaccine Alliance, reference number: MOZ-HSS-2-INS; WHO Reference: 2014405143-0, creation DFC to support HIB & Surveillance System. Full article

(This article belongs to the Special Issue Pneumococcal Vaccines: Current Status and Future Prospects)

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14 pages, 651 KB

Open AccessArticle

Safety and Efficacy of Simultaneous Vaccination with Polysaccharide Conjugate Vaccines Against Pneumococcal (13-Valent Vaccine) and Haemophilus Type B Infections in Children with Systemic Juvenile Idiopathic Arthritis: Prospective Cohort Study

by Ekaterina Alexeeva, Tatyana Dvoryakovskaya, Dmitry Kudlay, Anna Fetisova, Ivan Kriulin, Elizaveta Krekhova, Anna Kabanova, Vladimir Labinov, Elizaveta Labinova and Mikhail Kostik

Vaccines 2025, 13(6), 644; https://doi.org/10.3390/vaccines13060644 - 15 Jun 2025

Viewed by 2007

Abstract

Background: The introduction of biological drugs into clinical practice for the treatment of children with systemic juvenile idiopathic arthritis (sJIA) allows disease control but increases the risk of infectious events. Infectious events cause immunosuppressive therapy interruptions, leading to disease flare and life-threatening complications, namely macrophage activation syndrome. Our study aimed to evaluate the efficacy and safety of simultaneous vaccination against pneumococcal and Haemophilus influenzae type b (Hib) in children with sJIA. Methods: This study included 100 sJIA patients receiving immunosuppressive therapy who were simultaneously vaccinated against pneumococcal and Haemophilus influenzae type b (Hib) infections. The mean age of disease onset was 5.5 years. The median age at vaccination was 10 ± 4.5 years. Clinical and laboratory parameters of sJIA activity, immunization efficacy, and safety, including anti-SP and anti-Hib IgG antibodies, as well as all vaccination-related adverse events (AEs), were recorded in every patient before, 3 weeks after, and 6 months after vaccination. Results: At the time of vaccination, 29% of patients did not meet the criteria for the inactive disease stage, as defined by C. Wallace: active joints were present in 34.5% of patients, systemic manifestations (rash and/or fever) were present in 41.3%, and 24.2% of patients had solely inflammatory laboratory activity. The protective titer of anti-SP and anti-Hib IgG antibodies was detected in the majority of patients 3 weeks after vaccination (100% and 93%, respectively). The results remained unchanged (99% and 92%, respectively) for 6 months of follow-up, compared to the baseline (91% and 37%, p = 0.000001). Anti-SP IgG and anti-Hib titers raised from 48.3 (18.2; 76.5) and 0.64 (0.3; 3.2) U/mL at the baseline to 103.5 (47.3; 185.4) and 4 (3.5; 4.2) U/mL at D22 and 105 (48.7; 171.8) and 4 (3.8; 4) U/mL (EOS), respectively. Immunosuppressive therapy regimens (combined therapy or biological disease-modifying antirheumatic drug monotherapy) did not influence the immunogenic efficacy of vaccination. The incidence of infectious complications (p = 0.0000001) and antibiotic prescriptions (p = 0.0000001) decreased by more than two times, to 29.9 and 13.8 events per 100 patient months, respectively, within 6 months after vaccination—the average duration of acute infectious events was reduced by five times after immunization (p = 0.0000001). Vaccination did not lead to disease flare: the number of patients with active joints decreased by half compared to the baseline, and the number of patients with systemic manifestations decreased by six times. All vaccine-associated adverse events were considered mild and resolved within 1–2 days. Conclusions: Simultaneous vaccination against pneumococcal and Hib infections in sJIA children is an effective and safe tool that reduces the number and duration of infectious events and does not cause disease flare-ups. Full article

(This article belongs to the Special Issue Pneumococcal Vaccines: Current Status and Future Prospects)

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14 pages, 670 KB

Open AccessArticle

Epidemiological Impact of Increasing Vaccination Coverage Rate and Re-Vaccination on Pneumococcal Disease in Older Adults in Germany

by Oluwaseun Sharomi, Marion de Lepper, Sarah Mihm-Sippel, Thorsten Reuter, Claudia Solleder, Giulio Meleleo, Tufail M. Malik, Kevin M. Bakker and Rachel J. Oidtman

Vaccines 2025, 13(5), 475; https://doi.org/10.3390/vaccines13050475 - 28 Apr 2025

Cited by 4 | Viewed by 2809

Abstract

Background/Objectives: The clinical impact of replacing the 23-valent pneumococcal polysaccharide vaccine (PPSV23) for the vaccination of older (≥60 years) and at-risk German adults with either the 20-valent (PCV20) or 21-valent (V116) pneumococcal conjugate vaccine (PCV) was evaluated. Methods: An age- and serotype-specific transmission model was adapted to Germany to evaluate the impact of V116 versus PCV20 vaccination on pneumococcal disease (PD) incidence, including invasive pneumococcal disease (IPD) and inpatient and outpatient non-bacteremic pneumococcal pneumonia, over 10 years. A reference strategy (PPSV23 vaccination at a constant 30% vaccine coverage rate (VCR)) was compared against eight strategies varying by PCV (PCV20 vs. V116), VCR (30% vs. 60%), with or without the PCV revaccination of previously PPSV23-vaccinated adults (0% vs. 50% revaccination). Results: Vaccination with PCV20 and V116 initially decreased PD incidence, but incidence returned to pre-vaccine levels after five and eight years, respectively. Increasing the VCR to 60% prevented this resurgence. At a 10-year time horizon, V116 with 30% VCR reduced IPD cases by 9%, inpatient NBPP cases by 10%, and outpatient NBPP cases by 7% compared to the reference strategy. PCV20 with 30% VCR reduced these cases by 6%, 5%, and 4%, respectively. Increasing the VCR to 60% and revaccinating 50% of previously PPSV23-vaccinated adults further reduced IPD cases by 14% and 13% for V116, and by 9% and 9% for PCV20. Conclusions: Increasing the vaccination coverage rate to 60% and strategically revaccinating previously PPSV23-vaccinated adults significantly enhanced the effectiveness of pneumococcal vaccines, with V116 showing greater overall reductions in disease incidence compared to PCV20 or PPSV23. Full article

(This article belongs to the Special Issue Pneumococcal Vaccines: Current Status and Future Prospects)

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13 pages, 392 KB

Open AccessArticle

Burden of Pneumococcal Disease in Young Children Due to Serotypes Contained in Different Pneumococcal Conjugate Vaccines in Eight Asian Countries and Territories

by Liping Huang, Xiuyan Li, Ng Eugenia, Johnnie Leung, Sheng-Tzu (Alice) Hung, Ervin Zhi Bin Cheong, Ricardo Avila, Winniefer Nua, Kornvipa Choowanich, Ritika Rampal, Namrata Kulkarni, Derek Daigle and Bulent Nuri Taysi

Vaccines 2024, 12(10), 1197; https://doi.org/10.3390/vaccines12101197 - 19 Oct 2024

Cited by 5 | Viewed by 7216

Abstract

Background: Pneumococcal disease (PD) is a major cause of morbidity and mortality in young children in Asia and globally. Pneumococcal conjugate vaccines (PCVs) have significantly reduced the burden of PD when included in pediatric national immunization programs (NIPs). This study estimates the clinical and economic burden of PD due to serotypes contained in different PCVs in children aged < 5 years in eight Asian countries/territories. Methods: Based on published data, a cohort-based decision analytic model was used to estimate annual PD cases, deaths, and direct medical costs associated with serotypes contained in PCV10, PCV13, PCV15, and PCV20. Results: PD incidence rates were lower in regions with PCV13 in their NIP than those without. Serotypes contained in higher but not lower valency PCVs resulted in a significant incremental clinical and economic burden, although the difference between PCV13 and PCV15 serotypes was generally small. Moving from PCV13 to PCV20 was estimated to result in greater clinical and economic burden reductions. Conclusions: This study demonstrates the remaining and incremental burden of PD from PCV10 to PCV20 serotypes in young children in selected Asian regions. Extending NIP access to higher-valency PCVs with broader serotype coverage and improving vaccine uptake will help prevent morbidity and deaths and save healthcare costs. Full article

(This article belongs to the Special Issue Pneumococcal Vaccines: Current Status and Future Prospects)

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15 pages, 553 KB

Open AccessArticle

Post-Transplantation Seroprotection Rates in Liver, Lung, and Heart Transplant Recipients Vaccinated Pre-Transplantation against Hepatitis B Virus and Invasive Pneumococcal Disease

by Lise Bank Hornung, Sebastian Rask Hamm, Annemette Hald, Zitta Barrella Harboe, Lene Fogt Lundbo, Neval Ete Wareham, Line Dam Heftdal, Christina Ekenberg, Stephanie Bjerrum, Jon Gitz Holler, Inger Hee Mabuza Mathiesen, Paul Suno Krohn, Peter Nissen Bjerring, Finn Gustafsson, Michael Perch, Allan Rasmussen and Susanne Dam Nielsen

Vaccines 2024, 12(10), 1092; https://doi.org/10.3390/vaccines12101092 - 25 Sep 2024

Cited by 5 | Viewed by 2684

Abstract

Vaccination before solid organ transplantation is recommended since post-transplantation immunosuppression is known to impair vaccine responses. However, little is known about post-transplantation seroprotection rates in organ transplant recipients vaccinated pre-transplantation. We aimed to investigate the proportion of transplant recipients vaccinated against hepatitis B virus (HBV) and invasive pneumococcal disease (IPD) pre-transplantation at the time of listing for transplantation with post-transplantation seroprotection. We included 136 solid organ transplant (SOT) recipients vaccinated at the time of listing for transplantation. We investigated post-transplantation antibody concentrations against HBV and IPD. Established antibody thresholds were used to define seroprotection. The proportions of SOT recipients with post-transplantation seroprotection were 27.9% (n = 38) and 42.6% (n = 58) against HBV and IPD, respectively. Compared to completing HBV vaccination pre-transplantation, completing post-transplantation vaccination (adjusted odds ratio (aOR): 7.8, 95% CI: 2.5–24.5, p < 0.001) and incomplete vaccination (aOR: 6.3, 95% CI: 1.2–32.6, p = 0.028) were associated with non-response against HBV, after adjustment for confounders. Importantly, patients with seroprotection at the time of listing had lower odds of non-response against HBV (aOR: 0.04, 95% CI: 0.0–0.1, p < 0.001) and IPD (aOR: 0.3, 95% CI: 0.1–0.7, p = 0.007) compared to those without seroprotection. SOT recipients vaccinated pre-transplantation had low post-transplantation seroprotection rates against HBV and IPD. However, SOT recipients with seroprotection at the time of listing had lower odds of non-response, suggesting early vaccination should be a priority. Full article

(This article belongs to the Special Issue Pneumococcal Vaccines: Current Status and Future Prospects)

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11 pages, 1579 KB

Open AccessArticle

The Divergent Effect of Different Infant Vaccination Schedules of the 13-Valent Pneumococcal Conjugate Vaccine on Serotype-Specific Immunological Memory

by Irene Tzovara, Ioanna Papadatou, Marianna Tzanoudaki, Christina Piperi, Christina Kanaka-Gantenbein and Vana Spoulou

Vaccines 2024, 12(9), 1024; https://doi.org/10.3390/vaccines12091024 - 7 Sep 2024

Cited by 1 | Viewed by 3238

Abstract

Pneumococcal vaccination schedules are traditionally assessed based on the antibody response. The Memory B Cell (MBC) response has been less studied, despite its role in the magnitude and longevity of protection. We compared the immune response to different vaccination schedules with the 13-valent Pneumococcal Conjugate Vaccine (PCV13) and investigated the relationship between MBCs and the antibody response. Total and pneumococcal serotype (PS)-specific MBCs, their subsets and PS-specific IgG antibodies induced by a 3 + 0 (group A), 2 + 1 (group B) or 3 + 1 (group C) schedule in healthy infants were studied before and 1 month after the last PCV13. The relatively immature IgM+IgD+ MBC subset was the predominant subset in all groups but was larger in group A compared to group B and group C, indicating that age might be a significant parameter of the composition of the MBC pool. PS-specific MBCs at baseline were higher in group A, but they increased significantly only in the groups receiving the booster schedules (groups B and C). PS-specific IgM-only MBCs at baseline positively corelated with the antibody response and the PS-specific swIg MBCs post-immunization. Our findings illustrate the importance of a booster dose for the enrichment of PS-specific immunological memory. IgM-only MBCs and swIg MBCs may serve as additional correlates of vaccine-induced protection. Full article

(This article belongs to the Special Issue Pneumococcal Vaccines: Current Status and Future Prospects)

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Review

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19 pages, 1915 KB

Open AccessReview

Predicting the Epidemiological Effects in the United Kingdom of Moving from PCV13 to PCV15 in the Routine Pediatric 1 + 1 Vaccination Schedule

by Rachel J. Oidtman, Natalie Banniettis, Jessica Weaver, Ian R. Matthews, Dionysios Ntais, Giulio Meleleo, Tufail M. Malik, John C. Lang and Oluwaseun Sharomi

Vaccines 2025, 13(6), 627; https://doi.org/10.3390/vaccines13060627 - 10 Jun 2025

Viewed by 2249

Abstract

Background/Objectives: Pneumococcal conjugate vaccines (PCVs) were first introduced in the pediatric UK National Immunization Programme (NIP) in 2006 and subsequently led to a significant decline in invasive pneumococcal disease (IPD). In 2020, the UK NIP reduced the pediatric PCV dosing schedule from two infant doses and one toddler dose (2 + 1) to one infant dose and one toddler dose (1 + 1). This analysis evaluated the public health impact of pediatric vaccination with PCV15 versus PCV13 under a 1 + 1 schedule. Methods: A population-level compartmental model was previously adapted to the UK setting. The impact on the IPD incidence of vaccination with PCV15 versus PCV13 under a 1 + 1 schedule was evaluated over a 20-year time horizon. The uncertainty regarding the vaccine efficacy (VE) of PCV13 and PCV15 under a 1 + 1 schedule was investigated through a probabilistic sensitivity analysis, i.e., the PCV VE under a 1 + 1 schedule was assumed to be 0–24% lower than the PCV VE under a 2 + 1 schedule. Results: Relative to the initial IPD incidence, vaccination with PCV13 and PCV15 under a 1 + 1 schedule resulted in the IPD incidence in children <2 years old increasing by 11.1% (95% region: 8.4–14.5%) and 3.5% (0.2–7.7%), respectively, over the time horizon. At the end of the time horizon, in the overall population, PCV15 would lead to a 6.0% lower IPD incidence than PCV13 (10.70 IPD cases per 100,000 versus 11.38 per 100,000, respectively). Conclusions: Switching from PCV13 to PCV15 for routine pediatric vaccinations under the 1 + 1 dosing schedule in the UK led to a lower IPD incidence in both the pediatric and overall populations. Full article

(This article belongs to the Special Issue Pneumococcal Vaccines: Current Status and Future Prospects)

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